“Apping Up”: Prospects for Information Technology Innovation in Return to Work Communication

  • Ripdaman Singh
  • Fergal O’Hagan


Purpose During return to work (RTW), communication between health care providers and employers largely takes place through standardize paper-based forms. Information technology (IT) platforms may provide advantages in enabling information exchange and decision-making through sharing of guidelines and resources. We investigated stakeholder perspectives on the prospect of IT use for RTW communication in Ontario, Canada. Methods Consistent with the exploratory nature of the questions, qualitative methods were used. Primary data were interviews with health care providers (HCPs), employers, and workers with experience in RTW. The first portion of initial interviews elicited general perspectives and experiences related to RTW communication. Participants were then exposed to a prototype IT communication platform and elicited their feedback. Follow-up interviews with HCP’s and EMP’s were used to allow further reflection and clarification of data. We used progressive, thematic coding to analyze data. Results 12 HCPs, 7 employers, and 5 workers participated in the study. Five inter-related themes were obtained. Participants expressed no absolute objection to the use of IT for RTW communication but varying degrees of support. Participants revealed how media change depended on a prospective IT innovation’s perceived usefulness, fit with current practices, capacity to gain buy-in from other stakeholders, and ability to demonstrate positive performance in actual practice. Conclusions Findings suggest that a transition to an IT-mediated tool for RTW communication is supported in principle; however, major caveats exist in relation to perceived value and fit with stakeholder practice. System support and stakeholder cooperation are likely necessary to adopt the change, yet IT-mediated communication has yet to demonstrate value. To avoid circularity, proof of principal needs to be established through an implementation trial of such technology.


Sickness absence Return to work Disability management Rehabilitation Communication 



We would like to acknowledge our participants for the generous gift of their time and experiences, the RTW Ex app developers for allowing us to use their product as a means to this research, Deborah Kennett for her advice on the research and Keeley Moloney and Amy Sayles for their assistance with data management.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Supplementary material 1 (DOCX 157 KB)
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Supplementary material 2 (DOCX 101 KB)


