Implementation Of eHealth Services Research Articles

To be or not to be digital? A bibliometric analysis of adoption of eHealth services

PurposeThe purpose of this study is to introduce new tools to develop a more precise and focused bibliometric analysis on the field of digitalization in healthcare management. Furthermore, this study aims to provide an overview of the existing resources in healthcare management and education and other developing interdisciplinary fields.Design/methodology/approachThis work uses bibliometric analysis to conduct a comprehensive review to map the use of the unified theory of acceptance and use of technology (UTAUT) and the unified theory of acceptance and use of technology 2 (UTAUT2) research models in healthcare academic studies. Bibliometric studies are considered an important tool to evaluate research studies and to gain a comprehensive view of the state of the art.FindingsAlthough UTAUT dates to 2003, our bibliometric analysis reveals that only since 2016 has the model, together with UTAUT2 (2012), had relevant application in the literature. Nonetheless, studies have shown that UTAUT and UTAUT2 are particularly suitable for understanding the reasons that underlie the adoption and non-adoption choices of eHealth services. Further, this study highlights the lack of a multidisciplinary approach in the implementation of eHealth services. Equally significant is the fact that many studies have focused on the acceptance and the adoption of eHealth services by end users, whereas very few have focused on the level of acceptance of healthcare professionals.Originality/valueTo the best of the authors’ knowledge, this is the first study to conduct a bibliometric analysis of technology acceptance and adoption by using advanced tools that were conceived specifically for this purpose. In addition, the examination was not limited to a certain era and aimed to give a worldwide overview of eHealth service acceptance and adoption.

BPJS Patients Satisfaction Analysis Towards Service Quality of Public Health Center in Surabaya

Surabaya is a growing city and actively develope basic service innovations through Public Health Center (PHC) such as implementing E-Health services, BPJS p-care, including various quality health services and oriented in increasing patient, family, or public satisfaction in Surabaya. The purpose of the study was to identify the level of satisfaction of Badan Penyelenggara Jaminan Sosial (BPJS) and non-BPJS patients with the quality of health services at Manukan Kulon PHC. This research method was a cross-sectional study. The measuring satisfaction instrument used the patient satisfaction index (Customer Satisfaction Index (CSI)). Meanwhile, the satisfaction dimension used the SERVQUAL Principle by looking at the value of gap between expectation and reality from the aspects of responsiveness, tangibles, assurance, empathy, and reliability. The research sample was determined by simple random sampling and the total samples collected were 110 respondents (67 BPJS patients and 43 non-BPJS patients). The results showed that BPJS patients were more satisfied (CSI 83.9%) than non-BPJS patients (CSI 83.4%). Specifically, BPJS patients’ satisfaction dimension gap related to responsiveness is (0.3), tangibles (-0.3), assurance (0.9), empathy (0.6), and reliability (-1.0.) While non BPJS patients have a satisfaction gap value for responsiveness (- 0.1), tangibles (0.1), assurance (0.1), empathy (0.2), and reliability (0.1). This means that in general, BPJS and Non-BPJS patients are very satisfied with the health services of Manukan Kulon PHC. However, it is necessary to prioritize service improvement on the aspects of responsiveness, tangibles and reliability as expected by patients.

Stakeholders' Perspectives on eHealth Support in Colorectal Cancer Survivorship: Qualitative Interview Study.

BackgroundeHealth interventions may represent the way forward in following up patients with colorectal cancer (CRC) after hospital discharge to support them in coping with the illness, strengthen their self-management, and increase their quality of life. By involving end users of eHealth in cocreation processes when designing eHealth solutions, an acceptable and relevant product can be secured. Stakeholders’ perspectives could aid in closing the gap between research-developed products and the implementation of eHealth services in real-life scenarios.ObjectiveThis study aims to explore the views of patients with CRC, their informal caregivers, and health care professionals (HCPs) on information technology and the design of eHealth support in CRC care.MethodsA qualitative, explorative design was used to conduct 31 semistructured individual interviews with 41% (13/31) patients with CRC, 29% (9/31) informal caregivers, and 29% (9/31) HCPs recruited from the gastrosurgical ward of a university hospital in southwestern Norway. A semistructured interview guide was used for data collection, and the data were analyzed by systematic text condensation.ResultsParticipants described the diverse experiences of patients with CRC seeking web-based information. Age and digital competence were highlighted as influencers of the use of information technology. Patients rarely received advice from HCPs about relevant and secure websites containing information on CRC diagnosis and treatment. Features of desired eHealth interventions in following up patients with CRC were patient education, health monitoring, and communication with HCPs.ConclusionsSeveral elements affect the activities of patients with CRC seeking health information. Age, inexperience with computer technology, and lack of access to web-based health information may reduce the ability of patients with CRC to engage in decision-making processes regarding illness and treatment. An eHealth service for patients with CRC should comprise features for information, education, and support for self-management and should aim to be individually adapted to the patient’s age and digital competence. Involving end users of eHealth services is necessary to ensure high-quality tailored services that are perceived as user friendly and relevant to the end users.

