Beyond the Go-Live: Negotiating the "Perfect Fit" in Digital Implementation
Tracks
Room 3
| Wednesday, December 2, 2026 |
| 12:10 PM - 12:30 PM |
| Concurrent Room 2 |
Overview
Chisom Victor Ukaegbu
Speaker
Mr Chisom Victor Ukaegbu
Beyond the Go-Live: Negotiating the "Perfect Fit" in Digital Implementation
Abstract
Aim: Despite sustained investment, digital transformation in complex healthcare environments often yields unintended consequences due to a mismatch between technology and clinical workflows. Aligning with the theme of "The Perfect Fit", this study investigates how interacting organisational, technical, and relational mechanisms shape the implementation of Electronic Prescription and Medicines Administration (EPMA) systems in NHS Wales. The aim is to understand how people actively negotiate and sustain the fit between digital health systems and end-users over time.
Methods: The study employs a longitudinal sequential mixed-methods design during the national rollout of EPMA across NHS Wales. Initial phases utilised a theory-informed scoping review to develop a conceptual framework. This will be followed by semi-structured qualitative interviews with clinical and non-clinical stakeholders to trace implementation narratives. Subsequent phases will validate findings using a cross-site survey and analysing organisational performance metrics, including prescribing errors, workflow turnaround times and similar metrics.
Results: Preliminary findings from the scoping review identified 11 interacting mechanisms synthesised into four domains: people and identity, workflow and technology alignment, organisational readiness, and longitudinal learning. Evidence suggests that achieving a perfect fit is not driven by static, individual-level technology acceptance but by continuous local adaptation and informal workflow redesign. The successful embedding of EPMA relies heavily on mitigating cognitive burden and ensuring technology aligns with the reality of clinical practice.
Discussion/Implications: The perfect fit in healthcare digital transformation is an ongoing sociotechnical process rather than a plug-and-play outcome. By shifting the analytical focus from passive adoption to dynamic interaction, this mechanism-based framework provides Human Factors and Ergonomics practitioners with actionable strategies to better align digital systems with hospital workflows. Ultimately, these insights will offer practical guidance for managing complex innovation programs to improve patient safety and clinical user experience.
Methods: The study employs a longitudinal sequential mixed-methods design during the national rollout of EPMA across NHS Wales. Initial phases utilised a theory-informed scoping review to develop a conceptual framework. This will be followed by semi-structured qualitative interviews with clinical and non-clinical stakeholders to trace implementation narratives. Subsequent phases will validate findings using a cross-site survey and analysing organisational performance metrics, including prescribing errors, workflow turnaround times and similar metrics.
Results: Preliminary findings from the scoping review identified 11 interacting mechanisms synthesised into four domains: people and identity, workflow and technology alignment, organisational readiness, and longitudinal learning. Evidence suggests that achieving a perfect fit is not driven by static, individual-level technology acceptance but by continuous local adaptation and informal workflow redesign. The successful embedding of EPMA relies heavily on mitigating cognitive burden and ensuring technology aligns with the reality of clinical practice.
Discussion/Implications: The perfect fit in healthcare digital transformation is an ongoing sociotechnical process rather than a plug-and-play outcome. By shifting the analytical focus from passive adoption to dynamic interaction, this mechanism-based framework provides Human Factors and Ergonomics practitioners with actionable strategies to better align digital systems with hospital workflows. Ultimately, these insights will offer practical guidance for managing complex innovation programs to improve patient safety and clinical user experience.
Biography
Chisom Victor Ukaegbu is a digital health researcher currently pursuing a fully funded PhD at Swansea University, supported by the Welsh Government through Digital Health and Care Wales (DHCW). His primary research investigates the longitudinal implementation of Electronic Prescription and Medicines Administration (EPMA) systems across NHS Wales. By employing sequential mixed-methods designs and sociotechnical frameworks, his work evaluates how complex healthcare organisations embed digital innovations, particularly Electronic Medicine Management Systems (EMMS) such as EPMA, focusing on improving patient safety, operational efficiency and staff experience.
Chisom holds an MSc in Global Health from City St George’s, University of London, where he was the sole recipient of the International Global Health Scholarship in 2023. His master’s research used an integrated mixed-methods systematic review to evaluate the role of digital mental health interventions in improving access to mental health services in sub-Saharan Africa. He also holds a bachelor's in pharmacy, which provided his foundational training in critical thinking, experimental design and statistical analysis.
Beyond his academic studies, Chisom has built a strong portfolio in applied health equity and public health research. As a research assistant for the Migrant Health Community Research Network (MHCRN) in London, he specialises in extensive literature synthesis, qualitative coding, and policy analysis. Previously, he served as a research, monitoring, and evaluation associate in Nigeria, where he applied both quantitative and qualitative methods to drive evidence-based health intervention evaluations.
Leveraging his clinical pharmacy background, Chisom’s core research expertise lies in healthcare implementation science, systematic data synthesis, and the critical evaluation of human-system interactions. His overarching academic goal is to translate sociotechnical theories into actionable strategies that optimise digital transformation and improve patient safety, efficiency and staff experience in hospital settings.
