Stina Bollerup is a PhD student at the Department of Public Health at Aarhus University and DEFACTUM – Public Health & Health Services Research at the Central Denmark Region. She holds a Master of Political Science from Aarhus University. Her PhD project focuses on large-scale implementation through the investigation of the national implementation process of a telehealth intervention targeting patients with Chronic Obstructive Pulmonary Disease (COPD). In the project, she studies the implementation process on multiple levels. Her research interests are implementation- and organisation studies in healthcare, focusing on complex interventions and technology.
Implementing technologies on a large scale is a continuous challenge in healthcare systems. This challenge also applies to telemedicine, where implementation to practice and scale-up has proven difficult. The political-administrative system plays a vital role in the implementation process of technologies. However, this level of the implementation process remains understudied. To address this gap, this study will explore the political-administrative level of the national implementation process of TeleCOPD in Denmark – a home-monitoring telehealth intervention targeting patients with Chronic Obstructive Pulmonary Disease (COPD). Denmark is a pioneer country in regards to the implementation of telemedicine on a national scale. This provides a unique chance to study the large-scale implementation of telemedicine.
An in-depth qualitative case study of the implementation process at the political-administrative level is undertaken. Data consists of semi-structured interviews with key implementation stakeholders at a national, regional, and municipality level. Furthermore, project descriptions and policy documents are analysed to discover how the intervention is implemented across settings. Data is analysed following thematic analysis.
The study is ongoing. However, early analysis of the collected material suggests:
• Key translation processes occur before implementation in practice. Investigating implementation on a political-administrative level provides valuable insights into the adaption and translation of telehealth to local contexts. Room for local adaption and translation can facilitate implementation.
• National scale-up is a time-consuming and complex process. Implementation on a national scale fosters knowledge sharing across settings but may also slow down the implementation process due to added complexity.
• Timeliness is crucial for successful implementation. Continuous delays in the implementation process impact the project’s credibility and motivation among stakeholders.
• Collaborative project management across sectors on a political-administrative level may facilitate implementation.
The results of this study will generate valuable knowledge about large-scale implementation of telemedicine and give insights into the role of the political-administrative level in the implementation process.