E-health Implementation Research Articles

Critical Environmental Factors that Affects the Implementation of Ehealth, Kenya

Information technology is used to offer Health services, the use of computers in health is referred to as eHealth. The benefits of using eHealth is enormous, however people have not appreciated it fully because of problematic factors associated with its adoption and implementation. The main objective of the study was to investigate the environmental factors that influences the adoption and implementation of eHealth in Kenya. The study was guided by technology organization and environmental framework (TOE) as the base that informed it. This study used quantitative approach methods. The quantitative research used the deductive research approach. This was achieved by using primary research where organized questionnaire was deployed for the interaction with primary research responded. The respondents were individuals or experts with knowledge of eHealth, ICT in health care service provider’s facilities at the county referral hospital and other health facilities in Kakamega county in Kenya. The results suggest that there is a significant statistical relationship between the environmental sub factors and decision to adopt and implement eHealth technology. The findings advocate that for adoption and implementation of the eHealth technology do not just rely on technical expertise to evaluate the technology but also evaluate the environmental factors of the organization. This study mutually supports and contrasts previous findings providing new insights and avenues for future study.

E-Health Implementation in Kenya : Current Position

Health care systems face many challenges both in developed and developing countries like Kenya. EHealth, which is the application of ICT, has turned out to be a remedy for most of these problems. In this paper, the researcher looked at what E-health is and why EHealth in Kenya has trailed behind compared to other industries like banking and the education sector. The study was guided by Actor Network Theory (ANT). The researcher used literature review as a methodology for the study. The key EHealth solutions that have been adopted and implemented in Kenya were identified and the status of e-health in Kenya was also identified. The study also looked at the environment provided by Kenya for e-health. Some of the policies put in place for e-health implementation and challenges facing e-health in Kenya were also highlighted. And it was found out that EHealth is still at the infancy stage in the country.

Barriers and Supports in eHealth Implementation among People with Chronic Cardiovascular Ailments: Integrative Review.

eHealth interventions use information technology to provide attention to patients with chronic cardiovascular conditions, thereby supporting their self-management abilities. Objective: Identify barriers and aids to the implementation of eHealth interventions in people with chronic cardiovascular conditions from the perspectives of users, health professionals and institutions. Method: An integrative database review of WoS, Scopus, PubMed and Scielo of publications between 2016 and 2020 reporting eHealth interventions in people with chronic cardiovascular diseases. Keywords used were eHealth and chronic disease. Following inclusion and exclusion criteria application, 14 articles were identified. Results: Barriers and aids were identified from the viewpoints of users, health professionals and health institutions. Some notable barriers include users’ age and low technological literacy, perceived depersonalization in attention, limitations in technology access and usability, and associated costs. Aids included digital education and support from significant others. Conclusions: eHealth interventions are an alternative with wide potentiality for chronic disease management; however, their implementation must be actively managed.

Digital tools/eHealth to support CKD self-management: A qualitative study of perceptions, attitudes and needs of patients and health care professionals in China

