Healthcare interventions utilizing new technologies are developed and employed across multiple contexts at a staggering rate in the United States. Unfortunately, research suggests that some interventions that have demonstrated benefits still encounter implementation challenges. Telemedicine, the use of communication technologies to deliver health care over a distance, is a prime example of an application that has demonstrated great promise in research trials, yet rarely enjoys successful long-term implementation. The objective of this proposal is to assess the feasibility of an implementation model for telemedicine in rural oncology settings. Specifically, a telepsychiatry intervention will be designed and implemented in rural oncology clinics located in New Albany and Lafayette, Indiana. Feasibility will be assessed through a formative implementation evaluation. The formative evaluation will focus on the development and implementation of the intervention, as well as how exactly the implementation followed the deployment plan. Although a formal summative evaluation is not included in this study, semi-structured interviews will capture the retrospective success of the telemedicine intervention from the perspective of stakeholders, as well as an evaluation of health outcomes of the patients utilizing the new intervention. The Unified Theory of Acceptance and Use of Technology (UTAUT) will be used to identify potential barriers to implementation that influence the deployment and use of a telemedicine intervention in rural oncology clinics. In addition, we seek to refine the UTAUT within this healthcare context.
By understanding the individual and organizational issues that impact the implementation of a telemedicine program in a rural location, we will contribute to work in this field by identifying factors that will impact the implementation of other rural telemedicine initiatives. Not only will those who utilize this telemedicine intervention benefit from access to healthcare that was otherwise not available, but also the lessons that are learned from the implementation of the intervention will impact other rural communities and their ability to implement such services. Furthermore, this investigation marks a significant attempt at grounding implementation research in a theoretical framework. This investigation is both unique and innovative as we are utilizing a novel approach to address the problem of providing mental health services to rural oncology patients. The proposal seeks to test the feasibility of a telemedicine implementation model. Specifically, this research will test and refine a diffusion model, the Unified Theory of Acceptance and Use of Technology (UTAUT), in the implementation of a telemedicine intervention to assess and treat depression in rural cancer patients. The lessons that are learned from studying the implementation of this intervention will impact other rural communities and their ability to implement telemedicine-based services.
|Lauckner, Carolyn; Whitten, Pamela (2016) The State and Sustainability of Telepsychiatry Programs. J Behav Health Serv Res 43:305-18|