2,957 research outputs found

    The relevance of telehealth across the digital divided the transfer of knowledge over distance

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    This paper explores the concept of Relevance as an explanatory factor to the diffusion of ITuse, or, in this paper particularly, the use of Telehealth. Relevance is the net value of performance expectancy and effort expectancy and contains both micro-relevance (i.e. here-and-now) and macro-relevance (i.e. actual goals) Following the case-study approach, two Telehealth situations were studied in Rwanda and The Netherlands. In the comparison, two more existing studies in Canada and Tanzania were included. The conclusion is that Relevance is the explanatory factor, whereas particularly micro-relevance is crucial. Without the micro-relevant occasions that initiate use, there will be no use on longer term In the cases studied the micro-relevance of knowledge-transfer was crucial. Furthermore distance determined Telehealth relevance. Practical conclusions to cases were drawn

    A Contextualist Approach to Telehealth Innovations

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    A Contextualist Approach to Telehealth Innovations By Sunyoung Cho Abstract Healthcare is considered one of the most important social issues in the U.S. as well as in other societies with ever-increasing costs of medical service provision. The information-intensive nature of the healthcare industry and the perception of information technology (IT) as a way to ease up healthcare costs and improve quality have lead to increased use of and experiments with IT-based innovations. These activities present interesting research opportunities for IS researchers and they have led to an increasing body of knowledge on healthcare information systems. This research aims at contributing to this line of research by adopting a contextualist approach to examine the adoption, use, and further diffusion of telehealth innovations. A contextualist approach provides a particularly interesting and relevant perspective to study adoption and diffusion processes of healthcare innovations. The adopted contextualist approach is process-oriented, it applies multiple levels of analysis, and it accommodates different theoretical lenses to make sense of the two telehealth innovations under investigation. A key assumption is that innovations should be understood as ongoing processes of change, not just technologies, or isolated change events with clear boundaries. Healthcare innovations have in this view much broader connotations, including development of IT-based applications, their adoption and diffusion over time, and the interactions between many stakeholders and organizations that shape the innovation in a specific context. The contextualist approach suggested by Pettigrew is adopted as an overarching framework for multiple studies based on empirical investigation of two telehealth innovations; the main focus is on a telestroke innovation in the U.S. while a radiology innovation in Sweden serves as a complementary case. Each study is documented as an independent research publication with its own theoretical perspective and contributions. The overall contextualist approach and the related findings are then summarized across the individual studies. Telehealth innovations are particularly interesting examples of healthcare information systems. They leverage contemporary network infrastructures and interaction devices to allow provision of healthcare services, clinical information, and education over distance, thereby reducing the costs and improving the availability of medical services. The two telehealth innovations are investigated through in-depth case studies. This theses summary presents the theoretical background for the studies; it motivates and details how the qualitative case studies based on critical realist assumptions were designed and conducted; it outlines the resulting research publications; and it discusses the contributions of investigating telehealth innovations from a contextualist approach

    Examining the adoption of telehealth during public health emergencies based on technology organization environment framework

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    Purpose Disasters and pandemics pose challenges to health-care provision. Accordingly, the need for adopting innovative approach is required in providing care to patient. Therefore, the purpose of this study is to present telehealth as an innovative approach for providing care to patients and reducing spread of the infection and advocates for the adoption of telehealth for digitalized treatment of patients. Design/methodology/approach An integrative review methodology of existing evidence was conducted to provide implications for integration of telehealth for digitalized treatment of patients. This paper draws on Technology Organization Environment (TOE) framework to develop a model and propositions to investigate the factors that influence telehealth adoption from the perspective of the supply side and the demand side of medical services. Findings Findings from this study discuss applications adopted for telehealth and recommendations on how telehealth can be adopted for medical-care delivery. More importantly, the findings and propositions of this study can act as a roadmap to potential research opportunities within and beyond the pandemic. In addition, findings from this study help provide guidelines on how health practitioners can rapidly integrate telehealth into practice for public health emergencies. Originality/value This study identifies the social, technological and organizational factors that influence telehealth adoption, and opportunities of adopting telehealth during the public health emergencies. This study concludes that specific policy changes to improve integration of interoperable solutions; data security; better physical infrastructures; broadband access; better transition and workflow balance; availability of funding and remuneration; regulations and reimbursement; awareness; and training will improve telehealth adoption during public health emergencies.acceptedVersio