EHealth Technology: What Do We Know and What do We Need to Learn

eHealth is the use of information and communication technologies for health. eHealth serves multiple utilization purposes for storage, exchange, and retrieval of digital data for administrative, clinical, educational and research purposes. The ultimate purpose of the eHealth use globally is to promote health for individuals efficiently and effectively [1]. A growing body of evidence reveals potential benefits of eHealth on delivery of health care that are cost-effective and responsive to patient’s needs without compromising the quality of service [2]. Systematic reviews revealed promising results on improvement of patient outcomes with implementation of eHealth services [3] especially with challenging behavioral lifestyle modifications such as improving medication adherence [4] physical activity [5] and HIV prevention [6] as well as addressing mental health [7]. With the continuous evolution of eHealth services, challenges to its application and utilization are on rise. Systematic review identified multiple challenges. First, stakeholders and systems users need to have enough training to use the eHealth technology effectively and optimally. Second, the robustness of the technology and its interoperability such as integrity of data and security concerns [8]. Third, capital and startup costs and maintenance can be too costly. Fourth, legal clarity and legal framework challenge relates to legal issues such as privacy [9]. Fifth, organizational context pertains to the environment where eHealth technology is utilized [10]. A critical focus on the emerging technologies currently provides the next context for the integration of eHealth data in every aspect of human activity. The Internet of Things will cause an unpredicted explosion in the delivery of directed custom-made eHealth services to human beings; and thus, the new generation of eHealth data movement will exploit this feature to its full potential. In a way the matching of eHealth services to human needs will incorporate the identification, distribution, and management of many machine-generated eHealth data. With the most documented challenges reported, what are the lessons learnt and how do we tackle them? Opportunities for confronting such challenges are proposed. Investment in advancing competencies of human resources in relation to information systems design and implementation as deemed crucial for optimal utilization of eHealth technology. Governments and national bodies should support eHealth technology to achieve its optimal purposes and become incorporated in health organizations. Researchers and clinicians also need to learn how to apply eHealth technology fully to extend their ability to study and influence health behavior as well as engage patients.

Pushing towards ehealth for iraqi hypertensives: an integrated class association rules into SECI model

<span lang="EN-GB">This paper highlights the barriers that have led to a delay in the implementation of E-Health services in Iraq. A new framework is proposed to improve the E-Health sector using a SECI model which describes how explicit and tacit knowledge is generated, transferred, and recreated in organizations through main stages (socialization, externalization, combination and internalization). Class association rules (CARs) is integrated to mine the SECI model by extracting related rules which correspond to the medical advice. The proposed framework (SECICAR) can be done through a web portal to assemble healthcare professionals, patients in one environment. SECICAR will be applied to the hypertension community to show that disease if left untreated, frequently leads to serious illnesses such as heart disease. The SECICAR aims to facilitate the dissemination of tacit knowledge, which is explicit to hypertensives, in the form of strategies, guidelines and best practices. The validation of the SECICAR results displays satisfactory accuracy and reliability. Heuristic evaluation was used to test the web portal, the participants stating that there were no major issues regarding its usability.</span>

Applying and Extending the FITT Framework to Identify the Challenges and Opportunities of Successful eHealth Services for Patient Self-Management: Qualitative Interview Study

BackgroundThe number of public eHealth services that support patient self-management is rapidly increasing. However, the implementation of these eHealth services for self-management has encountered challenges.ObjectiveThe purpose of this paper was to analyze the challenges and opportunities of implementing eHealth services for self-management by focusing on the fit between the technical solution and clinical use.MethodsWe performed in-depth interviews with 10 clinical project coordinators and managers who were responsible for developing and implementing various eHealth services for self-management interventions in five university hospitals in Finland. The results were analyzed using content analysis and open coding. The Fit between Individuals, Task, and Technology (FITT) framework was used to interpret the findings.ResultsThe implementation of self-management services involved many challenges related to technical problems, health professional acceptance, patient motivation, and health organization and management. The implementers identified practices to manage the identified challenges, including improving the design of the technology, supporting health professionals in the adoption of the eHealth services, changing the work processes and tasks, involving patients, and collectively planning the implementation inside an organization. The findings could be mostly attributed to the dimensions of the FITT framework.ConclusionsThe FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit. The importance of patients as stakeholders in eHealth services for patient self-management needs to be highlighted. Thus, we propose that patients should be added as a different type of individual dimension to the FITT framework. In addition, the framework could be extended to include organization and management in a new context dimension.

Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis.

