Perceived quality of e‐health services

A Conceptual Model to Evaluate Service Quality of Direct-to-Consumer Telemedicine Consultation from Patient Perspective

Objective and Background: This research aims to develop a theoretical service quality (SQ) model for direct-to-consumer (DTC) telemedicine consultations. Although it can change care delivery for the better, it is crucial to create the appropriate measurement tool to collect and analyze patient's perceptions of SQ to identify any service pitfall and encourage a faster adoption. To the best of the authors' knowledge, this article is one of the first to investigate and propose a SQ model for DTC telemedicine consultations. This study is therefore motivated by a clear need for such a model as it is currently inexistent. Methods: A literature review of health and e-service quality (e-SQ) models was conducted to identify a suitable instrument for the research. A total of 60 studies were included. Results: The main findings are threefold: (1) DTC telemedicine SQ is interdisciplinary: it encompasses generic and context-specific dimensions from the health, e-SQ, and information system literature; (2) the existing SQ models are not adequate, they do not cover all dimensions of DTC telemedicine services; (3) although LeRouge et al.'s Telemedicine service encounter quality model was identified as a reference model, it is inadequate to simply transpose it to the context of the study. Thus, the elaboration of a more suitable instrument and creation of a new updated model by the authors. Conclusion: The conceptual model captures three primary dimensions (system quality, interaction quality and use quality) that represent SQ of DTC telemedicine consultations from a patient perspective.

The impact and success of health-care-related social media usage – pre- and post-COVID analysis

Purpose

The overall purpose of this empirically validated research paper is to determine factors that impact the success of using social media channels by consumers for salvaging health-care information by integrating constructs of the information system (IS) success model, e-health service quality and perceived usefulness during pre- and post-COVID settings.

Design/methodology/approach

Online survey responses of 243 consumers for study 1 and 184 consumers for study 2 were validated using factor analysis to understand consumers’ attitudes toward social media use. Constructs from existing literature and theories have been extracted to develop the proposed model, which has been empirically validated through statistical tests. A paired-samples t-test was also conducted to compare the customer satisfaction mean of pre- and post-COVID conditions; and word of mouth (WOM) for pre- and post-COVID conditions.

Findings

The outcome of this study supports that service quality and information quality conclusively influence customer satisfaction of consumers for health-care information among respondents pre COVID, and service quality, perceived usefulness and information quality conclusively affect customer satisfaction of consumers for health-care information among respondents post COVID. Furthermore, the e-health service quality contributes noteworthy in shaping the consumers’ satisfaction with social media usage for study 2 and information quality for study 1. A paired-samples t-test revealed that the two groups behaved significantly differently for customer satisfaction and WOM in the two groups.

Research limitations/implications

At prima facie, this study has a geographical limitation for the sample size. The respondents for the online research were from the urban suburb of Bengaluru, India. The data collection has not focused on any precise social media channel.

Practical implications

Identification and comprehension of constructs that influence consumer satisfaction related to social media usage for health-care information can assist health-care managers in developing appropriate strategies for consumers to maximize social media usage. Moreover, this study provides an insight into the consumer’s perception of using social media channels for seeking health-care information.

Originality/value

This study recommends an empirically validated model for the success of social media in a consumer setting for the health-care scenario. This research is a unique attempt that inspects social media satisfaction by adapting constructs from existing theories of the IS success model, e-health service quality and perceived usefulness.

Digital health care services in post COVID-19 scenario: modeling the enabling factors

Purpose

The recent pandemic of COVID-19 has posed challenges for delivering essential and desirable health-care services for the masses. Digital health-care services initiated by several hospitals and health practitioners promise efficient and safe health care in the new normal post-COVID era but need a supportive enabling ecosystem. Therefore, this study aims toward identifying and modeling the key enabling factors for digital health-care services.

Design/methodology/approach

A total of nine factors were identified from the literature review and verified by the domain experts which can enable the wider acceptance of digital health-care services. The identified factors were then modeled with the help of the total interpretive structural modeling (TISM) approach and fuzzy Matrices d’Impacts Croises Multiplication Appliquée à un Classement (MICMAC) and a meaningful contextual relationship were developed for the factors.

