Barriers and opportunities relating to the implementation and evaluation of a complex digital intervention in England: A case study of Greater Manchester Diabetes My Way

Introduction Digital diabetes management systems have the potential to deliver cost-effective, flexible self-management support to patients with type 2 diabetes. DiabetesMyWay (DMW) is a platform for an open access website that aims to support diabetes self-management and provide patients with access to their care records. We present a case study focusing on a project involving patients across the large urban area of Greater Manchester (GM). Methods Interviews were undertaken with 8 members of the project team and 3 patients using the platform. Data were analysed thematically using the template analysis approach. Results Three themes are presented: Complex approvals, permissions and access across multiple organisations and systems; Capacity challenges in primary care settings; Ongoing support for the project. Implementation and evaluation of GMDMW involved navigating data sharing systems and regulations for complex private and public sector organisations and these impacted on the electronic data sharing necessary for the DMW platform to work as intended. Participants felt that the complexities associated with merging different systems, operated by different organisations, with different data controllers and data owners were greater than anticipated. Discussion The complexity, number of organisations and levels of governance involved in implementing and evaluating GMDMW were barriers to implementation and evaluation. This reflects inherent problems around mobilising innovation in the NHS. Our findings can help the development and evaluation electronic interventions to improve health to navigate this complex research landscape and ensure that patients can access the most innovative and effective ways to support their health. (245/250 words) Author summary Digital health interventions and Public Private Partnerships for innovation in the NHS are on the rise and in order to establish efficacy, these need to be evaluated. Often, this research and evaluation is carried out by Universities. However, challenges around navigating governance across these complex, multiple organisations exist where there is a need to share data and collaborate across systems effectively. Here, we describe the many unexpected challenges and solutions to effective data sharing reported by professionals and patients involved in the delivery and evaluation of a UK-based NHS/ private sector collaboration to provide a digital platform to support self-management of diabetes.