Abstract
BackgroundHealth care organizations are increasingly working with eHealth. However, the integration of eHealth into regular health care is challenging. It requires organizations to change the way they work and their structure and care processes to be adapted to ensure that eHealth supports the attainment of the desired outcomes.ObjectiveThe aims of this study are to investigate whether there are identifiable indicators in the structure, process, and outcome categories that are related to the successful integration of eHealth in regular health care, as well as to investigate which indicators of structure and process are related to outcome indicators.MethodsA systematic literature review was conducted using the Donabedian Structure-Process-Outcome (SPO) framework to identify indicators that are related to the integration of eHealth into health care organizations. Data extraction sheets were designed to provide an overview of the study characteristics, eHealth characteristics, and indicators. The extracted indicators were organized into themes and subthemes of the structure, process, and outcome categories.ResultsEleven studies were included, covering a variety of study designs, diseases, and eHealth tools. All studies identified structure, process, and outcome indicators that were potentially related to the integration of eHealth. The number of indicators found in the structure, process, and outcome categories was 175, 84, and 88, respectively. The themes with the most-noted indicators and their mutual interaction were inner setting (51 indicators, 16 interactions), care receiver (40 indicators, 11 interactions), and technology (38 indicators, 12 interactions)—all within the structure category; health care actions (38 indicators, 15 interactions) within the process category; and efficiency (30 indicators, 15 interactions) within the outcome category. In-depth examination identified four most-reported indicators, namely “deployment of human resources” (n=11), in the inner setting theme within the structure category; “ease of use” (n=16) and “technical issue” (n=10), both in the technology theme within the structure category; and “health logistics” (n=26), in the efficiency theme within the outcome category.ConclusionsThree principles are important for the successful integration of eHealth into health care. First, the role of the care receiver needs to be incorporated into the organizational structure and daily care process. Second, the technology must be well attuned to the organizational structure and daily care process. Third, the deployment of human resources to the daily care processes needs to be aligned with the desired end results. Not adhering to these points could negatively affect the organization, daily process, or the end results.
Highlights
Health care is changing, whereby patient empowerment, democratization of the internet, and an increasing burden on health care professionals play influential roles [1,2,3]
Three principles are important for the successful integration of eHealth into health care
The role of the care receiver needs to be incorporated into the organizational structure and daily care process
Summary
Whereby patient empowerment, democratization of the internet, and an increasing burden on health care professionals play influential roles [1,2,3]. In line with these trends, innovations such as eHealth are required to maintain high quality of care [4,5,6]. EHealth is more than a technology; it is another way of working and thinking and requires a change in attitude, which goes beyond the boundaries of a local health care organization [9,10]. It requires organizations to change the way they work and their structure and care processes to be adapted to ensure that eHealth supports the attainment of the desired outcomes
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