Findings

This study reflects that the trust of patients is required for the acceptance of digital health care. Quality of patient care and affordability cum accessibility of online services will define mass engagement. Hospital staff resilience, hospital care service capacity, strategic partnerships and collaborations supported by technology and regulatory structure are the major factors defining the enabling ecosystem.

Originality/value

This study has its uniqueness in the way the TISM approach and fuzzy MICMAC are used for modeling the enabling factors toward growth and acceptance of digital health-care services in the days to come in developing nations. The focus of this study can be considered as relevant for the study interested in investigating the role of cognitive dimensions in influencing actors’ behaviors and decisions.

Electronic service quality (e-SQ) measurement: a cross-functional review

Purpose

Although comprehensive work has been conducted in several scholarly journals in electronic service quality (e-SQ) measurement, there has been no cross-functional review of these studies. The majority of the review studies focus on e-SQ assessment in the field of electronic retail. This paper explores and synthesizes e-SQ evaluation work across the various functional domains in the last two decades and maps critical methodological challenges. It further classifies the dimensions used by researchers in six broad categories for better comprehension.

Design/methodology/approach

To analyze and appreciate past e-SQ measurement research, a content assessment of the 50 most relevant research papers from various functional domains drawn from prestigious repositories was undertaken.

Findings

The results indicate shortcomings noticed in methodological issues in the e-SQ measurement research like research approaches, data analysis procedures, sampling methods, generation and purification of items, validity and reliability assessment, and dimensionality analysis. It further reveals that though e-SQ is multi-dimensional and context-specific, dimensions like content/information quality, website design, ease of use/usability, efficiency, security/and privacy, responsiveness, reliability, customer service, trust and fulfillment have been consistently cited in the reviewed studies across the various functional domains.

Originality/value

An assessment of 50 publications over the past 2 decades identifies key areas of concern in the existing research on e-SQ measurement in various functional domains for scholars and professionals. This study also provides a unique categorization of e-SQ dimensions used in various functional domains and has the potential to guide future research.

Sustainable Governance on the Intention of Medical Tourism in Uzbekistan

Medical tourism is a growing niche market with huge potential as the 6th industry of medical services, including an unforgettable trip. Due to these advantages, Uzbekistan hopes to be a leader in central Asia concerning medical tourism. Contrary to this ambitious goal, Uzbekistan patients still prefer going abroad for medical services. Therefore, in order for Uzbekistan to be a hub for medical tourism, the sustainable governance factors of medical tourism need to be found for local patients going overseas. Under this research motivation, this study evaluates how the medical, tourism, and information sharing factors influence behavioral intention based on the structural equation model (SEM) with a random sample of 498 residents in Uzbekistan. Perceived value and behavioral intention are used as a mediating variable and a dependent variable, respectively. The main findings are summarized as follows. First, the medical factor and information sharing are very important factors for behavioral intention, with high coefficient values of 0.399 and 0.516, respectively, while the tourism factor is not influential on the behavioral intention statistically. This implies that Uzbekistani patients do not consider tourism factors as a core condition, instead focusing on the service quality of the medical operation and convenience for foreign patients. Second, in the indirect model, we found that perceived value takes a fully mediating role between medical factors and behavioral intention, while it takes a partially mediating role between information sharing and behavioral intention, implying that strong promotion policies are required for the advantages of tourism and enhanced access to information.

Consumers’ usage and adoption of e-pharmacy in India

Purpose

This paper aims to identify and empirically validate the various factors for adoption, usage and intention to recommend e-pharmacy for purchasing medications by consumers.

Design/methodology/approach

Based on constructs from well-established theoretical models, the technology acceptance model, extended unified theory of acceptance and use of technology and self-determination theory, a model was proposed for the study. The model was validated with a sample size of 184 respondents using partial least squares method and factor analysis to establish and validate relationships among the various identified constructs.

