The document summarizes challenges and strategies related to implementing eHealth innovations beyond pilot programs. It discusses four common roadblocks: 1) socio-cultural factors like resistance to change, 2) difficulties engaging networks of stakeholders, 3) lack of appropriate evidence, and 4) inadequate policies and funding. For each challenge, it provides lessons learned on overcoming barriers through strategies like co-designing with end users, building community buy-in, simplifying evidence, and aligning innovations with local strategies. It concludes that while successful spread requires planning, real-world implementation often differs and there is no single formula for scaling innovations.

1. Jordi Piera
Badalona Serveis Assistencials
Did you know this about
eHealth implementation?
Taking innovations
beyond pilots
ImpleMentAll Midterm Workshop
10th October 2018

2. What’s the problem?
Innovations ranging from care pathways,
checklists, to telemedicine and telehealth
solutions and patient self-management
programmes are shaping the way we understand
healthcare. Yet little is known about how and why
some of those succeed and others do not.
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

3. What are the roadblocks on the way?
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

4. What we did to overcome them?
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

5. Common problems we found in our way
1. Socio-cultural
2. The network
3. Evidence-base
4. Policy and funding
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

6. Socio-cultural factor (1)
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018
Most of the people don’t like change

7. Socio-cultural factor (2)
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

8. 1. Socio-cultural factors – take aways
 Medicine Faculties need to change the way they teach
 Nurses are more dynamic to embrace change
 Acceptability is enhanced when innovations are co-designed
 Influence and advocacy vs position and authority
 Expert support, space and time must be provided to adopt and
adapt the innovations to scale them up
 Innovation rewards vs adoption recognition
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

9. 2. The network
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

10. 2. The network (2)
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

11. 2. The network (3)
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

12. 2. The network (4)
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

13. 2. The network – take aways
• Engaging committed individuals it’s not sufficient
• Community building
• Agreement between stakeholders on intentions and goals is key
• Plays a pivotal role in spreading innovations by increasing buy-in
and sharing of resources, knowledge & experience
• When all the stakeholders are represented and involved since the
very beginning innovations tend to scale easier
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

14. 3. Evidence-base
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

15. 3. Evidence-base – take aways
• Producing evidence is not a scaling strategy but can help
• Must take into account all the perspectives from all the different
stakeholders
• Must be both quantitative and qualitative
• Not everyone is ready to understand research so consider
simplifying
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

16. 4. Policy and funding
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

17. 4. Policy and funding – take aways
• Leadership is a key factor
• Alignment with local and national strategies helps spread
• Financial incentives may encourage adoption but have a limited
scope
• Activity-based vs outcome-based financial schemes
• Promote spin-offs vs public system
• When policy making think about spread of innovation
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

18. Final thoughts
• There is evidence here and there of successful spread…
BUT no single formula for successful spread
• You think you will be able to manage the timings…
BUT they are organic and always slower than you wish
• Money can help sometimes…
BUT most of the times can not
• Evidence may help...
BUT less than you think it should
• You must plan for successful scaling-up…
BUT they won’t fit reality
ImpleMentAll – G.A. 733025 Midterm Workshop
Odense, 10 October 2018

19. Thanks a lot!
Jordi Piera Jiménez
Chief Information and R&D Officer
Badalona Serveis Assistencials
jpiera@bsa.cat
@jpieraj