BackgroundThe field of eHealth has a history of more than 20 years. During that time, many different eHealth services were developed. However, factors influencing the adoption of such services were seldom the main focus of analyses. For this reason, organizations adopting and implementing eHealth services seem not to be fully aware of the barriers and facilitators influencing the integration of eHealth services into routine care.ObjectiveThe objective of this work is to provide (1) a comprehensive list of relevant barriers to be considered and (2) a list of facilitators or success factors to help in planning and implementing successful eHealth services.MethodsFor this study, a twofold approach was applied. First, we gathered experts’ current opinions on facilitators and barriers in implementing eHealth services via expert discussions at two health informatics conferences held in Europe. Second, we conducted a systematic literature analysis concerning the barriers and facilitators for the implementation of eHealth services. Finally, we merged the results of the expert discussions with those of the systematic literature analysis.ResultsBoth expert discussions (23 and 10 experts, respectively) identified 15 barriers and 31 facilitators, whereas 76 barriers and 268 facilitators were found in 38 of the initial 56 articles published from 12 different countries. For the analyzed publications, the count of distinct barriers reported ranged from 0 to 40 (mean 10.24, SD 8.87, median 8). Likewise, between 0 and 48 facilitators were mentioned in the literature (mean 9.18, SD 9.33, median 6). The combination of both sources resulted in 77 barriers and 292 facilitators for the adoption and implementation of eHealth services.ConclusionsThis work contributes a comprehensive list of barriers and facilitators for the implementation and adoption of eHealth services. Addressing barriers early, and leveraging facilitators during the implementation, can help create eHealth services that better meet the needs of users and provide higher benefits for patients and caregivers.

The Role of Frontline Leaders in Building Health Professional Support for a New Patient Portal: Survey Study.

BackgroundEffective leadership and change management are thought to contribute to the successful implementation of health information technology innovations. However, limited attention has been paid to the role of frontline leaders in building health professional support for new technical innovations.ObjectiveFirst, we examined whether frontline leaders’ positive expectations of a patient portal and perceptions of its implementation were associated with their support for the portal. Second, we explored whether leaders’ positive perceptions influenced the same unit’s health professional support for the portal.MethodsData were collected through an online survey of 2067 health professionals and 401 frontline leaders working in 44 units from 14 health organizations in Finland. The participating organizations run a joint self-care and digital value services project developing a new patient portal for self-management. The survey was conducted before the piloting and implementation of the patient portal.ResultsThe frontline leaders’ perception of vision clarity had the strongest association with their own support for the portal (ß=.40, P<.001). Results also showed an association between leaders’ view of organizational readiness and their support (ß=.15, P=.04). The leaders’ positive perceptions of the quality of informing about the patient portal was associated with both leaders’ own (ß=.16, P=.02) and subordinate health professionals’ support for the portal (ß=.08, P<.001). Furthermore, professional participation in the planning of the portal was positively associated with their support (ß=.57, P<.001).ConclusionsFindings suggest that assuring good informing, communicating a clear vision to frontline leaders, and acknowledging organizational readiness for change can increase health professional support for electronic health (eHealth) services in the pre-implementation phase. Results highlight the role of frontline leaders in engaging professionals in the planning and implementation of eHealth services and in building health professionals’ positive attitudes toward the implementation of eHealth services.

The importance of ethical aspects when implementing eHealth services in healthcare

The importance of ethical aspects when implementing eHealth services in healthcare

Guidance Through Use: Value as a Pathfinder in e-Health Services Implementation.

The lack of awareness and confidence in eHealth solutions among certain stakeholders creates a barrier for the implementation of e-Health services. The aim of this paper is to explore issues that promote the development and implementation of patient-centered care services for the elderly. An exploratory case study approach is applied to a e-Health monitoring service that was developed and piloted in 38 homes for the elderly in Sweden and the Netherlands. The unit of analysis, concept of 'value-in-use', was used in order to determine how pilot participants felt about a service of this kind benefiting them the most. The findings were then translated into actionable considerations for implementing organizations. The results indicate a need for active participation, technical support infrastructure, mobility demands, and an extension of the concept of trust in e-Health services. The knowledge presented in the study is important for decisions makers, public organization strategists, and policy writers.

The importance of ethical aspects when implementing eHealth services in healthcare: A discussion paper.

The aim of this paper was to discuss the importance of ethical aspects when implementing eHealth services in health care. Challenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services. Discussion paper. Research literature published from 2000-2017 in CINAHL, PubMed and Scopus. Implementing eHealth services in health care involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals' presumption to provide high-quality care. To preserve patients' integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in health care. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centred approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care.

Older People Using e-Health Services—Exploring Frequency of Use and Associations with Perceived Benefits for Spouse Caregivers

ICT, information- and communication technologies, and e-health services are essential for meeting future care demands. Greater knowledge regarding the implementation of e-health services in long-term care for older people is needed. The purpose of the study was to explore older people’s use of e-health services and associations between frequency of use and perceived benefits. In the longitudinal comparative intervention study (n = 65), intervention group participants (n = 42) used an e-health service for 1.5 years. A control group (n = 23) used similar services provided in a traditional manner. Data was collected through questionnaires and analyzed using linear and logistic regressions. Although general use of the Internet was similar in both groups, the e-health group perceived significantly higher benefits. The component information- and education programs, developed specifically for the e-health service, had the highest association with benefits. Conclusion: e-health services targeted at supporting older people who care for a spouse at home can provide benefits which most likely will not be obtained without participation in an organized e-service. Care professionals play an essential role in encouraging spouse caregivers to become e-service users.