Evidence generation plan
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6 Implementation considerations
The following considerations around implementing the evidence generation process have been identified through working with system partners.
System requirements
Conventional cardiac rehabilitation may be offered by various healthcare professionals and involve multiple allied healthcare professionals. The mode of delivery of conventional cardiac rehab should be reported during evidence generation to minimise risk of bias, and accurately assess costs for cost comparisons.
Evidence generation
Issues with data quality may impact analysis. Clear reporting about data quality is important and approaches such as multiple imputation could be used to address them.
Trusts should take into account the costs of the digital technologies used in this assessment when implementing the technologies. When negotiating with companies, trusts should also consider the upfront costs for implementing a technology, staff and user training, integration with NHS systems and providing smart devices that need an internet connection.
Equalities
Face-to-face cardiac rehabilitation sessions should be available for people with conditions that are not indicated for use with the digital technologies, or who decline using the technologies.
People who are eligible to use a technology in line with its intended use but who are excluded for any other reasons should be described in the reporting of future evidence.
There is risk that using digital technologies could widen the gap in access to cardiac rehabilitation.Support and resources may be needed for people:
unfamiliar with digital technologies
without access to smart devices or the internet
with visual, hearing, or cognitive impairment, problems with manual dexterity or a learning disability
with a mental health condition
with a lower reading ability (including people who do not have English as a first language)
experiencing homelessness
living in a multiple occupancy household
having residential care.
Adverse events
Reporting intervention-related adverse events is essential to assess any risk associated with the technologies' use in the NHS.
ISBN: [to be added at publication]
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