Findings

The results show that performance expectancy, effort expectancy, social influence and hedonic motivation have a positive co-relation with adoption of e-pharmacy and the intention to recommend. The results depict that gender and educational background have no correlation toward adoption and intention to recommend e-pharmacies for purchasing medicines in India.

Research limitations/implications

This research comes along with a geographic limitation of the sample size. The research was conducted in an urban suburb city of Bengaluru, India.

Practical implications

At an academic level, this research will provide interesting insights for exploring adoption and usage intention of consumers toward e-pharmacy. At a managerial level, this empirically supported study will provide insights into the relationship among the various constructs and the consumers’ motivation toward adoption and usage intention of e-pharmacy.

Originality/value

This research is the first of its form which uses constructs from the technology acceptance model, extended unified theory of acceptance and use of technology and self-determination theory in the online healthcare space to understand consumer usage behavior.

Physician-user interaction and users' perceived service quality: evidence from Chinese mobile healthcare consultation

Purpose

The significance of physician-user interaction has been widely acknowledged in offline and online healthcare consultation. However, limited attempts have been made to explore the influence of physician-user interaction on users' perceived service quality (PSQ) in the mobile context. Based on the literature on physician-user interaction and media synchronicity theory, this study proposes a theoretical model where the interactive factors common across the offline, online and mobile context, i.e. physicians' informational support and emotional support, the interactive factors unique in the mobile context, i.e. physicians' response speed and voice service, and the interaction between the two categories of interactive factors predict users' PSQ in mobile consultation.

Design/methodology/approach

This study collects consultation records between 25,225 users and 738 physicians from a leading Chinese mobile consultation application, and employs linear regression to verify the proposed theoretical model.

Findings

Physicians' informational, emotional support, response speed and voice service are found to have significant positive impacts on users' PSQ. Besides, physicians' response speed strengthens the positive impacts of physicians' informational and emotional support on users' PSQ, while physicians' voice service weakens the positive link between physicians' informational support on users' PSQ.

Originality/value

This study contributes to the antecedents for users' PSQ in mobile consultation by identifying unique interactive factors in the mobile context, and highlighting the individual and interaction effects of different physician-user interactive factors. Besides, this study employs novel methods, which leverages text classification and text pattern recognition to more accurately depict physicians' online behaviors based on objective communication records.

Factors influencing internet usage for health purposes

Purpose

The objective of this paper is to analyse the simultaneous effect of intention, attitude, knowledge, injunctive norm, descriptive norm, facility access, perceived Internet health information, hedonic motivation, utilitarian motivation, and perceived threat of non-communicable diseases (NCD) on Internet usage for health purposes.

Design/methodology/approach

The empirical data were collected through a survey. The respondents of the survey are 369 Jakarta residents. Multiple regression analysis was conducted.

Findings

Internet usage for health purposes is significantly affected by intention, knowledge, descriptive norm, and the perceived threat of NCD. Internet usage for health purposes is not influenced by attitude, facility access, perceived Internet health information, hedonic and utilitarian motivation.

Research limitations/implications

This research was conducted only in Jakarta. It also employed a purposive sampling technique. Future research should be conducted in other locations and used a probability sampling technique.

Practical implications

To improve the level of Internet usage for health purposes, it is essential to increase the public’s intention to use the Internet for health purposes, their knowledge on Internet usage for health purposes, and their awareness of the dangers of NCD. It is also important to persuade the community influential leaders/persons to use the Internet for health purposes.

Originality/value

This study is the first to develop and test an Internet usage for health purposes model that involves intention, attitude, knowledge, injunctive norm, descriptive norm, facility access, perceived Internet health information, hedonic motivation, utilitarian motivation, and perceived threat of NCD.

Nobody understands me! The need for empathy

Purpose

This paper aims to explore the mind-set of consumers with negative mood states during mundane consumption activities.

Design/methodology/approach

The authors conducted in-depth interviews with 17 informants who have recently experienced severe yet temporary medical problems.

Findings

Consumers with severe medical problems experience an increased need for empathy during mundane business interactions, and their reaction to service failures is aggravated.

