Improving the success of complex technology-supported change: digitisation and empirical testing of the NASSS-CAT tools University of Oxford

This Evidence into Practice project by the University of Oxford involved the production of a set of practical digital tools to support the implementation and evaluation of digital health projects, such as virtual consulting.

Health technology projects are complex and characterised by multiple interdependencies. The NASSS (non-adoption, abandonment and challenges to scale-up, spread, sustainability) framework allows researchers to surface and explain the complexity of technology-supported change. It consists of seven domains: the condition or illness, the technology, the value proposition, the adopter system, the organisation(s), the wider system, and emergence over time.

Building on the NASSS framework, the project team had developed a practical complexity assessment toolkit (NASSS-CAT) that can be used for different purposes, for example when deciding to invest in a technology, to guide project management or to evaluate implementation success. This project involved converting these tools to a digital format, to enhance usability and make it easier for people to use them collaboratively.

The team worked with a non-profit co-design and digital inclusion agency to carry out needs assessment, technical prototyping, iterative testing and refinement of the tools. Four co-design workshops were held virtually, focusing on journey mapping and identification of core user needs.

The tools have been developed as online spreadsheets that work across Google Suite and Microsoft Office 365 to allow contribution from distributed teams. They are open access and in two formats: 1) the eNASSS-CAT complexity toolkit which helps guide thinking around complexity in innovation projects; and 2) the eNASSS-CAT project tool to assess, monitor, reduce and respond to complexity in innovation projects over time.

An online community of NASSS-CAT users is being established, where users can share examples of good practice and troubleshoot any issues.

The project team is currently working with a team from the Netherlands that is replicating the NASSS framework and tools for the Dutch context.

Contact details

For more information, please contact Professor Trisha Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford.