The Stakeholder Empowered Adoption Model (SEAM) for telehealth

Report on technology adoption issues in telehealth. Evidence based medicine and the highly structured regulatory system that protects us from risks mean that many good innovations get stuck in the pilot/evaluation stage and never become adopted as mainstream services. There are particular problems with telehealth. Firstly, the technology is mature in other domains, but often has short product lifecycles, so that a conventional RCT approach simply takes too long. Secondly, the users are not just healthcare staff, they are also patients and service users (or their families), so the stakeholder group is complex. There could be more than one professional group, or healthcare organisation involved. Some elements of the solution (e.g. a smartphone) may not even be owned and maintained by the patient. All these stakeholders influence if and how the innovation is adopted, although the transactional relationship just involves two of them (the commissioners and the supplier). In many cases, telehealth solutions that provide significant patient benefits may be obstructed as they cause real implementation problems in someone’s work flow.