University of Oulu

Nadav J, Kaihlanen A, Kujala S, Laukka E, Hilama P, Koivisto J, Keskimäki I, Heponiemi T. How to Implement Digital Services in a Way That They Integrate Into Routine Work: Qualitative Interview Study Among Health and Social Care Professionals. J Med Internet Res 2021;23(12):e31668, doi: 10.2196/31668, PMID: 34855610

How to implement digital services in a way that they integrate into routine work : qualitative interview study among health and social care professionals

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Author: Nadav, Janna1,2; Kaihlanen, Anu-Marja1; Kujala, Sari3;
Organizations: 1Finnish Institution for Health and Welfare, Helsinki, Finland
2Department of Health and Social Care Systems, Tampere, Finland
3Aalto University, Espoo, Finland
4Oulu University, Oulu, Finland
5South Savo Social and Health Care Authority, Mikkeli, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: JMIR Publications, 2021
Publish Date: 2021-12-10


Background: Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more.

Objective: The aim of this study is to examine health and social care professionals’ experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals’ routine work.

Methods: A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory.

Results: Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals’ routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals’ work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals’ work tasks.

Conclusions: We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services.

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Series: Journal of medical internet research
ISSN: 1439-4456
ISSN-E: 1438-8871
ISSN-L: 1439-4456
Volume: 23
Issue: 12
Article number: e31668
DOI: 10.2196/31668
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
Funding: This study was supported by the Strategic Research Council at the Academy of Finland (project nos. 327145 and 327147) and Finnish Institute for Health and Welfare (THL)-coordinated funding for COVID-19 research included in the Finnish government’s supplementary budget. None of these entities had any role in the design of the study or in its data collection, analysis, interpretation of data, or writing of this study.
Copyright information: © Janna Nadav, Anu-Marja Kaihlanen, Sari Kujala, Elina Laukka, Pirjo Hilama, Juha Koivisto, Ilmo Keskimäki, Tarja Heponiemi. Originally published in the Journal of Medical Internet Research (, 01.12.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.