BackgroundA growing body of evidence supports the potential effectiveness of electronic health (eHealth) self-management interventions in improving disease self-management skills and health outcomes of patients suffering from chronic kidney disease (CKD). However, current research on CKD eHealth self-management interventions has almost exclusively focused on high-income, western countries. ObjectiveTo inform the adaptation of a tailored eHealth self-management intervention for patients with CKD in China based on the Dutch Medical Dashboard (MD) intervention, we examined the perceptions, attitudes and needs of Chinese patients with CKD and health care professionals (HCPs) towards eHealth based (self-management) interventions in general and the Dutch MD intervention in specific. MethodsWe conducted a basic interpretive, cross-sectional qualitative study comprising semi-structured interviews with 11 patients with CKD and 10 HCPs, and 2 focus group discussions with 9 patients with CKD. This study was conducted in the First Affiliated Hospital of Zhengzhou University in China. Data collection continued until data saturation was reached. All data were transcribed verbatim and analyzed using a framework approach. ResultsThree themes emerged: (1) experience with eHealth in CKD (self-management), (2) needs for supporting CKD self-management with the use of eHealth, and (3) adaptation and implementation of the Dutch MD intervention in China. Both patients and HCPs had experience with and solely mentioned eHealth to ‘inform, monitor and track’ as potentially relevant interventions to support CKD self-management, not those to support ‘interaction’ and ‘data utilization’. Factors reported to influence the implementation of CKD eHealth self-management interventions included information barriers (i.e. quality and consistency of the disease-related information obtained via eHealth), perceived trustworthiness and safety of eHealth sources, clinical compatibility and complexity of eHealth, time constraints and eHealth literacy. Moreover, patients and HCPs expressed that eHealth interventions should support CKD self-management by improving the access to reliable and relevant disease related knowledge and optimizing the timeliness and quality of patient and HCPs interactions. Finally, suggestions to adaptation and implementation of the Dutch MD intervention in China were mainly related to improving the intervention functionalities and content of MD such as addressing the complexity of the platform and compatibility with HCPs’ workflows. ConclusionsThe identified perceptions, attitudes and needs towards eHealth self-management interventions in Chinese settings should be considered by researchers and intervention developers to adapt a tailored eHealth self-management intervention for patients with CKD in China. In more detail, future research needs to engage in co-creation processes with vulnerable groups during eHealth development and implementation, increase eHealth literacy and credibility of eHealth (information resource), ensure eHealth to be easy to use and well-integrated into HCPs’ workflows.

Culturally Safe eHealth Interventions With Aboriginal and Torres Strait Islander People: Protocol for a Best Practice Framework.

BackgroundThere is growing global evidence on the adoption and effectiveness of eHealth (including mobile health and telehealth) by First Nation peoples including Aboriginal and Torres Strait Islander people. Although there are frameworks to guide eHealth development, implementation, and evaluation, it is unknown whether they adequately encapsulate the health, cultural, and community-related priorities of Aboriginal and Torres Strait Islander people.ObjectiveThe aim of this research program is to prepare a best practice framework that will guide the co-design, implementation, and evaluation of culturally safe eHealth interventions within existing models of health care for Aboriginal and Torres Strait Islander people. The framework will be a synthesis of evidence that represents best practices in eHealth, as determined by Aboriginal and Torres Strait Islander people.MethodsResearch activities to develop the best practice framework will occur in stepped but overlapping qualitative research phases with governance from an existing multiagency research collaboration (the Collaboration). The research protocol has been informed by key research frameworks such as the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and Developers of Health Research Reporting Guidelines. The seven phases of research will include the following: systematic literature review, scoping review, theme development, theme consultation, Delphi processes for expert reviews, and dissemination.ResultsMembers of the Collaboration conceived this research program in August 2020, and a draft was produced in June 2021 with subsequent funding obtained in July 2021. The Collaboration approved the protocol in December 2021. Results for several research phases of the best practice framework development are expected by January 2023, commencing with the systematic literature review and the scoping review.ConclusionsThe research program outlined in this protocol is a timely response to the growing number of eHealth interventions with Aboriginal and Torres Strait Islander people. A best practice framework is needed to guide the rigorous development and evaluation of eHealth innovations to promote genuine co-design and ensure cultural safety and clinical effectiveness for Aboriginal and Torres Strait Islander people.International Registered Report Identifier (IRRID)DERR1-10.2196/34904

A quantitative study exploring the acceptance of the eHealth model for mental wellness among digital workers

eHealth makes use of information and communication technologies (ICT) to improve health. In the digital age, the use of eHealth applications and other health-related applications has gained popularity,particularlyduring theCOVID-19 pandemic. As a result of the pandemic, many uncertainties havearisen, causing stress andaffecting the mental health of many skilled workers in the digital industry, particularly in the ICT, computing, and creative media industries.eHealthapplicationshavethe potential to benefit people's health. As a prerequisite for effective implementation of eHealth for mental wellness (EHMW), this paper examines the acceptance of EHMW amongdigital workersin Malaysia. The objectives of this research are two-fold:1) To explore the acceptance of EHMW amongdigital workersin a localPremier Digital Tech Institution(PDTI), and 2)To explore how these talents' demographic profiles, mental health literacy and workplace wellness influence their acceptance of EHMW. Methods:This research surveyed41digital workerswho played vital roles in providing digital skills at a tertiary education level. Results:Mostrespondentsagreed that eHealthwas appropriate for managing mental wellness. Among the three eHealth domainsfor managing mental wellness, the acceptance level is the highest for the application domain of "interacting for health",with malerespondentsmore likely to accept the use ofEHMW. Conclusions:This small-scale survey could not fully examine theacceptance ofeHealth anditsusage patterns for mental wellness amongdigital workersin Malaysia. Future research will target moredigital workersin Malaysia.This research addresses the research gap ontheeHealth perspectives ofdigital workerson their acceptance,and the potential influence of demographic profiles, mental health literacy, and workplace wellness on EHMW's acceptance of digital health tools/platforms to promote their mental wellness.

