Improving customer satisfaction and loyalty through mHealth service digitalization

NPS MedicineWise application in supporting medication adherence in chronic heart failure: an acceptability and feasibility pilot study

Introduction

Heart failure (HF) is an increasing global concern. Despite evidence-based pharmacotherapy, associated morbidity and mortality remain high. This study aimed to assess the acceptability, feasibility, and value of the NPS MedicineWise dose reminder app in a tiered, pharmacist-led intervention to address medication non-adherence in patients with HF.

Methods

This prospective, single-blinded, randomised controlled trial recruited 55 patients with HF between September 2019 and October 2020. Participants were randomly assigned to either the intervention or control arms. Intervention participants used the app which prompted medication administration at each dosing interval. Control participants received standard care and remained blinded to the app throughout the study. Treatment non-adherence prompted a tiered, pharmacist-led intervention. Comparison of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) at baseline and 6-months measured the app's value in supporting medication adherence. Secondary outcome measures included self-reported medication knowledge, health-related quality of life, psychological wellbeing, and signs and symptoms of HF. Data were analysed using standard statistical tests with significance set at α 0.05.

Results

Approximately half of respondents reported managing HF and medications better by using the MedicineWise app (Tier 1). Most respondents expressed satisfaction with the in-app messages (Tier 2) and pharmacists' phone calls (Tier 3). The intervention participants demonstrated a significant improvement in the SEAMS between baseline and 6-months follow-up.

Discussion

It is feasible and potentially of value to use the MedicineWise app with a tiered, pharmacist-led intervention to support medication adherence in patients with HF. Our findings provide clinicians with "real-world" information on the practicality and potential value of using mobile health to support treatment adherence in patients with HF.

Trial registration number

Australian New Zealand Clinical Trials Registry Clinical trial registration number: ACTRN12619000289112p (http://www.ANZCTR.org.au/ACTRN12619000289112p.aspx).

Analysis of factors inhibiting the customer engagement of eHealth in India: Modeling the barriers using ISM-Fuzzy MICMAC analysis

INTRODUCTION

The current study aims to evaluate and measure the relationship between the customer engagement barriers influencing the adoption of eHealth in India. Previous studies have shown that low levels of engagement can lead to worse health outcomes, so this study is an expanded version of those findings to highlight those challenges.

METHODOLOGY

For this, the study followed three phases of research: factor identification through a review of the literature; expert opinion for selecting key and pertinent factors for the study; and application of interpretive structural modelling approach to capture the proper association between various factors. Using fuzzy-MICMAC analysis, the factors were divided into independent, dependent, autonomous and linkage categories.

RESULTS

A model is created in this study that shows the relationship between different barriers that aid the Indian healthcare industry in better implementation and also Indian citizens in better adoption of eHealth services. According to the research and derived model, some of the biggest obstacles in the eHealth are need of product portfolio, Lack of Customer support and Low first call resolution rate.

CONCLUSION

This study contributes to the body of knowledge by offering novel perspective into the types of hierarchical relationships that exist among barriers. These insights will be valuable to academicians and practitioners interested in India's healthcare market and its strategic expansion.

Digital Transformation in Healthcare: Technology Acceptance and Its Applications

Technological innovation has become an integral aspect of our daily life, such as wearable and information technology, virtual reality and the Internet of Things which have contributed to transforming healthcare business and operations. Patients will now have a broader range and more mindful healthcare choices and experience a new era of healthcare with a patient-centric culture. Digital transformation determines personal and institutional health care. This paper aims to analyse the changes taking place in the field of healthcare due to digital transformation. For this purpose, a systematic bibliographic review is performed, utilising Scopus, Science Direct and PubMed databases from 2008 to 2021. Our methodology is based on the approach by Wester and Watson, which classify the related articles based on a concept-centric method and an ad hoc classification system which identify the categories used to describe areas of literature. The search was made during August 2022 and identified 5847 papers, of which 321 fulfilled the inclusion criteria for further process. Finally, by removing and adding additional studies, we ended with 287 articles grouped into five themes: information technology in health, the educational impact of e-health, the acceptance of e-health, telemedicine and security issues.

