TY - JOUR
AU - S. A. Robinson
AU - J. M. Lipschitz
AU - N. Ndiwane
AU - F. R. Bixler
AU - B. Etingen
AU - M. S. Zocchi
AU - S. L. Shimada
AU - J. A. Palmer
AU - T. J. Newton
AU - N. Shah
AU - T. P. Hogan
A1 - 
AB - IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure, due to its subjective and complex nature. This evaluation examined alignment among stakeholder perceptions of context related to connected care implementation across VHA.MethodsA national, cross-sectional survey assessed perceptions of 11 contextual factors relevant to connected care implementation as identified in published reviews within the implementation science literature. Across 142 VHA facilities and 18 regions, surveys were sent to four stakeholder groups: clinical team members, connected care coordinators, facility leadership, and regional leadership. Mean scores for each factor were compared between stakeholder groups using Welch's ANOVA and Bonferroni-corrected post-hoc comparisons.ResultsA total of 5541 respondents (36.1% response rate) participated. Organizational Culture and Climate was rated the most favorable contextual factor (mean = 3.9, SD = 0.7), while Financial Resources was perceived as least favorable (mean = 3.0, SD = 1.0). Significant differences emerged between the perceptions of frontline workers (clinical team members, connected care coordinators) and leadership (facility, regional). Clinical team members rated nearly all contextual factors less favorably than facility leadership. Coordinators similarly rated most factors less favorably than leadership.DiscussionFindings highlight a misalignment between leadership and frontline workers in their perceptions of organizational context for implementing connected care technologies. Leadership viewed key contextual factors (e.g. Organizational Readiness to Change, Leadership Support) more favorably than frontline workers. This misalignment may impact implementation success, suggesting a need for strategies to better align stakeholder perceptions.
AD - eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, USA. RINGGOLD: 7171; Center for Health Optimization and Implementation Research (CHOIR), Veterans Affairs Bedford Healthcare System, Bedford, MA, USA.; The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.; Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.; Research and Development Service, Dallas Veterans Affairs Medical Center, Dallas, TX, USA.; Department of Health Economics, Systems, and Policy, Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA.; Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.; Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.; Center for Health Optimization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, MA, USA.; Office of Connected Care, Veterans Health Administration, Washington, DC, USA.
AN - 40910952
BT - J Telemed Telecare
C5 - HIT & Telehealth
DA - Sep 5
DO - 10.1177/1357633x251371113
DP - NLM
ET - 20250905
JF - J Telemed Telecare
LA - eng
N2 - IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure, due to its subjective and complex nature. This evaluation examined alignment among stakeholder perceptions of context related to connected care implementation across VHA.MethodsA national, cross-sectional survey assessed perceptions of 11 contextual factors relevant to connected care implementation as identified in published reviews within the implementation science literature. Across 142 VHA facilities and 18 regions, surveys were sent to four stakeholder groups: clinical team members, connected care coordinators, facility leadership, and regional leadership. Mean scores for each factor were compared between stakeholder groups using Welch's ANOVA and Bonferroni-corrected post-hoc comparisons.ResultsA total of 5541 respondents (36.1% response rate) participated. Organizational Culture and Climate was rated the most favorable contextual factor (mean = 3.9, SD = 0.7), while Financial Resources was perceived as least favorable (mean = 3.0, SD = 1.0). Significant differences emerged between the perceptions of frontline workers (clinical team members, connected care coordinators) and leadership (facility, regional). Clinical team members rated nearly all contextual factors less favorably than facility leadership. Coordinators similarly rated most factors less favorably than leadership.DiscussionFindings highlight a misalignment between leadership and frontline workers in their perceptions of organizational context for implementing connected care technologies. Leadership viewed key contextual factors (e.g. Organizational Readiness to Change, Leadership Support) more favorably than frontline workers. This misalignment may impact implementation success, suggesting a need for strategies to better align stakeholder perceptions.
PY - 2025
SN - 1357-633x
SP - 1357633x251371113
ST - Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system
T1 - Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system
T2 - J Telemed Telecare
TI - Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system
U1 - HIT & Telehealth
U3 - 10.1177/1357633x251371113
VO - 1357-633x
Y1 - 2025
ER -