Application of activity theory to examine the implementation of e-health in Namibia

ABSTRACT Despite the investment and efforts to improve the health systems through the e-health solution, systems and activities remain fragmented, which hamper service delivery. These challenges persist because either the factors that influence the implementation of the e-health solutions are not known or they remain speculative. Empirically, this study reveals the factors that influence the development of e-health solutions in the country. It is an interpretivist study in which the semi-structured interview technique was employed to collect data and relevant documents authored by different health stakeholders, such as Ministry of Health and Social Services (MoHSS), Office of the Prime Minister (OPM) and from public and private health facilities in the country were gathered. The activity theory (AT) underpins the study, meaning it guided the analysis, from which eight factors: (1) disparity, which affects transparency; (2) isolation; means that e-health solutions are currently stand-alone; (3) governance; which includes standardization, policies, and principles; (4) requirements that cover functions and technology specifications; (5) know-how; entails skillset and human capacity; (6) interoperability; exchange and information use between IT solutions; (7) synchronization of data and processes; and (8) heterogeneity were found to be the main influence on the implementation of e-health solutions in the country.

A comprehensive eHealth implementation guide constructed on a qualitative case study on barriers and facilitators of the digital care platform CMyLife

BackgroundSubstantial proliferation of eHealth has enabled a move in patient-centred cancer care from the traditional in-person care model to real-time, dynamic, and technology supported on-demand care. However, in general, the uptake of these innovations is low. Studies show that eHealth is helpful in providing patient empowerment through e.g. providing high quality and timely information, enabling self-monitoring and shared decision making, but dropout rates are high and guidance for optimal implementation is lacking.AimTo explore barriers to and facilitators for nationwide implementation and consolidation of CMyLife, a multi-component, patient-centred, digital care platform, and to construct a comprehensive implementation guide for launching digital care platforms in daily clinical practice.MethodsThe first qualitative case study of a digital care platform like CMyLife was performed including five focus group- and eighteen in-depth interviews with stakeholders. Data were collected using a semi-structured interview guide, based on the frameworks of Grol and Flottorp. Transcripts of the interviews were analysed and barriers and facilitators were identified and categorized according to the frameworks. An iterative process including participation of main stakeholders and using the CFIR-ERIC framework led to creating a comprehensive implementation guide for digital care platforms.ResultsIn total, 45 barriers and 41 facilitators were identified. Main barriers were lack of connectivity between information technology systems, changing role for both health care providers and patients, insufficient time and resources, doubts about privacy and security of data, and insufficient digital skills of users. Main facilitators mentioned were motivating patients and health care providers by clarifying the added value of use of a digital care platform, clear business case with vision, demonstrating (cost) effectiveness, using an implementation guide, and educating patients and health care providers about how to use CMyLife. Based on these barriers and facilitators a clear and comprehensive implementation guide was developed for digital care platforms.ConclusionSeveral barriers to and facilitators for implementation were identified, a clear overview was presented, and a unique comprehensive implementation guide was developed for launching future digital care platforms in daily clinical practice. The next step is to validate the implementation guide in other (oncological) diseases.