    Telehealth: Advances in Alternative Payment Models

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    Introduction Previous studies indicated that telehealth services may improve hospital performance. However, the extent to which these telehealth provisions would improve hospital total performance score under the hospital value-based purchasing (HVBP) programme is not clear. The aim of this study is to examine the association between telehealth provision and hospital performance. Methods We performed a retrospective analysis of the association between the provision of telehealth services and 2699 hospital’s total performance score (TPS) on the 2018 HVBP programme and its four domains. Multivariate regression models were used to analyse TPS and hospital performance on each domain. Telehealth services offered by a hospital was categorically operationalized as hospitals with no telehealth services, with one to two telehealth services, and with three or more telehealth services. Results Hospitals with one to two telehealth services have TPS (ß coefficient = 1.50; 95% confident intervals (CI): 0.28, 2.73; p \u3c 0.05) and hospitals with three or more telehealth services have higher efficiency and cost reduction (ß = 1.10; 95% CI: 0.32, 1.87; p \u3c 0.01) domain scores. However, the impact of telehealth on clinical care, person and community engagement, and safety domain scores was not significant. Discussion The expansion of hospital telehealth service provision can improve not only the efficiency of care, but also the total performance of the hospital. Since total performance is directly associated with hospital payments from the government, these findings have significant practice and policy implications. In addition, the effect of telehealth on other quality measures such as clinical care and safety needs further investigation

    Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

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    Background: Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals. Objective: We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research. Methods: We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study. Results: Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results. Conclusions: In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations

    Commercialisation of eHealth Innovations in the Market of UK Healthcare Sector: A Framework for Sustainable Business Model.

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    This is the peer reviewed version of the following article: Festus Oluseyi Oderanti, and Feng Li, ‘Commercialization of eHealth innovations in the market of the UK healthcare sector: A framework for a sustainable business model’, Psychology & Marketing, Vol. 35 (2): 120-137, February 2018, which has been published in final form at https://doi.org/10.1002/mar.21074. Under embargo until 10 January 2020. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Demographic trends with extended life expectancy are placing increasing pressures on the UK state-funded healthcare budgets. eHealth innovations are expected to facilitate new avenues for cost-effective and safe methods of care, for enabling elderly people to live independently at their own homes and for assisting governments to cope with the demographic challenges. However, despite heavy investment in these innovations, large-scale deployment of eHealth continues to face significant obstacles, and lack of sustainable business models (BMs) is widely regarded as part of the greatest barriers. Through various empirical methods that include facilitated workshops, case studies of relevant organizations, and user groups, this paper investigates the reasons the private market of eHealth innovations has proved difficult to establish, and therefore it develops a framework for sustainable BMs that could elimiesnate barriers of eHealth innovation commercialization. Results of the study suggest that to achieve sustainable commercialization, BM frameworks and innovation diffusion characteristics should be considered complements but not substitutes.Peer reviewe

    UNDERSTANDING PREDICTORS OF TELEMEDICINE ADOPTION BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC

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    This study examined change in physicians’ use of telemedicine before, during, and expectations after the COVID-19 pandemic. It also examined the ability of personal and environmental variables to predict telemedicine adoption, and applied the theory of reasoned action and technology acceptance model to physicians’ adoption of telemedicine during the pandemic. A total of 230 licensed physicians currently practicing in the United States were recruited. Telemedicine accounted for 3.72% of physicians’ clinical work prior to the pandemic, 46.03% during the pandemic, and predicted 25.44% after the pandemic ends. Physicians within hospitals reported less telemedicine use during the pandemic (M = 31.72%) than within group practice (M = 53.42%, p = .016) and less change in use at hospitals (M = 28.02%) compared to academic medical centers (M = 43.22%, p = .027) and group practice (M = 51.09%, p = .008). Results indicate greater use of telemedicine was predicted by greater years in practice (β = .17, p = .009), supportive organizational policies (β = .26, p = .001), organizational encouragement (β = .28, p = .003), expectations of greater patient volume (β = .20, p = .003), and higher quality of patient care (β = .17, p = .032). Model testing indicated the TRA was an adequate to poor fit, while the TAM demonstrated better fit, although a slightly trimmed TAM was ultimately retained for parsimony. Implications of the results, limitations, and future directions are discussed

