Exploring barriers and facilitators of implementation of digital technologies in diagnosis of heart disease: a qualitative study of stakeholder perspectives (Preprint)

Abstract

BACKGROUND Digital technologies are increasingly being implemented in healthcare to improve the quality and efficiency of care for patients. However, the rapid adoption of health technologies over the last five years has failed to adequately consider patient and clinician needs, which results in ineffective implementation. There is also a lack of consideration for the differences between patient and clinician needs, resulting in over generalised approaches to implementation and use of digital health technologies. OBJECTIVE This study aimed to explore barriers and facilitators of implementation of digital technologies in the diagnosis of heart disease for both patients and clinicians and provide recommendations to increase the acceptability of novel health technologies. METHODS We recruited 32 individuals; 23 with lived experience of heart disease and 9 clinicians involved with diagnosis of heart disease. Participants with experience of living with heart took part in semi-structured focused groups, while clinicians undertook one-to-one semi-structured interviews. Inductive thematic analysis using a phenomenological approach was used to analyse the resulting qualitative data and to identify themes. RESULTS Emerging themes were separated into facilitators and barriers, and categorised into resource, technology and user-related themes. Resource-related barriers and facilitators related to clinician workload, system-level influences, cost implications, efficiency and support infrastructure. Technology-related barriers and facilitators included themes related to reliability, accuracy, safety parameters, data security, ease of use and personalisation. Finally, the most prominent themes were the user-related barriers and facilitators, which encompassed user attitudes, individual-level variations, and impact on quality of healthcare experiences. This theme captured a wide variety of perspectives amongst the sample and revealed how patient and clinician attitudes and personal experiences substantially impact engagement with digital health technologies across the cardiovascular care pathway. CONCLUSIONS Our findings highlight the importance of considering both patient and clinician needs and preferences when investigating the barriers and facilitators to effective implementation of digital health technologies considering the increasing reliance on digital health tools to improve quality of care and create a more efficient diagnosis pathway for heart disease. CLINICALTRIAL Not applicable. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2023-072952