Toward a Framework for Interweaving Adoption and Scaling Requirements Into Healthcare System Development and Project Management Processes

In order to enhance their impact on traditional healthcare systems and improve health outcomes, digital health interventions must undergo widespread adoption, scaling, and consistent use. However, achieving the adoption and scaling of digital tools in healthcare remains a challenging goal globally. This challenge is compounded by an inconsistent and fragmented approach to adoption and scaling, as well as a limited reliance on theoretical tools throughout a digital health intervention's lifecycle phase. This article argues that adoption and scaling requirements should be prominently integrated into each phase of traditional healthcare system development and project management processes to facilitate these systems’ widespread adoption and use. Addressing this necessitates the operationalization of multiple theoretical tools across a digital health intervention's lifecycle. To tackle the identified weakness of limited reliance on theoretical tools, we conducted a qualitative evidence synthesis, culminating in a reusable framework for theory operationalization. To illustrate how the above framework can be applied in practice, we provide and discuss a use case scenario, involving a hypothetical design, development, and implementation of a remote patient management application. This work expands the existing literature on technology implementation in healthcare by introducing a framework that assists practitioners to connect theoretical concepts to traditional system development and project management activities and phases.