Enablers and Barriers of digitalisation impacting the innovation life cycle of primary health organisations specifically General Practices Medical Centres during a pandemic: A New Zealand study

Nargis Mashal

Abstract

AimTechnological innovation in General Practice (GP) medical centres in New Zealand (NZ) is proven to be the most important factor needed for the sustainability of primary care during the Covid-19 pandemic. However, GP Medical centres faced many barriers that eventually impacted the dynamic sustainability of the primary care system, specifically GP in NZ. This paper focuses on using the identified barriers and enablers to the innovation life cycle to develop a System Dynamic (SD) framework that would provide the required direction towards the sustainability of the GP Medical Centres.MethodThe barrier and enabler factors that influenced the GP medical centres’ innovation life cycle are identified as themes from qualitative research conducted in personal interviews with 86 participants in 16 GP medical from February 28th to August 30th, 2020, in urban, rural, and suburban practices from different decile areas of NZ. A dynamic system methodology is used to develop the causal loop and stock and flow diagrams for the four phases: (Opportunity, refine, establish, decide) of the innovation dynamic framework developed for the paper, assists in putting into context the development feedback loops for the driver’s cycle framework creates a research gap that should allow for further research into the development of a system dynamic model that can be executed within a simulation environment.ResultsThe result presents the innovation life cycle process for digitalising the GP medical centres during the Covid-19 pandemic in NZ. The most influential drivers are 1) Telehealth capability with existing hardware and 2) Readiness to respond to pandemic demand with a weight of 3.51% each, followed by 3) Accessibility, integration and ease of use, 4) Gain of income and revenue from new services and subsidy with each weighting 3.37%.ConclusionThe decision to adopt digitalisation had a significant impact on GP centres, disrupting the norm but also allowing continued access to health services to patients who were the most vulnerable during the pandemic. The pandemic forced to change to digitalisation, leading to significant changes in the GP business model and the adoption of innovative solutions. In the four phases of the innovation life cycle frame, a more significant effort had to be placed on establishing tools (phase 3) due to the weight of influence of the many identified barrier drivers. Deciding to permanently keep the digitalised healthcare services (phase 4) of the innovation life cycle framework has higher enablers driver by number and weight influences. This means phase 3 of digitisation is the most critical phase of life cycle innovation. The GP medical centre must be more focused on changing its operation process to switch its service model from doctor-centric to patient-centric. 
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