Building quality chronic illness care: implementation of a web-based care plan
Shiva Vasi A , Jenny Advocat A B , Akuh Adaji A and Grant Russell A
+ Author Affiliations
- Author Affiliations
A Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
B Corresponding author. Email: jenny.advocat@monash.edu
Australian Journal of Primary Health 26(2) 173-177 https://doi.org/10.1071/PY19039
Submitted: 6 February 2019 Accepted: 23 September 2019 Published: 7 February 2020
Abstract
Structured, multidisciplinary approaches to chronic disease management (CDM) in primary care, supported by eHealth tools, show improved clinical outcomes, yet the uptake of eHealth tools remains low. The adoption of cdmNet, an eHealth tool for chronic disease management, in general practice settings, was explored. This was a qualitative case study in three general practice clinics in Melbourne, Australia. Methods included non-participant observation, reflexive note taking and semi-structured interviews with GPs, non-GP clinical staff, administrative staff and patients with chronic conditions. Data were analysed iteratively and results were reviewed at regular team meetings. Findings highlighted the significance of clinical and organisational routines in determining practice readiness for embedding innovations. In particular, clinical routines that supported a structured approach to CDM involving team-based care, allocation of resources, training and leadership were fundamental to facilitating the adoption of the eHealth tool. Non-GP roles were found to be key in developing routines that facilitated the adoption of cdmNet within a structured approach to CDM. Practice managers, administrators and clinicians should first focus on routinising processes in primary care practices that support structured and team-based processes for CDM because without these processes, new technologies will not be embedded.
Additional keywords: chronic disease management, clinical routines, eHealth, implementation in primary care, organisational routines.
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