JMIR Publications

ABSTRACT

Background:

e-Health interventions have the potential to increase efficiency and effectiveness of healthcare. However, research has shown that implementing e-Health in routine healthcare practice is difficult. Organizational readiness to change has shown to be central in successful implementation. This paper describes the development and formative evaluation of a generic self-help tool, “E-Ready”, designed to be used by managers, project leaders or others responsible for implementation in a broad range of healthcare settings.

Objective:

To develop and evaluate a tool that could facilitate e-Health implementation in for example healthcare.

Methods:

A first version of the tool was generated based on implementation theory (E-Ready 1.0). A formative evaluation was undertaken through expert panels (n=15), cognitive interviews (n=17) and statistical tests. To assess measurement properties, we further conducted Rasch analyses on E-Ready items from three different workplaces (n=165). E-Ready 1.0 was also field tested among the target population (n=29). Iterative revisions were conducted during the formative evaluation process and E-Ready 2.0 was generated.

Results:

The E-Ready tool consists of a readiness assessment survey and a hands-on manual. The survey measures perceived readiness for change (willingness and capability) on individual and collective levels: perceived (1) conditions for change at the workplace; (2) individual conditions for change; (3) support and engagement among management; (4) readiness among colleagues; (5) consequences on status quo; and (6) workplace attitudes. The manual contains a brief introduction, instructions on how to use the tool, information on the themes of E-Ready, how to create an implementation plan, brief advice for success and tips for further reading on implementation theory. Rasch analyses showed overall acceptable measurement properties with the lowest person reliability for Individual conditions for change (0.56), based on three items, while Perceived consequences on status quo (5 items) had the highest person reliability (0.87).

Conclusions:

E-Ready 2.0 is a new promising self-help tool to guide implementation of e-Health initiatives in health care settings. E-Ready could be improved further, revising items and be evaluated in a larger sample.