E-Health Application, Implementation and Challenges: A Literature Review

Abstract Background: World Health Organization, through a partnership with European Union, encourages the implementation e-health systems. E-health is a relatively old concept that is upgraded with new technologies and is directed toward monitoring different health conditions with the help of technology. Objectives: This paper’s main objective is to demonstrate e-health application possibilities in today’s healthcare organisations and its impact on the quality of provided health care services using ISO/TR 14639 Health informatics Capacity-based eHealth architecture roadmap. Methods/Approach: In this paper, we used the e-health architecture model for literature review based on individual areas of the model - ICT infrastructure, e-health infastructure, health process domain components, governance and national ownership. Results: Research confirms that new technologies have a favourable and significant impact on population health; however, more developed countries show a better understanding of the concept and are moving towards implementing laws and regulations for e-health practices. Conclusions: Through this research, we concluded that new technology significantly impacts health, but this impact is limited due to different development of countries. That is why it is very important to develop health literacy, which is the ability to comprehend, access, retrieve, and use health information or health services.

Strategies for Implementing Occupational eMental Health Interventions: Scoping Review.

BackgroundThe implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers.ObjectiveThe objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures.MethodsA scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research.ResultsA total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions.ConclusionsThis scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review’s findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.

"Get Used to the Fact That Some of the Care Is Really Going to Take Place in a Different Way": General Practitioners' Experiences with E-Health during the COVID-19 Pandemic.

The first outbreak of the COVID-19 pandemic led to the introduction of the more extensive use of e-health in Dutch general practices. The objective of this study was to investigate the experiences of general practitioners (GPs) regarding this change. In addition, the necessary conditions for e-health technology to be of added value to general practices were explored. In April 2020, 30 GPs were recruited for in-depth interviews via a web survey which contained questions regarding the use of e-health during the first wave of the pandemic. While most GPs intend to keep using e-health applications more extensively than before the pandemic, the actual use of e-health depends on several factors, including the characteristics of the application’s users. The following conditions for successful and sustainable implementation of e-health were identified: (1) integration of e-health technology in the organization of GP care, (2) sufficient user-friendliness of applications as well as digital skills of professionals and patients, and (3) adequate technological and financial support of e-health services. GPs clearly recognize the benefits of using e-health, and most GPs intend to keep using e-health applications more extensively than before the pandemic. However, improvements are needed to allow widespread and sustainable adoption of e-health technology in general practices.

A quantitative study exploring the acceptance of the eHealth model for mental wellness among digital workers

Background: eHealth makes use of information and communication technologies (ICT) to improve health. In the digital age, the use of eHealth applications and other health-related applications has gained popularity, particularly during the COVID-19 pandemic. As a result of the pandemic, many uncertainties have arisen, causing stress and affecting the mental health of many skilled workers in the digital industry, particularly in the ICT, computing, and creative media industries. eHealth applications have the potential to benefit people's health. As a prerequisite for effective implementation of eHealth for mental wellness (EHMW), this paper examines the acceptance of EHMW among digital workers in Malaysia. The objectives of this research are two-fold: 1) To explore the acceptance of EHMW among digital workers in a local Premier Digital Tech Institution (PDTI), and 2) To explore how these talents' demographic profiles, mental health literacy and workplace wellness influence their acceptance of EHMW. Methods: This research surveyed 41 digital workers who played vital roles in providing digital skills at a tertiary education level. Results: Most respondents agreed that eHealth was appropriate for managing mental wellness. Among the three eHealth domains for managing mental wellness, the acceptance level is the highest for the application domain of "interacting for health", with male respondents more likely to accept the use of EHMW. Conclusions: This small-scale survey could not fully examine the acceptance of eHealth and its usage patterns for mental wellness among digital workers in Malaysia. Future research will target more digital workers in Malaysia. This research addresses the research gap on the eHealth perspectives of digital workers on their acceptance, and the potential influence of demographic profiles, mental health literacy, and workplace wellness on EHMW's acceptance of digital health tools/platforms to promote their mental wellness.

