DARE – Phase 1 FIRE
Factors Influencing the Implementation of technologies in Rehabilitation
The Rehabilitation Technologies Implementation Model
The RiTe model has been developed from extensive literature searches and 48 interviews with a range of stakeholders that influence technology adoption in the NHS.
This is a simplified image of the model highlighting the key elements and some of the key considerations that will influence the implementation of technologies in your setting.
ACCESS THE MODEL AND TOOLKIT HERE
How did we develop the RiTe model?
The RiTe model was generated by combining the findings from real-world experiences of rehabilitation technology adoption with learning from research literature.
The model identifies the key people, processes and resources needed to support technology adoption into clinical rehabilitation. It doesn’t mean the process of getting technologies into practice will always be easy, but we hope it will help adopters plan the process and support people who want to harness technologies to improve practice and transform outcomes for patients.
1. Understanding Behaviour change in technology supported rehabilitation
Behaviour change is an integral part of rehabilitation as rehabilitation typically requires us to undertake exercises or activities frequently and regularly, often for weeks and months. Digital Health Technologies (DHT) provide new opportunities for facilitating and supporting this behaviour change. For instance, some DHT are thought to make rehabilitation fun by using engaging games which may encourage people to participate more regularly in exercises whilst others provide regular feedback so users can see their progress. However, we don’t know which strategies to change behaviour are used in DHT.
We have undertaken a rigorous scoping review to identify and explore behaviour change approaches within digital health technology-based interventions in physical rehabilitation following stroke.
Read our published findings here: Gooch HJ, Jarvis KA, Stockley RC Behavior Change Approaches in Digital Technology–Based Physical Rehabilitation Interventions Following Stroke: Scoping Review J Med Internet Res 2024;26:e48725
doi: 10.2196/48725 PMID: 38656777 PMCID: 11079774
Our findings provide important understanding of how technology-based interventions report and use recognised behaviour change techniques and were integrated into the RiTe model.
2. What theories, models and frameworks are currently used to guide or evaluate DHT in healthcare?
We wanted to learn from the theories, models and frameworks that others have used to implement technologies in both rehabilitation and wider healthcare. We did this by searching for and reviewing evidence reporting in the research literature.
We undertook two different kinds of reviews to capture (i) the implementation tools used to guide technology adoption in neurological rehabilitation and (ii) the relevant theories and models used in any form of technologies adoption across healthcare.
See our published findings here: Jarvis K, Thetford C, Turck E, Ogley K, Stockley RC. Understanding the Barriers and Facilitators of Digital Health Technology (DHT) Implementation in Neurological Rehabilitation: An Integrative Systematic Review. Health Services Insights. 2024;17. doi:10.1177/11786329241229917
As well as providing useful information about the models that have been used in technology implementation in neurological rehabilitation, the findings of this review were combined with the other reviews and the interview study results to inform the RiTe model.
3. What can we learn from people’s experiences of implementing DHT into rehabilitation?
There are a range of people (stakeholders) that are key supporting and using DHT to improve rehabilitation in the UK’s National Health Service. All of them can influence if and how technologies get to be used. To date, no studies have considered all these stakeholder’s views, but we think this is vital if we want to understand how we can ensure technology becomes embedded in usual practice.
We identified the key stakeholders – these include people who use technologies as part of their rehabilitation (patients and those who care for them) clinicians, people who design technologies, information technology team members, people working in organisational governance, service mangers and organisation leaders – and interviewed them about their experiences. We analysed all their rich and detailed experiences which told us about the real-life challenges and good practices in technology implementation and use.
Bringing it all together
To build the RiTe model, we brought together all the information from these three work streams. This means that the RiTe model brings together global learning from research and the real-life experiences of people who have used and implemented technologies in clinical settings.
You can access the RiTe model here and watch this space for the published article.
