Date of Submission
5-2024
Document Type
Thesis
Degree Name
Doctor of Health Science
Department
Health Sciences
First Advisor
Sandra D'Amato-Palumbo, R.D.H., M.P.S., Ed.D.
Second Advisor
Pavani Rangachari, Ph. D.
Third Advisor
Joseph Scott Gladstone, Ph.D.
MeSH
Telemedicine, Delivery of Health Care
LCSH
Medical telematics, Health services administration
Abstract
As a disruptive innovation, telehealth creates a new hybrid model of care that delivers significant value to stakeholders. However, healthcare innovation implementation failure ranges from 30% to 90%. Extensive research has been conducted on the barriers to widespread telehealth implementation but has yet to completely understand its failure. COVID-19 accelerated telehealth use by relaxing regulations to support continuity of care, but its use remained widely variable across specialties. Therefore, the literature calls for an understanding of the complex processes and social challenges underlying telehealth as an innovation in the health system setting. Tensions in innovation processes supply a foundation to explore the dynamic relationship between navigating social conflicts and the implementation process. This study explored the tensions and management strategies for successful telehealth implementation in health systems. A qualitative social phenomenological study was conducted using semistructured interviews with administrative, medical, and technological healthcare leaders from three health systems. The approach to data analysis followed a hybrid inductive and deductive thematic analysis. The findings of this study highlight tensions between human and technological connections within trust dynamics; geographic, competitive, and legal and regulatory influences; and financial reimbursement and innovation investment drivers. It presents management strategies with purposeful, collaborative, and adaptive leadership. Furthermore, it presents a novel conceptual framework that integrates tensions and management strategies within the Consolidated Framework for Implementation Research. Overall, this research contributes to the literature by providing actionable insights for health systems and leaders, policymakers, professional organizations, and researchers to effectively navigate telehealth implementation.
Recommended Citation
Schweidenback, Jordan Scott, "Exploring Tensions in Innovation Processes (TIPs) for Telehealth Implementation in Health Systems" (2024). Health Science Doctoral Thesis. 12.
https://digitalcommons.newhaven.edu/healthscidocthesis/12