Placing equity at the heart of eHealth implementation: a qualitative pilot study

BackgroundThere is a growing urgency to tackle issues of equity and justice in the implementation of eHealth technologies.MethodsQualitative interviews were conducted with 19 multidisciplinary health professionals to explore the implementation and uptake of eHealth technologies in practice. The aim of this article was to examine in more detail issues of equity and justice in the implementation and uptake of eHealth technologies in practice. Results were analysed using Braun and Clarke’s six-step reflexive thematic analysis approach.ResultsNancy Fraser’s concept of social justice is introduced as a novel framework for inquiry into the implementation of digital health services. Health professionals reported that eHealth offered their clients a greater sense of safety, convenience, and flexibility, allowing them to determine the nature and pace of their healthcare, and giving them more control over their treatment and recovery. However, they also expressed concerns about the use of eHealth with clients whose home environment is unsafe. Application of Fraser’s framework revealed that eHealth technologies may not always provide a secure clinical space in which the voices of vulnerable clients can be recognised and heard. It also highlighted critical systemic and cultural barriers that hinder the representation of clients’ voices in the decision to use eHealth technologies and perpetuate inequalities in the distribution of eHealth services.ConclusionsTo facilitate broad participation, eHealth tools need to be adaptable to the needs and circumstances of diverse groups. Future implementation science efforts must also be directed at identifying and addressing the underlying structures that hinder equitable recognition, representation, and distribution in the implementation of eHealth resources.

EHealth, telehealth, and telemedicine in the management of the COVID-19 pandemic and beyond: Lessons learned and future perspectives.

In this article, we discuss evidence supporting the effective implementation of eHealth, telehealth, and telemedicine during the coronavirus disease 2019 pandemic, with a view towards its permanent future integration in healthcare. We performed a literature search for articles describing the use of telehealth/ telemedicine in the pandemic context using five databases. The articles selected describe the use of telemedicine as its advantages in terms of practicality and cost-effectiveness. This synthesis of articles is applicable to high-, middle- and low-income countries. Some of the notable benefits include breaking down geographical and time barriers, reducing waiting lists and crowding in healthcare facilities, and saving on national healthcare expenditure. However, there are a number of difficulties with the widespread implementation of telemedicine services that mainly relate to bureaucratic and regulatory concerns. Moreover, it is also important to make healthcare professionals and providers aware of the limits of this tool to avoid potential cases of negligence. Patients in turn will have to be made aware of and be educated on the use of this new healthcare modality before it is accepted by them. In the current socio-economic climate, it is therefore essential to implement a telehealth model aimed at efficiency and continuity of healthcare, as well as leading to an improvement in the quality of life of patients, whilst optimising existing resources and reducing costs. In that regard, the adoption of eHealth, telehealth, and telemedicine services should be considered highly timely, despite current existing limitations.

Improving the Development and Implementation of Audit and Feedback Systems to Support Health Care Workers in Limiting Antimicrobial Resistance in the Hospital: Scoping Review.

BackgroundFor eHealth technologies in general and audit and feedback (AF) systems specifically, integrating interdisciplinary theoretical underpinnings is essential, as it increases the likelihood of achieving desired outcomes by ensuring a fit among eHealth technology, stakeholders, and their context. In addition, reporting on the development and implementation process of AF systems, including substantiations of choices, enables the identification of best practices and accumulation of knowledge across studies but is often not elaborated on in publications.ObjectiveThis scoping review aims to provide insights into the development and implementation strategies for AF systems for a real-world problem that threatens modern health care—antimicrobial resistance—and provide an interdisciplinary conceptual framework that can serve as a checklist and guidance for making informed choices in the development and implementation of future AF systems.MethodsA scoping review was conducted by querying PubMed, Scopus, Web of Science, IEEE Xplore Digital Library, and Embase (≥2010) for studies describing either the development or implementation process, or both, of an AF system for antimicrobial resistance or infections in hospitals. Studies reporting only on effectiveness or impact were excluded. A total of 3 independent reviewers performed the study selection, and 2 reviewers constructed the conceptual framework through the axial and selective coding of often-used theories, models, and frameworks (TMFs) from the literature on AF and eHealth development and implementation. Subsequently, the conceptual framework was used for the systematic extraction and interpretation of the studies’ descriptions of AF systems and their development and implementation.ResultsThe search resulted in 2125 studies that were screened for eligibility, of which 12 (0.56%); 2012-2020) were included. These studies described the development and implementation processes heterogeneously in terms of study aims, study targets, target groups, methods, and theoretical underpinnings. Few studies have explicitly explained how choices for the development and implementation of AF systems were substantiated by the TMFs. The conceptual framework provided insights into what is reported on the development and implementation process and revealed underreported AF system constructs (eg, AF system design; engagement with the AF system; and comparison, goal setting, and action planning) and development and implementation (eg, champions) constructs.ConclusionsThis scoping review showed the current heterogeneous reporting of AF systems and their development and implementation processes and exemplified how interdisciplinary TMFs can (and should) be balanced in a conceptual framework to capture relevant AF systems and development and implementation constructs. Thereby, it provides a concrete checklist and overall guidance that supports the professionalization and harmonization of AF system development and implementation. For the development and implementation of future AF systems and other eHealth technologies, researchers and health care workers should be supported in selecting and integrating TMFs into their development and implementation process and encouraged to explicitly report on theoretical underpinnings and the substantiation of choices.

