SERIES: eHealth in primary care. Part 4: Addressing the challenges of implementation

Figures & data

Figure 1. Hype cycle of Gartner. Source: https://en.wikipedia.org/wiki/Hype_cycle.

Figure 2. Overview of the different domains related to eHealth implementation in primary care, including several potential barriers and facilitators per domain.

Table 1. A stepwise tool to build an evidence-based implementation strategy.

Step	Explanation
1. Specify eHealth application	Which eHealth application do you want to implement? What is the goal of the eHealth application?
2. Define problem	What implementation problems do you anticipate or have you encountered? And which of these problems is most important and changeable?
3. Specify desired implementation behaviour
3a. Action	A concrete, observable behaviour to address the implementation problem.
3b. Actor	The individual or group that will act.
3c. Context	The physical, emotional or social setting in which the actor will act.
3d. Target	The individual or group for/with/on behalf of whom the actor will act.
3e. Time	The time and duration that the actor will perform the action with/for the target.
4. Choose implementation strategy	Choose the implementation strategy of the list of Powell et al. [22] that fits best. Choosing an implementation strategy that fits with the phase of the implementation process (i.e. adoption phase vs implementation phase).
5. Evaluate implementation strategy	Evaluate the implementation of the eHealth application.

Note. Based on the action, actor, context, target, time (AACTT) framework of Presseau et al. [23].

Powell BJ , Waltz TJ , Chinman MJ , et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implement Sci. 2015;10:21.

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Presseau J , McCleary N , Lorencatto F , et al. Action, actor, context, target, time (AACTT): A framework for specifying behaviour. Implement Sci. 2019;14:102.

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