  1. 1.
    Loisel P, Anema JR, Feuerstein M, Pransky G, MacEachen E., Costa-Black KM. Preface. In: Loisel P, Anema J, editors. Handbook of work disability: prevention and management. New York: Springer; 2014. p. ix–ixiii.Google Scholar
  2. 2.
    O’Hagan FT, Coutu MF, Thomas SG, Mertens DJ. Work reintegration and cardiovascular disease: medical and rehabilitation influences. J Occup Rehabil. 2011;22(2):270–281. Scholar
  3. 3.
    Franche R, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J. The Institute for Work and Health (IWH) Workplace-Based RTW Intervention Literature Review Research Team. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15(4):607–631. Scholar
  4. 4.
    MacEachen E, Clarke J, Franche R, Irvin E., The Workplace-Based Return to Work Literature Review Group. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health. 2006;32(4):257–269. Scholar
  5. 5.
    Tompa E, de Oliveira C, Dolinschi R, Irvin E. A systematic review of disability management interventions with economic evaluation. J Occup Rehabil. 2008;18(1):16–26. Scholar
  6. 6.
    Higgins A, Porter S, O’Halloran P. General practitioners’ management of the long-term sick role. Soc Sci Med. 2014;107:52–60. Scholar
  7. 7.
    MacEachen E, Kosny A, Ferrier S, Chambers L. The “toxic dose” of system problems: why some injured workers don’t return to work as expected. J Occup Rehabil. 2010;20(3):349–366. Scholar
  8. 8.
    Soklaridis S, Tang G, Cartmill C, Cassidy JD, Andersen J. “Can you go back to work?” Family physicians’ experiences with assessing patients’ functional ability to return to work. Can Family Physician. 2011;57(2):202–209.Google Scholar
  9. 9.
    Wainwright E, Wainwright D, Keogh E, Eccleston C. The social negotiation of fitness for work: tensions in doctor–patient relationships over medical certification of chronic pain. Health 2015;19(1):17–33. Scholar
  10. 10.
    Pransky GS, Shaw WS, Franche R, Clarke A. Disability prevention and communication among workers, physicians, employers, and insurers—current models and opportunities for improvement. Disabil Rehabil. 2004;26(11):625–634. Scholar
  11. 11.
    Haigh J. Information technology in health professional education: why IT matters. Nurse Educ Today. 2004;24(7):547–552. Scholar
  12. 12.
    Moshiri S, Simpson W. Information technology and the changing workplace in Canada: firm-level evidence. Ind Corp Change. 2011;20(6):1601–1636. Scholar
  13. 13.
    Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Thousand Oaks: Sage; 2006.Google Scholar
  14. 14.
    Clarke AE. Situational analysis: Grounded theory after the postmodern turn. Thousand Oaks: Sage; 2005.CrossRefGoogle Scholar
  15. 15.
    Morrow SL. Quality and trustworthiness in qualitative research in counseling psychology. J Couns Psychol. 2005;52(2):250–260. Scholar
  16. 16.
    Krefting L. Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991;45(3):214–222.CrossRefPubMedGoogle Scholar
  17. 17.
    Seale C, Silverman D. Ensuring rigor in qualitative research. Eur J Pub Health. 1997;7(4):379–384. Scholar
  18. 18.
    Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22(2):63–75.Google Scholar
  19. 19.
    Joseph RC. Individual resistance to IT innovations. Commun ACM. 2010;53(4):144–146. Scholar
  20. 20.
    Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. Manag Inf Syst Q. 2003;27(3):425–478.CrossRefGoogle Scholar
  21. 21.
    Yarbrough AK, Smith TB. Technology acceptance among physicians. Med Care Res Rev. 2007;64(6):650–672. Scholar
  22. 22.
    Gagnon M, Desmartis M, Labrecque M, Car J, Pagliari C, Pluye P, Frémont P, Gagnon J, Tremblay N, Légaré F. Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals. J Med Syst. 2012;36(1):241–277. Scholar
  23. 23.
    Sun H, Zhang P. The role of moderating factors in user technology acceptance. Int J Hum Comput Stud. 2006;64(2):53–78. Scholar
  24. 24.
    Holden RJ, Karsh B. The technology acceptance model: Its past and its future in health care. J Biomed Inform. 2010;43(1):159–172. Scholar
  25. 25.
    Kapoor KK, Dwivedi YK, Williams MD. Roger’s innovation adoption attributes: a systematic review and synthesis of existing research. Inf Syst Manag. 2014;31(1):74–91. Scholar
  26. 26.
    Marangunić N, Granić A. Technology acceptance model: a literature review from 1986 to 2013. Univ Access Inf Soc. 2015;14(1):81–95. Scholar
  27. 27.
    Ross J, Stevenson F, Lau R, Murray E. Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implement Sci. 2016;11(1):1–12. Scholar
  28. 28.
    Wisdom JP, Chor KHB, Hoagwood KE, Horwitz SM. Innovation adoption: a review of theories and constructs. Adm Policy Mental Health. 2014;41(4):480–502. Scholar
  29. 29.
    Kaye R, Kokia E, Shalev V, Idar D, Chinitz D. Barriers and success factors in health information technology: a practitioner’s perspective. J Manag Market Healthc. 2010;3(2):163–175. Scholar
  30. 30.
    Klein KJ, Knight AP, Innovation implementation. Curr Dir Psychol Sci. 2005;14(5):243–246. Scholar
  31. 31.
    Klein KJ, Sorra JS. The challenge of innovation implementation. Acad Manag Rev. 1996;21(4):1055–1080.Google Scholar
  32. 32.
    Baril R, Clarke J, Friesen M, Stock S, Cole D., The Work-Ready group. Management of return-to-work programs for workers with musculoskeletal disorders: a qualitative study in three Canadian provinces. Soc Sci Med. 2003;57(11):2101–2114. Scholar
  33. 33.
    Frank J, Sinclair S, Hogg-Johnson S, Shannon H, Bombardier C, Beaton D, Cole D. Preventing disability from work-related low-back pain: new evidence gives new hope—if we can just get all the players onside. Can Med Assoc. 1998;158(12):1625–1631.Google Scholar
  34. 34.
    Guzman J, Frank J, Stock S, Yassi A, Loisel P. Stakeholder views of return to work after occupational injury. In: Sullivan T, Frank J, editors. Preventing and managing disabling injury at work. New York: Taylor & Francis; 2003. p. 87–100.Google Scholar
  35. 35.
    Muenchberger H, Kendall E, Mills E. Creating successful rehabilitation partnerships between health professionals and employers. Int J Disabil Manag Res. 2006;1(1):10–20. Scholar
  36. 36.
    Callen JL, Alderton M, McIntosh J. Evaluation of electronic discharge summaries: a comparison of documentation in electronic and handwritten discharge summaries. Int J Med Inf. 2008;77(9):613–620. Scholar
  37. 37.
    Callen J, Paoloni R, Li J, Stewart M, Gibson K, Georgiou A, Braithwaite J, Westbrook J. Perceptions of the effect of information and communication technology on the quality of care delivered in emergency departments: a cross-site qualitative study. Ann Emerg Med. 2012;61(2):131–144. Scholar
  38. 38.
    McAlearney AS, Schweikhart SB, Medow MA. Doctor’s experience with handheld computers in clinical practice: qualitative study. BMJ 2004;328(7449):1–5. Scholar
  39. 39.
    Petrakaki D, Waring J, Barber N. Technological affordances of risk and blame: the case of the electronic prescription service in England. Soc Health Illn. 2014;36(5):703–718. Scholar
  40. 40.
    Walter Z, Lopez MS. Physician acceptance of information technologies: role of perceived threat to professional autonomy. Decis Support Syst. 2008;46(1):206–215. Scholar
  41. 41.
    Fichman RG. Going beyond the dominant paradigm for information technology innovation research: emerging concepts and methods. J Assoc Inf Syst. 2004;5(8):314–355.Google Scholar
  42. 42.
    Sezgin E, Yıldırım SO. A literature review of attitudes of health professionals towards health information systems: from e-health to m-health. Proced Technol. 2014;16:1317–1326. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyTrent UniversityPeterboroughCanada

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