ABSTRACT
Contemporary healthcare is characterised by rapid change as new treatments and (eHealth) technologies are introduced. Translating an innovation (such as a research finding, a medical device, or a piece of software) into business as usual in a healthcare organisation is difficult and complex. This chapter begins by distinguishing between three related processes: Innovation, improvement, and implementation, and introducing other key concepts such as complexity, spread, scale up, and sustainability. We then describe three frameworks which were all developed to support and evaluate efforts in innovation, improvement and implementation and are thus relevant for eHealth implementation: The diffusion of innovations (DOI) framework, the consolidated framework for implementation research (CFIR), and the nonadoption, abandonment, scale up, spread and sustainability (NASSS) framework. The first two frameworks cover innovation and implementation respectively but were not designed with digital technologies in mind. NASSS was developed more recently to consider the many different domains of complexity in digital technology implementation, making it especially suitable for eHealth. We also include some brief worked examples to illustrate the concepts and frameworks in this chapter.