Impact of the Fourth Industrial Revolution on clinical pharmaceutical services: A scoping review

BACKGROUND

Digital technologies are becoming increasingly sophisticated and integrated, but the scope of the Fourth Industrial Revolution (4IR) is wider: technologies and innovations are diffusing faster and more widely. Despite the extensive use of telepharmacy technology by patients and pharmacists, there is an absence of research that examines the use of telepharmacy.

OBJECTIVE

To investigate the current evidence concerning the impact of the 4IR on the provision of pharmaceutical services.

METHODS

A scoping review based on the PCC (Population, Concept, and Context) mnemonic was conducted in Pubmed, Scopus and Web of Science. Population included pharmacist/clinical pharmaceutical services, the concept referred to the 4IR and the context was open. Electronic searches retrieved 8,694 articles that were screened by titles and abstracts. The search yielded 59 studies that were analyzed in terms of country of focus, publication year, type of publication, main technologies, types of pharmacy services, and the role of the Fourth Industrial Revolution.

RESULTS

Most of the included studies were conducted in the United States and were published between 2005 and 2021, with the highest number of publications in the year of 2021. The majority of included articles were observational studies. Technologies addressed in the studies were those within the scope of telepharmacy, and most of the articles discussed more than one pharmaceutical service, with medication therapy management as the most frequent.

CONCLUSIONS

The Covid-19 pandemic accelerated the use of technologies, identifying promising niches for pharmacists in the field of Pharmaceutical Care. This should encourage pharmacists to fortify their capacity to adopt new technologies in the provision of pharmaceutical services. The frequent use of various technologies has been demonstrated, which indicates the exigency for further health education actions by the pharmacist.

Quality 4.0 – understanding the criticality of the dimensions using the analytic hierarchy process (AHP) technique

Purpose

In this era of Industry 4.0, characterized by disruptive technologies, there is a need to identify and understand the role of the quality function in the excellence journey. Quality 4.0 refers to the digitalization of quality work in the context of Industry 4.0. As Quality 4.0 is a new concept, empirical research on the subject is extremely scant. Therefore, this study aims to identify and understand the criticality of the dimensions of Quality 4.0.

Design/methodology/approach

The present research identifies 12 axes (dimensions) of Quality 4.0 based on literature review and inputs from experts. The identified axes have been prioritized using the analytic hierarchy process (AHP) technique.

Findings

The study concludes that the 12 dimensions contribute to outcome indicators such as organizational performance, agility and sustainability. It further adds that though technology is vital for Quality 4.0, elements of traditional quality such as leadership, quality culture, customer focus, quality systems, compliance, competence, analytical thinking, data-driven decision making, etc. are mandatory for the transformation journey. In today's context except for a few matured organizations, others are even struggling to implement the traditional aspects of quality.

Research limitations/implications

Cues to further research are provided which would help in the better understanding of Quality 4.0 and its role in the Industry 4.0 scenario.

Practical implications

This research would help the practitioners understand the determinants of Quality 4.0 system and their effects on organizational performance, agility and sustainability.

Originality/value

The present research work strives to throw light on the criticality of the dimensions of Quality 4.0, thereby contributing to theory building, especially given the paucity of literature in Quality 4.0.

Enabler toward successful implementation of Quality 4.0 in digital transformation era: a comprehensive review and future research agenda

Purpose

Quality 4.0 (Q4.0) is related to quality management in the era of Industry 4.0 (I4.0). In particular, it concentrates on digital techniques used to improve organizational capabilities and ensure the delivery of the best quality products and services to its customer. The aim of this research to examine the vital elements for the Q4.0 implementation.

Design/methodology/approach

A review of the literature was carried out to analyze past studies in this emerging research field.

Findings

This research identified ten factors that contribute to the successful implementation of Q4.0. The key factors are (1) data, (2) analytics, (3) connectivity, (4) collaboration, (5) development of APP, (6) scalability, (7) compliance, (8) organization culture, (9) leadership and (10) training for Q4.0.

Originality/value

As a result of the research, a new understanding of factors of successful implementation of Q4.0 in the digital transformation era can assist firms in developing new ways to implement Q4.0.