Technology and Sexual Health: A discussion on e-Health tools for the promotion of sexual and reproductive care

Along the present discussion we debate the implementation of e-Health in context of sexual health using information on various recent digital tools. Considering the information collected, there are various challenges that come with such new technologies, but accessibility, low costs and several positive outcomes seem to count for the further development and integration of e-Health in sexual health care. Furthermore, promoting a safe and positive sex life among various populations, even the ones harder to access, may promote gender equality, socioeconomic disparities and literacy on sexuality.

Implementation of eHealth to Support Assessment and Decision-making for Residents With Dementia in Long-term Care: Systematic Review.

BackgroundAs dementia progresses, symptoms and concerns increase, causing considerable distress for the person and their caregiver. The integration of care between care homes and health care services is vital to meet increasing care needs and maintain quality of life. However, care home access to high-quality health care is inequitable. eHealth can facilitate this by supporting remote specialist input on care processes, such as clinical assessment and decision-making, and streamlining care on site. How to best implement eHealth in the care home setting is unclear.ObjectiveThe aim of this review was to identify the key factors that influence the implementation of eHealth for people living with dementia in long-term care.MethodsA systematic search of Embase, PsycINFO, MEDLINE, and CINAHL was conducted to identify studies published between 2000 and 2020. Studies were eligible if they focused on eHealth interventions to improve treatment and care assessment or decision-making for residents with dementia in care homes. Data were thematically analyzed and deductively mapped onto the 6 constructs of the adapted Consolidated Framework for Implementation Research (CFIR). The results are presented as a narrative synthesis.ResultsA total of 29 studies were included, focusing on a variety of eHealth interventions, including remote video consultations and clinical decision support tools. Key factors that influenced eHealth implementation were identified across all 6 constructs of the CFIR. Most concerned the inner setting construct on requirements for implementation in the care home, such as providing a conducive learning climate, engaged leadership, and sufficient training and resources. A total of 4 novel subconstructs were identified to inform the implementation requirements to meet resident needs and engage end users.ConclusionsImplementing eHealth in care homes for people with dementia is multifactorial and complex, involving interaction between residents, staff, and organizations. It requires an emphasis on the needs of residents and the engagement of end users in the implementation process. A novel conceptual model of the key factors was developed and translated into 18 practical recommendations on the implementation of eHealth in long-term care to guide implementers or innovators in care homes. Successful implementation of eHealth is required to maximize uptake and drive improvements in integrated health and social care.

Perspectives of Policy Makers and Service Users Concerning the Implementation of eHealth in Sweden: Interview Study.

