Good Practice in the Implementation of Digital Social Care Records: A Rapid Scoping Review (Preprint)

BACKGROUND In the past decade, there has been a rise in the use of digital or electronic records in social care worldwide, capturing information key to service delivery. With the COVID-19 pandemic, the increased need for digital services further accelerated digitisation in health and social care. For example, the UK government created a fund specifically for adult social care providers to adopt digital social care records. These rapid developments offer valuable learning opportunities about digital care record implementation in adult social care settings. OBJECTIVE This rapid scoping review aimed to understand what is known about the implementation of digital social care records in adult social care and how implementation varies across use cases, settings, and broader contexts. METHODS The scoping review methodology was guided by Arksey and O’Malley and refined by Levac et al and the Joanna Briggs Institute. Following Tricco et al, some amendments were made to enable a rapid review. We conducted comprehensive searches based on the concepts of Digital Care Records, Social Care, and Interoperability in MEDLINE, EmCare, Web of Science Core Collection, HMIC Health Management Information Consortium, Social Policy and Practice, and Social Services Abstracts. Studies were limited to those published between 2018 and 2023 in English. One reviewer screened titles and abstracts, while two reviewers extracted data. Qualitative content analysis was conducted on the included studies, mapping findings against Greenhalgh et al’s NASSS (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) framework. RESULTS Our search identified 2499 references. After title and abstract screening, 71 records were selected for full-text review, resulting in 31 references from 29 studies. Studies originated from 11 countries (including one multi-country), with the UK being the most represented (n=10). Studies were most often undertaken in nursing homes/facilities (n=7) with older people as the target population (n=6). Health records were the most investigated record type (n=12). We identified 45 facilitators and 102 barriers to digital care record implementation across 28 studies, spanning six of the seven NASSS framework domains and aligning with five overarching themes that require greater active management with respect to implementation. Intended or actual implementation outcomes were reported in 17 studies. CONCLUSIONS Findings suggest implementing digital care records is particularly complex due to a lack of consensus on what digital care records and expected outcomes and impacts should look like. The literature often lacks clear definitions and robust study designs. To be successful, implementation should consider complexity, while studies should utilise robust frameworks and mixed methods or quantitative designs where appropriate. Future research should consider defining the target population, gathering data on carer/service user experiences, and focusing on digital care records specifically being used in social care.