The roadblocks to success – Identifying challenges in implementing a surgery support E-health solution: A qualitative interview study

Abstract

Background

Surgery accounts for 30 % of the global disease burden, but healthcare systems struggle with managing surgical waitlists, optimising operations, and minimising cancellations, leading to poor patient outcomes and financial strain. E-health technologies offer promising solutions to enhance perioperative care and improve surgical outcomes, yet their integration faces significant organisational and structural challenges. This paper aims to explore and analyse the perspectives of decision-making personnel regarding the challenges and opportunities of implementing a surgery support e-health application.

Methods

This study utilised an explorative qualitative approach, employing a rapid cycle qualitative evaluation informed by the NASSS framework. Data were collected through individual semi-structured interviews with decision-making personnel conducted. Framework analysis guided by the NASSS framework was used to analyse the interview transcripts.

Results

A total of 15 participants from public health and external organisations participated in the study. The analysis, framed by the seven domains of the NASSS framework, critical challenges in integrating new health technologies, emphasising the need for compatibility, cybersecurity, and demonstrating clear benefits. Key factors for successful adoption included early and continuous stakeholder engagement, organisational readiness, and ongoing support. Additionally, participants highlighted the importance of centralised information systems and continuous adaptation of health IT solutions to meet evolving needs.

Conclusion

This paper reveals that implementing surgical e-health interventions is a complex process fraught with organisational, technical, financial, and political challenges, particularly due to insufficient end-user involvement and the intricate healthcare landscape. Despite the recognised benefits, successful implementation necessitates comprehensive stakeholder engagement and co-design approaches. Additionally, while a partnership between commercial vendors and public health developers presents an attractive solution, significant obstacles such as intellectual property disputes and resource allocation must be overcome.