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Challenges in developing and facilitating delivery of consumer healthcare information; an organisational perspective
[Thesis]. Manchester, UK: The University of Manchester; 2012.
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Abstract
The University of Manchester Linda Joanne CowieMaster of Philosophy, MPhil 5 July 2012CHALLENGES IN DEVELOPING AND FACILITATING DELIVERY OF CONSUMER HEALTHCARE INFORMATION: AN ORGANISATIONAL PERSPECTIVE ABSTRACTThe past 35 years have seen healthcare policies driving towards empowering consumers to take more responsibility for their own health and its management. This is seen as one strategy to help contain rising healthcare costs and reduce pressures on healthcare services, while increasing overall population health. This study focuses on a vital element within the process of empowering consumers, that is, the development of consumer healthcare information and facilitation of its delivery. With chronic condition management representing one of the most significant cost burdens within primary and secondary care, it has been the focus of empowerment research and policy drivers. However progress has been slow in achieving a population engaged in taking more responsibility for their own health. While it is recognised that this is a complex arena, which encompasses an array of different areas of research interests and fields of enquiry, there has been relatively little focus on looking at the challenges being faced from the perspective of those in strategic positions within organisations involved in developing and facilitating delivery of healthcare information. This study aims to enhance the current knowledge base, through uncovering the perspectives of key stakeholders at the organisational level in relation to the process and the challenges they face. As this is a relatively under researched area, a critical realist approach was adopted, and qualitative research techniques were employed. Organisations involved were categorised into two broad groups: those involved in Policies, Funding and Guidance, referred to throughout as Organisational Group 1; and those involved in Development, Training and Facilitation, referred to throughout as Organisational Group 2. Identifying the challenges faced by Organisational Group 2 was the main objective of the empirical study. A fundamental challenge, evident from both the literature and the empirical study findings, is the lack of a universal definition of effective consumer healthcare information. This results in a lack of universal understanding of the complexities of delivering information-led consumer empowerment strategies. Other key challenges evident in the process include: the lack of universally agreed evaluation measures; recognising the inter-dependency of what is happening at an environmental, organisational, healthcare professional and consumer level; facilitating movement from an acute to a chronic care paradigm where appropriate; identifying and addressing the need for organisational culture change and its implications, and within this achieving the right balance between top-down and bottom-up leadership and engagement. This study offers a valuable addition to literature in conveying an organisational perspective on the challenges being faced in developing and facilitating the delivery of consumer healthcare information, and what actions those involved believe are needed to address key challenges identified.