BackgroundIncreasing life spans of populations and a growing demand for more advanced care make effective and cost-efficient provision of health care necessary. eHealth technology is often proposed, although research on barriers to and facilitators of the implementation of eHealth technology is still scarce and fragmented.ObjectiveThe aim of this study is to explore the perceptions concerning barriers to and facilitators of the implementation of eHealth among policy makers and service users and explore the ways in which their perceptions converge and differ.MethodsThis study used interview data from policy makers at different levels of health care (n=7) and service users enrolled in eHealth interventions (n=25). The analysis included separate qualitative content analyses for the 2 groups and then a second qualitative content analysis to explore differences and commonalities.ResultsImplementation barriers perceived by policy makers were that not all service users benefit from eHealth and that there is uncertainty about the impact of eHealth on the work of health care professionals. Policy makers also perceived political decision-making as complex; this included problems related to provision of technical infrastructure and lack of extra resources for health care digitalization. Facilitators were policy makers’ conviction that eHealth is what citizens want, their belief in eHealth solutions as beneficial for health care practice, and their belief in the importance of health care digitalization. Barriers for service users comprised capability limitations and varied preferences of service users and a mismatch of technology with user needs, lack of data protection, and their perception of eHealth as being more time consuming. Facilitators for service users were eHealth technology design and match with their skill set, personal feedback and staff support, a sense of privacy, a credible sender, and flexible use of time.There were several commonalities between the 2 stakeholder groups. Facilitators for both groups were the strong impetus toward technology adoption in society and expectations of time flexibility. Both groups perceived barriers in the difficulties of tailoring eHealth, and both groups expressed uncertainty about the care burden distribution. There were also differences: policy makers perceived that their decision-making was very complex and that resources for implementation were limited. Service users highlighted their need to feel that their digital data were protected and that they needed to trust the eHealth sender.ConclusionsPerceptions about barriers to and facilitators of eHealth implementation varied among stakeholders in different parts of the health care system. The study points to the need to reach an enhanced mutual understanding of priorities and overcome challenges at both the micro and macro levels of the health care system. More well-balanced decisions at the policy-maker level may lead to more effective and sustainable development and future implementation of eHealth.

Best Practices and Lessons Learned for Action Research in eHealth Design and Implementation: Literature Review.

BackgroundAction research (AR) is an established research framework to introduce change in a community following a cyclical approach and involving stakeholders as coresearchers in the process. In recent years, it has also been used for eHealth development. However, little is known about the best practices and lessons learned from using AR for eHealth development.ObjectiveThis literature review aims to provide more knowledge on the best practices and lessons learned from eHealth AR studies. Additionally, an overview of the context in which AR eHealth studies take place is given.MethodsA semisystematic review of 44 papers reporting on 40 different AR projects was conducted to identify the best practices and lessons learned in the research studies while accounting for the particular contextual setting and used AR approach.ResultsRecommendations include paying attention to the training of stakeholders’ academic skills, as well as the various roles and tasks of action researchers. The studies also highlight the need for constant reflection and accessible dissemination suiting the target group.ConclusionsThis literature review identified room for improvements regarding communicating and specifying the particular AR definition and applied approach.

A quantitative study exploringtheacceptance of theeHealthmodel formentalwellness amongdigital workers.

eHealth makes use of information and communication technologies (ICT) to improve health. In the digital age, the use of eHealth applications and other health-related applications has gained popularity,particularlyduring theCOVID-19 pandemic. As a result of the pandemic, many uncertainties havearisen, causing stress andaffecting the mental health of many skilled workers in the digital industry, particularly in the ICT, computing, and creative media industries.eHealthapplicationshavethe potential to benefit people's health. As a prerequisite for effective implementation of eHealth for mental wellness (EHMW), this paper examines the acceptance of EHMW amongdigital workersin Malaysia. The objectives of this research are two-fold:1) To explore the acceptance of EHMW amongdigital workersin a localPremier Digital Tech Institution(PDTI), and 2)To explore how these talents' demographic profiles, mental health literacy and workplace wellness influence their acceptance of EHMW. Methods:This research surveyed41digital workerswho played vital roles in providing digital skills at a tertiary education level. Results:Mostrespondentsagreed that eHealthwas appropriate for managing mental wellness. Among the three eHealth domainsfor managing mental wellness, the acceptance level is the highest for the application domain of "interacting for health",with malerespondentsmore likely to accept the use ofEHMW. Conclusions:This small-scale survey could not fully examine theacceptance ofeHealth anditsusage patterns for mental wellness amongdigital workersin Malaysia. Future research will target moredigital workersin Malaysia.This research addresses the research gap ontheeHealth perspectives ofdigital workerson their acceptance,and the potential influence of demographic profiles, mental health literacy, and workplace wellness on EHMW's acceptance of digital health tools/platforms to promote their mental wellness.