e-Health program development has rapidly moved from operationalising systematic real-time patient reported outcome (PRO) data capture and review underscored by evidence-based scoring algorithms, to questions about how best to implement these platforms. Implementation research to date has focused on the strategies to maximise health professional and patient engagement as a facilitator of wider system uptake. However, less attention has been applied to identifying strategies required to ensure e-Health programs and the resultant outcomes are sustained in the long-term once they move from a research context to adoption as part of routine practice.
This presentation provides an overview of considerations and challenges cancer services face when integrating e-Health programs into routine care. Drawing on the theory-driven approaches applied by two key psychosocial e-Health initiatives, PROMPT-Care and ADAPT, we propose a structured co-design approach to sustainability based on the domains outlined by Schell’s Program Sustainability Framework.
Sustainability planning requires sites to consider multi-level factors across the domains of organisational support and communication, funding stability, partnerships and organisational capacity and program evaluation and adaptation. The presentation will discuss the process and importance of local development and ownership of a sustainability plan which identifies contextual factors such as workflows and processes likely to influence the service’s ability to embed e-Health initiatives into routine care. The joint development of a sustainability toolkit by the ADAPT and PROMPT-Care teams to support sites to address sustainability challenges will also be discussed.
e-Health systems have the potential to revolutionise psychosocial care delivery. However, to fully realise the potential of these systems, sustainability must be addressed as part of the research, rather than as an afterthought after research completion. Robust frameworks and a commitment to evaluation at the service level are also required if gains observed in the research phase are to be maintained.