Bulletin of the World Health Organization

Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review

Frances S Mair, Carl May, Catherine O’Donnell, Tracy Finch, Frank Sullivan & Elizabeth Murray

Volume 90, Number 5, May 2012, 357-364

Table 1. Normalization process theory coding framework used for qualitative analysis of review data on e-health implementation

Coherence
(Sense-making work)
Cognitive participation
(Relationship work)
Collective action
(Enacting work)
Reflexive monitoring
(Appraisal work)
Differentiation
Is there a clear understanding of how a new e-health service differs from existing practice?
Enrolment
Do individuals “buy into” the idea of the e-health service?
Skill set workability
How does the innovation affect roles and responsibilities or training needs?
Reconfiguration
Do individuals try to alter the new service?
Communal specification
Do individuals have a shared understanding of the aims, objectives and expected benefits of the e-health service?
Activation
Can individuals sustain involvement?
Contextual Integration
Is there organizational support?
Communal appraisal
How do groups judge the value of the e-health service?
Individual specification
Do individuals have a clear understanding of their specific tasks and responsibilities in the implementation of an e-health service?
Initiation
Are key individuals willing to drive the implementation?
Interactional workability
Does the e-health service make people’s work easier?
Individual appraisal
How do individuals appraise the effects on them and their work environment?
Internalization
Do individuals understand the value, benefits and importance of the e-health service?
Legitimation
Do individuals believe it is right for them to be involved?
Relational integration
Do individuals have confidence in the new system?
Systematization
How are benefits or problems identified or measured?