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Factors Impacting the Implementation of Mobile Integrated Health Programs for the Acute Care of Older Adults
Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
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2024 (English)In: Prehospital Emergency Care, ISSN 1090-3127, E-ISSN 1545-0066, Vol. 28, no 8, p. 1037-1045Article in journal (Refereed) Published
Abstract [en]

Objective: Emergency services utilization is increasing in older adult populations. Many such encounters may be preventable with better access to acute care in the community. Mobile integrated health (MIH) programs leverage mobile resources to deliver care and services to patients in the out‐of‐hospital environment and have the potential to improve clinical outcomes and decrease health care costs; however, they have not been widely implemented. We assessed barriers, potential facilitators, and other factors critical to the implementation of MIH programs with key vested partners. Methods: Professional and community-member partners were purposefully recruited to participate in recorded structured interviews. The study team used the Practical Robust Implementation and Sustainability Model (PRISM) framework to develop an interview guide and codebook. Coders employed a combination of deductive and inductive coding strategies to identify common themes across partner groups. Results: The study team interviewed 22 participants (mean age 56, 68% female). A cohort of professional subject matter experts included physicians, paramedics, public health personnel, and hospital administrators. A cohort of lay community partners included patients and caregivers. Coders identified three prominent themes that impact MIH implementation. First, MIH is disruptive to existing clinical workflows. Second, using MIH to improve patients’ experience during acute care encounters is key to intervention adoption. Finally, legislative action is needed to augment central financial and regulatory policies to ensure the adoption of MIH programs. Conclusions: Common themes impacting the implementation of MIH programs were identified across vested partner groups. Multilevel strategies are needed to address patient adoption, clinical partners’ workflow, and legislative policies to ensure the success of MIH programs.

Place, publisher, year, edition, pages
Informa UK Limited , 2024. Vol. 28, no 8, p. 1037-1045
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health and Social Medicine
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URN: urn:nbn:se:kth:diva-367437DOI: 10.1080/10903127.2024.2333034ISI: 001194289100001PubMedID: 38498782Scopus ID: 2-s2.0-85188913057OAI: oai:DiVA.org:kth-367437DiVA, id: diva2:1984823
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QC 20250718

Available from: 2025-07-18 Created: 2025-07-18 Last updated: 2025-07-18Bibliographically approved

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Sundling, Elsa

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