Examination of aspects of pro-consumer refund system

Purpose

Pro-consumer refund system (PCRS) should be understood as a process in customer service, within which activities are related to the handling of goods that do not meet customer expectations, both in business-to-consumer (B2C) and business-to-business (B2B) relations. The research monitored three groups of variables – the importance of shopping decision factors, customer ID characteristics and PCRS characteristics. The authors explore relationships between these three groups of variables, and the authors tried to understand better the role of the PCRS system in customer perception of service quality.

Design/methodology/approach

An electronic survey was used to collect data in the planned structure. Research questions were developed into variables, and these were then the basis for creating questionnaires. Data were collected through electronic questionnaires. The sample consisted of 327 respondents from Poland (confidence level = 95%, confidence interval = 5.42).

Findings

The results of the research show that the PCRS is very important and appreciated from the customer's perspective. Most of the respondents are aware of their consumer rights and correctly understand the meaning of the term “pro-consumer refund system”. Respondents require complex service in terms of returns; their satisfaction does not depend on any individual factor. This also means that the return system must be lenient in each aspect.

Originality/value

A detailed analysis of aspects of PCRS has not yet been carried out in the literature. Although previous studies have focused, at least in part, on defining the essential attributes of PCRS, in most cases, it was an organization-driven view of this topic. The research examined the interrelationships between aspects of PCRS based on empirical data and offered a new perspective on this evolving concept.

Digital transformation of the mobile connected pharmacy: a first step toward community pharmacy 5.0

Community pharmacies have made significant advances in digital technology; however, mobile systems are only emerging in this sector and mostly focusing patient-centric connections. This study reveals a case of digital transformation in a mobile connected pharmacy, balancing efficient pharmaceutical services and digital innovation. A mobile connected pharmacy solution (mPharmaCare) is developed for a community of near 100.000. The first stage includes a bibliometric analysis and a structured literature review of the mobile connected pharmacy. In the second stage, action research was conducted to evaluate mPharmaCare adoption. A dual organizational structure was tested to cope with innovation and efficient exploration of pharmacy services. Community Pharmacy 5.0 is an inspiring vision that will take advantage of mobility. However, there are tensions between the core pharmacy business and the new technology layers of community connections. Community pharmacies require both client-centric and community-centric approaches to achieve individualization of patient care and horizontal and end-to-end digital integration of pharmacy data. Digital transformation can remove silos in the community pharmacy. Creating an - internal or outsourced - innovation division may be suitable for medium and large community pharmacies. Moreover, pharmacies must consider shifting to a product-service system offer, deploying synchronization mechanisms with different stakeholders.

Cross Sectional E-Health Evaluation Study for Telemedicine and M-Health Approaches in Monitoring COVID-19 Patients with Chronic Obstructive Pulmonary Disease (COPD)

Monitoring COVID-19 patients with COPD has become one of the major tasks in preventing transmission and delivering emergency healthcare services after vaccination in case of any issues. Most COVID-19-affected patients are suggested to self-quarantine at home or in institutionalized quarantine centers. In such cases, it is essential to provide remote healthcare services. For remote healthcare monitoring, two approaches are being considered in this study, which include mHealth and Telehealth. A mixed-methods approach is adopted, where survey questionnaires are used for collecting information from 108 patients and semi-structured interviews are used with seven physicians regarding mHealth and Telehealth approaches. Survey results indicated that mHealth is rated to be slightly more effective than Telehealth, and interview results indicated that Telehealth is identified to be slightly more effective than mHealth in relation to parameters including usefulness, ease of use and learnability, interface and interaction quality, reliability, and satisfaction. However, both physicians and patients opined that both mHealth and Telehealth have a promising future with increasing adoption. Based on the findings, it can be concluded that both mHealth and Telehealth are considered to be effective in delivering remote care for COPD patients infected with COVID-19 at home. Implications of the study findings are discussed.

Patterns emerging from the TQM paradigm in relation to the 21st century complex context within TQM journal

Purpose

The purpose of this research is to explore the deployment of the total quality management (TQM) paradigm in the TQM Journal in relation to the context of the 21st century. The study builds on the theoretical framework of the four quality paradigms that together compose TQM. The four paradigms differ in their effectiveness based on the context in which they are used. In a complex context, one would expect the reflective and the emergence paradigm to flourish. The TQM Journal is one of the leading scientific journals on TQM. If the assumption that the reflective and emergent paradigm would flourish in a complex environment is correct, one will see that represented in the past five years of scientific research in that magazine.

