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BACKGROUND Telehealth (TH) and telecare (TC) interventions are increasingly valued for supporting self-care in ageing populations; however, evaluation studies often report high rates of non-participation that are not well understood. This paper reports from a qualitative study nested within a large randomised controlled trial in the UK: the Whole System(More)
OBJECTIVE To assess the effect of home based telehealth interventions on the use of secondary healthcare and mortality. DESIGN Pragmatic, multisite, cluster randomised trial comparing telehealth with usual care, using data from routine administrative datasets. General practice was the unit of randomisation. We allocated practices using a minimisation(More)
BACKGROUND To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare). METHODS Case-studies of three sites forming the UK Department of Health's Whole Systems Demonstrator (WSD) Programme. Qualitative(More)
OBJECTIVES To describe the context for implementing the national programme for information technology (NPfIT) in England, actual and perceived barriers, and opportunities to facilitate implementation. DESIGN Case studies and in depth interviews, with themes identified using a framework developed from grounded theory. SETTING Four acute NHS trusts in(More)
In healthcare there is a long held wisdom that 'champions' are a key aspect of organizational change. Drawing on organizational management theory, we examine the role of champions in three health and social care organizations in England as they attempt to move services to a remote model of delivery, 'telecare'. The delivery of remote care is a significant(More)
BACKGROUND It is expected that increased demands on services will result from expanding numbers of older people with long-term conditions and social care needs. There is significant interest in the potential for technology to reduce utilisation of health services in these patient populations, including telecare (the remote, automatic and passive monitoring(More)
OBJECTIVES To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England. DESIGN Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts.(More)
OBJECTIVE To assess the impact of components of the national programme for information technology (NPfIT) on measures of clinical and operational efficiency. DESIGN Quasi-experimental controlled before and after study using routinely collected patient level data. SETTING Four NHS acute hospital trusts in England. DATA SOURCES Inpatient admissions and(More)
OBJECTIVES Whole system integration of health and social care has been positioned as key to improving care, increasing efficiency and controlling costs. However, evidence for the benefits of whole system integration is scarce. Drawing on organizational theory, this study uses the implementation of remote care services, viewed as an enabler for whole system(More)