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The Technology

Usability and dependability have often been cited as reasons for the failure of technology interventions. There has often been a failure to adequately prototype and test systems. There is also a risk that technology-produced data could be misinterpreted by patients or clinicians, particularly if it does not directly measure the underlying illness. Skills and training requirements can also be a barrier to scaling and spreading the initiative. Systems that are plug and play/off the shelf, which can be replaced by other, equivalent systems, avoid the risk of lock in or provider failure.

HealthTracker was co-designed with clinicians and was visually appealing, but technical glitches disrupted workflows and slowed down the EHR, so many clinicians stopped using it.

PatientsLikeMe established a reliable cloud-based database with an appealing user interface. Complexity was minimised by avoiding an interface with Electronic Record Systems. Over time, more advanced analytical capabilities were developed, but the system remained easy to use, in some ways resembling a dating website.

CYPHP’s core technologies are population health registers from primary and secondary care, used to identify risk or diagnoses; shared interoperable clinical notes between primary and secondary care; and a patient or parent portal that supports self-referral, collecting biopsychosocial data to help tailor care to need, and providing health promotion and supported self-management information. The patient portal connects to a research database, enabling participation in formal research evaluation, with patient or parent consent [22].

TRANSFoRm built a decision support system and a user interface from reusable components. It also used an ontology to overcome the challenge of interoperability between EHRs [116]. Building and sustaining interfaces with each of the EHRs was the most burdensome task [37].