A framework to improve enterprise-wide implementations : the case of the Veterans Health Administration Telehealth Expansion

This research applies an implementation framework derived from enterprise systems thinking to the Veterans Health Administration (VHA) Telehealth Expansion in order to characterize and evaluate the implementation methods used to expand Telehealth nation-wide. An in-depth, multi-disciplinary literature review was conducted to identify how enterprise-wide implementations are characterized in the literature and then was used to inform the development of a baseline enterprise implementation framework, the Timeline Implementation Framework. Said framework aims to characterize enterprise-wide implementations over time, from conceptualization to evaluation and sustainment, by breaking down an implementation into four phases (Enterprise Analysis, Implementation Planning, Implementation Execution and Innovation Evaluation) based on the nature of the activities and concepts that occur during each phase. The Timeline Implementation Framework was then applied to the VHA Telehealth Expansion. The framework guided study methods and facilitated analysis of a Clinical Video Telehealth clinic implementation. Further analysis was conducted in order to understand the VHA Telehealth expansion by considering an enterprise perspective of Telehealth's impact on VHA, and vice versa. Data collection included qualitative and quantitative evidence sources (e.g., interviews, observation, internal documents, and archival records) in order to gather information required to populate the developed framework. Fifteen interviews were conducted with VHA employees to allow for various perspectives emerging from multiple stakeholders with different roles across the enterprise. Conclusions aim to improve VHA implementation strategies in three key ways. First, by applying the framework to a Telehealth clinic, study findings help depict Telehealth expansion at a facility level. Second, results are used to provide constructive recommendations regarding implementation strategies throughout VHA. Third, this study tests the generalizability of the framework before applying it in further implementations.

Department dc:contributor.department

Massachusetts Institute of Technology. Department of Aeronautics and Astronautics.

Grantor dc:publisher

Massachusetts Institute of Technology

Year dc:date.issued

2013

Author dc:creator

• Andren, Julie C

Advisor dc:contributor.advisor

• Deborah Nightingale and Jorge Miguel dos Santos Fradinho.

• Aeronautics and Astronautics.

Statement dc:rights

• M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission.

Licence dc:rights.uri

• http://dspace.mit.edu/handle/1721.1/7582

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/1721.1/82501

OAI identifier oai:identifier

oai:dspace.mit.edu:1721.1/82501