Introduction:

Real-world optimisation of patient care using digital care depends on more than deploying technology. It requires understanding the contextual, relational, and practical challenges faced by frontline clinicians implementing these tools. As frontline clinicians directly witness patient needs and digital mismatches, their insights reveal why certain digital interventions fail to translate into meaningful improvements. This presentation shows how frontline clinicial innovators navigate the challenges of integrating digital tools into the provision of healthcare.

Methods:

The analysis is based on six qualitative case studies of frontline clinical innovators who led the implementation of digital interventions in clinical contexts. These frontline clinical innovators included an occupational therapist, a midwife, a speech and language therapist, two primary care managers, and a consultant neurologist. The digital tools were deployed in maternity care, primary care, neurology, occupational therapy, speech and language therapy, and community services. All data were collected post-implementation, following each innovator’s engagement and funding through the HSE Spark innovation programme. An inductive cross-case thematic analysis has been used to identify common themes across case studies.

Results:

Across the case studies , four shared themes emerged: frontline innovators identified needs through direct experience of service gaps; implementation exposed substantial organisational and technological barriers, particularly around governance, procurement, and IT; all digital tools required ongoing adaptation to align with patient needs and clinical workflows; and digital projects demanded significant relational and coordination work beyond clinicians’ usual roles. These themes illustrate why initial enthusiasm often declined as the practical realities of implementation became clear.

Conclusions:

Digital innovation is critical to the optimisation of healthcare. Therefore, understanding barriers and what needs to be changed to enable innovation in this space is critical. While based on six in-depth cases and therefore limited in breadth, our study on frontline clinicians offers essential insights into barriers to effective, equitable digital health adoption.