Analysing the role of complexity in explaining the fortunes of technology programmes: empirical application of the NASSS framework

BMC Medicine
Trisha GreenhalghSara Shaw

Abstract

Failures and partial successes are common in technology-supported innovation programmes in health and social care. Complexity theory can help explain why. Phenomena may be simple (straightforward, predictable, few components), complicated (multiple interacting components or issues) or complex (dynamic, unpredictable, not easily disaggregated into constituent components). The recently published NASSS framework applies this taxonomy to explain Non-adoption or Abandonment of technology by individuals and difficulties achieving Scale-up, Spread and Sustainability. This paper reports the first empirical application of the NASSS framework. Six technology-supported programmes were studied using ethnography and action research for up to 3 years across 20 health and care organisations and 10 national-level bodies. They comprised video outpatient consultations, GPS tracking technology for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organising software and integrated case management via data warehousing. Data were collected at three levels: micro (individual technology users), meso (organisational processes and systems) and macro (national policy and wider context). Data analysis and s...Continue Reading

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Citations

Nov 15, 2018·The New England Journal of Medicine·Lia BallyRoman Hovorka
Apr 18, 2020·Oncology Nursing Forum·Anke J E de VeerCornelia F van Uden-Kraan
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