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Implementing disruptive technological change in UK healthcare: exploring development of a smart phone app for remote patient monitoring as a boundary object using qualitative methods

Charlotte A. Sharp (Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK) (National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK) (National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK) (Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK)
Mike Bresnen (Faculty of Business and Law, Manchester Metropolitan University, Manchester, UK)
Lynn Austin (Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK) (National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK)
Jillian McCarthy (Alliance Manchester Business School, The University of Manchester, Manchester, UK)
William G. Dixon (Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK) (National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK) (Rheumatology Department, Salford Royal NHS Foundation Trust, Manchester, UK)
Caroline Sanders (National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK) (National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 8 December 2020

Issue publication date: 27 April 2021

533

Abstract

Purpose

Developing technological innovations in healthcare is made complex and difficult due to effects upon the practices of professional, managerial and other stakeholders. Drawing upon the concept of boundary object, this paper explores the challenges of achieving effective collaboration in the development and use of a novel healthcare innovation in the English healthcare system.

Design/methodology/approach

A case study is presented of the development and implementation of a smart phone application (app) for use by rheumatoid arthritis patients. Over a two-year period (2015–2017), qualitative data from recorded clinical consultations (n = 17), semi-structured interviews (n = 63) and two focus groups (n = 13) were obtained from participants involved in the app's development and use (clinicians, patients, researchers, practitioners, IT specialists and managers).

Findings

The case focuses on the use of the app and its outputs as a system of inter-connected boundary objects. The analysis highlights the challenges overcome in the innovation's development and how knowledge sharing between patients and clinicians was enhanced, altering the nature of the clinical consultation. It also shows how conditions surrounding the innovation both enabled its development and inhibited its wider scale-up.

Originality/value

By recognizing that technological artefacts can simultaneously enable and inhibit collaboration, this paper highlights the need to overcome tensions between the transformative capability of such healthcare innovations and the inhibiting effects simultaneously created on change at a wider system level.

Keywords

Acknowledgements

This project was funded by Arthritis Research UK (21226) and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Greater Manchester. Additional support was provided by the Arthritis Research UK Centre for Epidemiology (grant reference 20380). The NIHR CLAHRC Greater Manchester is a partnership between providers and commissioners from the NHS, industry and the third sector, as well as clinical and research staff from the University of Manchester. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health and Social Care.

Citation

Sharp, C.A., Bresnen, M., Austin, L., McCarthy, J., Dixon, W.G. and Sanders, C. (2021), "Implementing disruptive technological change in UK healthcare: exploring development of a smart phone app for remote patient monitoring as a boundary object using qualitative methods", Journal of Health Organization and Management, Vol. 35 No. 2, pp. 141-159. https://doi.org/10.1108/JHOM-07-2020-0295

Publisher

:

Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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