    A Multi-Level Assessment of Healthcare Facilities Readiness, Willingness, and Ability to Adopt and Sustain Telehealth Services

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    Telehealth technologies are becoming more pervasive throughout the healthcare system as a way to provide services to patients that would otherwise have difficulty with access. Currently, little is known about the current state of telehealth use within clinics and hospital in the US. Most studies evaluating telehealth programs are feasibility or small patient outcome studies from one location. Utilizing a hybrid framework combining the levels of complex socio-technical systems with the theory of ready, willing and able. The theory of ready, willing, and able is founded on the basis that these three preconditions need to be met for a change in behavior to occur, such as adoption of telehealth technologies. Study 1 utilizes multiple national healthcare data sets to analyze the higher levels of organizational factors that are associated with US hospitals who are ready and willing to implement telehealth technologies but lack the ability. Providing insight to the factors that can facilitate the ability to adopt such innovations. Study 2 is a mixed methods study that evaluates clinic data from the state of Nebraska. The quantitative survey data was used to develop interview questions and determine the sample population. The qualitative interviews yielded several themes on barriers to implementing and sustaining telehealth services in Nebraska. These include lack of providers to network with and technology malfunction issues. Many clinics want to increase their telehealth programs but are lacking the ability to do so. Study 3 is a combination of two meta-analyses that evaluate the effect of telehealth programs on the QOL for cancer patients in treatment and cancer survivors who are no longer in active treatment. The effect of the telehealth interventions on survivors QOL is significantly increased compared to survivors in usual care. More needs to be done to standardize telehealth evaluation and connection processes. Positive patient outcomes and clinical benefits can strengthen the legitimacy of telehealth technologies as part of normal healthcare practice. Yet without accurate data, the benefits cannot be fully assessed. Innovation is outpacing policy and procedures, this needs to be amended to fully maximize the benefits of telehealth technologies in the healthcare system

    The organizational implications of medical imaging in the context of Malaysian hospitals

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    This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

    Impact of the Increased Use of Telehealth on Health Care Management and Administration: The Case of New Care Management Practices

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    The COVID-19 pandemic has brought unprecedented challenges to healthcare systems worldwide, forcing them to adapt and implement alternative modes of healthcare delivery quickly. Telehealth, the delivery of healthcare services through telecommunication technologies, has become crucial in providing continuous care while reducing the risk of virus transmission. This qualitative study aimed to explore healthcare managers\u27 perceptions of the use of telehealth and its impact on healthcare practices during the pandemic, particularly in terms of provision and quality control. A purposive sample of 10 healthcare managers from different healthcare settings in the United States participated in semi-structured interviews conducted via video conferencing. The interviews were transcribed and analyzed using thematic analysis. The findings revealed six overarching themes: (1) perceived benefits of telehealth, including increased accessibility, convenience, and efficiency; (2) challenges and limitations of telehealth; (3) role of telehealth in shaping healthcare practices; (4) implications for quality control, including the need for standardization, training, and evaluation measures; (5) leadership and innovation in telehealth; and (6) future of telehealth in healthcare management. This study provides insights into how healthcare managers perceive the use of telehealth and how it shapes healthcare practices during the COVID-19 pandemic. The findings suggest that telehealth can potentially improve healthcare provision and quality control, but its implementation requires addressing challenges and limitations and adapting to evolving healthcare needs. Future research can build on these findings by exploring the perspectives of other stakeholders, such as healthcare providers and patients, and examining the long-term effects of telehealth on healthcare practices
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