Understanding digital health technology implementation in rehabilitation: Development of the Rehabilitation Technologies Implementation model

BackgroundTechnologies comprise a broad range of applications with the potential to transform outcomes for the millions of people requiring rehabilitation each year. Despite this potential, many technologies are not successfully implemented into clinical practice. No single consistent approach or model is used to support their implementation into any form of rehabilitation. This study aimed to understand the influences upon rehabilitation technology implementation in the UKs National Health Service and, using this understanding, develop a comprehensive implementation model to support the adoption of rehabilitation technologies. MethodsA multi-methodological approach comprising qualitative enquiry and literature reviews was used to identify, analyse and group key factors that influenced rehabilitation technology implementation. FindingsSeven themes, identified from qualitative enquiry of 48 participants, representing 8 stakeholder groups in the UK, were integrated with published technology and implementation models to generate five key domains that comprise Rehabilitation Technology Implementation Model (RiTe). These domains were: evidence, technology, users, team and organisation. InterpretationThe RiTe model provides a novel and comprehensive understanding of the key factors that influence rehabilitation technology implementation and can be used to plan, support and evaluate implementation efforts. The demands of rehabilitation require repeated, frequent and prolonged participation in interventions by users with variable needs, which means that barriers and facilitators are likely to exert a magnified effect upon the process and success of implementation. Consequently, the key influencers of rehabilitation technology implementation identified in this study provide a critical opportunity to understand factors which could influence technology uptake in other clinical specialties, attesting to the value of the RiTe model to both rehabilitation and wider healthcare.