Incorporating Systems-Level Stakeholder Perspectives into the Design of Mobile Integrated Health Programs.
Objectives: Despite early evidence of effectiveness, cost-savings, and resource optimization, mobile integrated health (MIH) programs have not been widely implemented in the United States. System, community, and organizational-level barriers often hinder evidence-based public health interventions, s...
| Publicado en: | Prehospital Emergency Care Vol. 30; no. 1; pp. 130 - 140 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191012037&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191012037 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10903127 FZB jtl: Prehospital Emergency Care issn: 10903127 maglogo: Y pubinfo: dt: 2026 vid: 30 iid: 1 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 191012037 181697390 191012037 191012037 10.1080/10903127.2024.2443485 191012037 ppf: 130 ppct: 10 formats: tig: atl: Incorporating Systems-Level Stakeholder Perspectives into the Design of Mobile Integrated Health Programs. aug: au: O'Connor, Laurel Behar, Stephanie Refuerzo, Jade Mele, Xhenifer Rowe, Joel Ulintz, Alexander Faro, Jamie M. Soni, Apurv Lindenauer, Peter K. affil: Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts sug: subj: Mobile Applications Telemedicine Health Care Delivery, Integrated Stakeholder Participation Program Development Mobile Health Units Implementation Science Human Funding Source United States Male Female Adult Middle Age Academic Medical Centers Massachusetts Massachusetts Semi-Structured Interview Interview Guides Work Engagement Pilot Studies Videoconferencing Audiorecording Coding Qualitative Studies Purposive Sample Program Implementation Ambulatory Care Program Evaluation Data Management Community Health Services Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Objectives: Despite early evidence of effectiveness, cost-savings, and resource optimization, mobile integrated health (MIH) programs have not been widely implemented in the United States. System, community, and organizational-level barriers often hinder evidence-based public health interventions, such as MIH programs, from being broadly adopted into real-world clinical practice. The objective of this study is to identify solutions to the barriers impeding the implementation of MIH through interviews with multilevel stakeholders. Methods: Using the CENTERing multi-level partner voices in Implementation Theory methodology, the study team recruited stakeholders to participate in semi-structured interviews that were recorded, transcribed, and open-coded. Stakeholders were asked to explore and propose solutions to established barriers to the implementation of MIH programs including poor understanding of the role of MIH, the absence of sustainable reimbursement for MIH programs, and its disruption of existing clinical workflows. The study team used the Consolidated Framework for Implementation Research to develop an interview guide and codebook. Coders employed a combination of deductive and inductive coding strategies to identify common themes related to pragmatic solutions for overcoming barriers to the adoption of MIH. Results: Interviews with Department of Public Health officials, medical directors of MIH programs, non-physician MIH program leaders, community paramedics, health insurance officials, ambulatory physicians, hospital administrators, and hospital contract specialists (n = 18) elicited solutions to address barriers including (1) Developing a consistent identity for the MIH paradigm, (2) adopting an interdisciplinary approach to the development of efficient MIH workflows that utilize informatics to mimic existing clinical work, and (3) implementing capitated fee schedules that are cost-effective by targeting high-risk populations that are already a priority for payors. Conclusions: An investigation of solutions to barriers that impede the translation of MIH models into sustainable practice elicited several unifying themes including the establishment of a cohesive identity for MIH to improve engagement and dissemination, the use of a strategic approach to program design that aligns with existing healthcare delivery workflows and collaboration with payors to promote a robust reimbursement structure. These findings may help accelerate the implementation of MIH programs into real clinical practice. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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