| Table of Contents | 6 |
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| Foreword | 8 |
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| List of Contributors | 10 |
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| Patient-Focused Technology and the Health Care Delivery System | 12 |
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| 1.1. Where Does Patient-Focused Technology Fit in Health Care Delivery? | 13 |
| 1.2. Achieving Success with Interactive Health Communications Systems | 15 |
| 1.3. Readiness for Implementation Scale | 16 |
| References | 17 |
| CHESS: Translating Research into Practice | 18 |
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| 2.1. The CHESS System | 19 |
| 2.2. Research and Development Process | 22 |
| 2.3. Dissemination and Implementation of CHESS | 24 |
| References | 28 |
| Theory and Literature Review | 29 |
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| 3.1. Theories that Guide and Explain Implementation of IHCS | 30 |
| 3.2. Applying These Theories to IHCS Implementation in Health Care Organizations | 36 |
| References | 37 |
| Considerations for Successful Implementation of Newly Adopted Technologies | 39 |
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| 4.1. Diffusion of Innovation Theory: Characterizing IHCS and Key Participants | 40 |
| 4.2. Organizational Change Theory | 42 |
| 4.3. Implementation Theories | 45 |
| References | 48 |
| Implementation Model Development and Testing | 49 |
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| 5.1. The IHCS Implementation Context | 49 |
| 5.2. Creating Models of Implementation | 50 |
| 5.3. Development of a Model to Predict IHCS Implementation Success | 51 |
| 5.4. Factors of a Model to Predict IHCS Implementation Success | 61 |
| Summary | 63 |
| References | 63 |
| Introduction to Case Studies | 65 |
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| Associated Practice, 1992–1997 | 75 |
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| 7.1. Description of the Environment at the Site | 75 |
| 7.2. Timing of the Implementation in the History of Chess | 77 |
| 7.3. Early Exposure and Decision to Adopt | 77 |
| 7.4. Implementation of Breast Cancer and HIV/ AIDS Modules | 79 |
| 7.5. Termination of CHESS at Associated Practice | 87 |
| 7.6. Analysis | 89 |
| Conclusion | 97 |
| Union Hospital, 1993–2001 | 99 |
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| 8.1. Description of the Environment at the Site | 99 |
| 8.2. Timing of the Implementation in the History of CHESS | 102 |
| 8.3. Early Exposure and the Decision to Adopt CHESS | 102 |
| 8.4. Implementation of the Breast Cancer Module | 106 |
| 8.5. Analysis of the Breast Cancer Module Implementation | 110 |
| 8.6. Implementation of the Heart Disease Module | 116 |
| 8.7. Analysis of the Heart Disease Module Implementation | 120 |
| Conclusion | 123 |
| Strand Hardin Health Care, 1995–2002 | 124 |
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| 9.1. Description of Environment at the Site | 124 |
| 9.2. Timing of the Implementation in the History of Chess | 127 |
| 9.3. Early Exposure and Decision to Adopt | 127 |
| 9.4. Implementation of the Breast Cancer Module | 129 |
| 9.5. Analysis of the Breast Cancer Module Implementation | 131 |
| 9.6. Implementation of the Heart Disease Module | 134 |
| 9.7. Analysis of the Heart Disease Module Implementation | 135 |
| 9.8. Exposure to Other Chess Modules | 136 |
| 9.9. Implementation Through Community Health | 137 |
| 9.10. Analysis of the Community Health Implementation | 141 |
| Conclusion | 143 |
| Grace Hospital, 1996–2000 | 145 |
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| 10.1. Description of the Environment at the Site | 145 |
| 10.2. Timing in the History of CHESS | 147 |
| 10.3. Early Exposure and the Decision to Adopt CHESS | 148 |
| 10.4. Implementation of the Heart Disease Module | 150 |
| 10.5. Implementation of Other CHESS Modules | 153 |
| 10.6. Analysis | 155 |
| 10.7. Conclusion | 162 |
| Simpson Hospital, 1997–2000 | 163 |
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| 11.1. Description of the Environment at the Site | 163 |
| 11.2. Timing of Implementation in the History of Chess | 165 |
| 11.3. Implementation of Chess | 168 |
| 11.4. Implementation of Other CHESS Modules | 170 |
| 11.5. Analysis of the CHESS Implementations | 172 |
| Conclusion | 179 |
| Caregiver Resource Center Network, 1999– 2002 | 180 |
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| 12.1. Description of Environment at the Site | 180 |
| 12.2. Timing of the Implementation in the History of CHESS | 183 |
| 12.3. The Decision to Create DementiaCare | 183 |
| 12.4. The Development of DementiaCare | 184 |
| 12.5. Initial Implementation of DementiaCare | 186 |
| 12.6. Redesign and Re-implementation of DementiaCare | 189 |
| 12.7. Analysis | 193 |
| Conclusion | 198 |
| References | 199 |
| Key Learning and Advice for Implementers | 200 |
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| 13.1. A Model for Implementation | 201 |
| 13.2. Vision and Direction for This Chapter | 203 |
| 13.3. Gestalt: Implementation Success Depends on the Whole Set of Factors | 213 |
| 13.4. Special Considerations for Research-based Innovations | 213 |
| 13.5. Using the Readiness for Implementation Scale for IHCS Implementation | 214 |
| 13.6. Improving Implementation Efforts | 217 |
| Conclusion | 221 |
| References | 222 |
| Index | 227 |