Originality/value

Although previous research has investigated the relationship between empathy and satisfaction in healthcare services, the current research provides a novel perspective by studying the mind-set of customers with medical problems during regular consumption activities. Further, previous research has called for a need for qualitative work in empathy research. This gap is also addressed by the current research.

Trust and online consumer health service success

We examine consumers’ early stage trust beliefs for effects on perceptions of information and system quality, later stage trust, satisfaction and usage intentions in the context of online health services. Using a longitudinal research design, data was collected from a sample of undergraduates during two time periods, approximately five weeks apart. Results show that trust in the website influences trust in the e-service provider at both early and later stages. Perceptions of system and information quality depend on trust, while trust and satisfaction are important to continued usage intentions. Results are important for understanding how trust interacts with IS success factors.

Developing a framework of service convenience in health care: An exploratory study for a primary care provider

From retail health clinics and online appointment scheduling to (mobile) kiosks that enable patient check-in and automate the collection of copays and open balances, convenience has become an important topic in the health care sector over the last few years. While service convenience has also gained much interest in academia, one common limitation is that authors have adopted a "goods-centered" perspective focusing primarily on retail settings. Results of this exploratory study reveal that health care service convenience encompasses seven different dimensions: decision, access, scheduling, registration and check-in, transaction, care delivery, and postconsultation convenience. Implications and future research suggestions are discussed.

Prioritizing factors influencing nurses' satisfaction with hospital information systems: a fuzzy analytic hierarchy process approach

Our aim was to use the fuzzy analytic hierarchy process approach to prioritize the factors that influence nurses' satisfaction with a hospital information system. First, we reviewed the related literature to identify and select possible factors. Second, we developed an analytic hierarchy process framework with three main factors (quality of services, of systems, and of information) and 22 subfactors. Third, we developed a questionnaire based on pairwise comparisons and invited 10 experienced nurses who were identified through snowball sampling to rate these factors. Finally, we used Chang's fuzzy extent analysis method to compute the weights of these factors and prioritize them. We found that information quality was the most important factor (58%), followed by service quality (22%) and then system quality (19%). In conclusion, although their weights were not similar, all factors were important and should be considered in evaluating nurses' satisfaction.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

A Framework to Identify Service Quality Determinants of IT Enabled Scalable Ventures: A Study from Indian Context

The introduction of information and communication technology (ICT) has altered the service delivery around the world by making it more accessible and cost effective across e-service markets. In a country like India the problem of health is an enormous one where a majority of poor are outside the effective medical network. In order to address these problems many information and technology (IT) oriented new ventures have been established to eliminate the gap in health inequity by creating network of hospitals exclusively in non-urban areas. Despite of huge popularity of these services, identifying the quality of such services need careful attention. Exhaustive review of literature highlights that there exists little understanding for such a study in IT enabled Indian healthcare domain in context to new ventures/start-ups with an emergence of a gap. With the increasing rise of technology enabled new healthcare ventures there have been high rates of failure too due to lack of providing quality service, so it has become imperative to prioritize the contextual and sectoral specific settings of service quality issues as it is being felt increasingly that it is the quality that would ultimately decide the value of services. This paper thus attempts to prioritize the context specific service quality dimensions in IT enabled scalable healthcare ventures from Indian context with focus in non-urban regions by deploying technique for order preference by similarity to ideal solution (TOPSIS) methodology as multi-criteria decision making technique. Further this paper proposed a conceptual model as conjectural understanding of the antecedents to the start-ups and as a guide that can provides new entrepreneurial insights to the service managers who can better apportion their resource in order to build quality and scalability.

Criteria for the evaluation of a cloud-based hospital information system outsourcing provider

As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.

The state of the journal: four years of publication

Purpose

The purpose of this paper is to reflect on the development and progression of the International Journal of Pharmaceutical and Healthcare Marketing and include comments on its future direction.

Design/methodology/approach

The paper takes the approach of an essay format.

Findings

The journal has published key papers in pharmaceutical and healthcare research and continues to develop an interdisciplinary character with contributions from scholarly and practice‐oriented sources.

Originality/value

The paper provides a contemporary appraisal of the status and positioning of the journal.