Design/methodology/approach

The TQM Journal articles of the past five years from January 2016 till January 2021 have been chosen as the scope of an exploratory review. The author assessed the title and abstract of all articles based on the characteristics of the four quality paradigms, as described in the theoretical framework. If the title and abstract did not provide enough data to take the decision for the assessment, the whole article has been taken into account. The results have been collated, summarized and reported. Based on the results, the author explores the possible patterns.

Findings

In total, 283 articles from 2016 to 2021 (from Volume 28, Issue 1 to Volume 33, Issue 1) were included in this study. In total, 45 were read fully to be able to characterize the article. Most of the studies relate the tertiary (33.3%) and secondary (27.9%) sectors. Healthcare was the sector in 32 of the cases (11.3%). Most studies have been conducted in Europe (n = 82, 28.9%) and Asia (n = 58, 20.5%). Within Europe, Italy was the most prolific country with, respectively, 25 (30.8%) of the articles. The USA and Canada only had five articles in these five years (1.8%). Many articles did not specify the region. More than half of the articles (52.4%) worked with surveys, questionnaires or other methods to involve the customer in the research; 16 articles (5.6%) used experts in the field through expert panels and such to collect data from. In total, 107 articles (37.8%) did involve no other stakeholders than the researchers themselves. Eight studies (2.8%) used action research or co-design methodology to create optimal stakeholder participation. Based on the data, four patterns can be discovered: the context sensitivity of the articles, reflexivity, coping with uncertainty and co-creation.

Research limitations/implications

It is acknowledged that the articles in the study were published in just one scientific journal. One can expect that this will be represented in other journals on TQM. Still, it would be interesting to conduct a follow-up study in other journals on TQM and compare the results. The research is done by one subjective researcher.

Practical implications

Research on TQM should take the complexity of the context into account. For that purpose, researchers should focus more on the emergence paradigm within TQM.

Originality/value

This study is the first to investigate TQM as a holistic paradigm, including the empirical, reflective, reference and emergence paradigm in TQM research.

Autobiographical internal dialogue on TQM

Purpose

To present the internal dialogue of a TQM practitioner using the conceptual lens of reflective practice.

Design/methodology/approach

This study used a pragmatic philosophical approach to collect qualitative critical reflection data and quantitative career construction data from stratified and purposively sampled respondents, using structured questionnaires. The qualitative data were analyzed through reconstruction, while the quantitative data were analyzed through co-construction using the percentage agreement value and Wilcoxon–Mann Whitney test.

Findings

Five questions were found to be valuable for steering the internal dialogue for critical reflection, thus recommended as a must-have in a TQM practitioner's toolkit. This study found the career adapt–abilities scale to be a valuable tool for assessing the career construction of a TQM practitioner. This was supported by a 64% agreement and non-significant difference between the two groups of raters used, p < 0.05 (U = 3356.5, W = 7451.5, Z = 1.9826), two-tailed.

Research limitations/implications

The pragmatic philosophical stance used in this study lends it to a certain level of subjectivity. However, the inputs from the three other participants neutralize the subjectivity. Most notably, this study is not about consensus-seeking but rather verifiable/testable self-reflection.

Practical implications

The theory-informed results presented in this study are useful for the continuing professional development of TQM practitioners.

Originality/value

This study provides insights for applying an individual-level self-assessment tool for TQM implementation.

Industry 4.0, quality management and TQM world. A systematic literature review and a proposed agenda for further research

Purpose

The main purpose of this paper is to analyse the current literature situation in terms of relationships between Industry 4.0 and quality management and TQM. The author wanted to understand what topics and issues can be considered the most relevant referring to the so-called Quality 4.0, what the literature is missing opening avenues for further research.

Design/methodology/approach

This research employed a systematic literature review. In total, 75 papers from different sources were reviewed using specific inclusion and exclusion criteria.

Findings

Four categories of topics emerged, namely: creating value within the company through quality (big) data, analytics and artificial intelligence; developing Quality 4.0 skills and culture for quality people; customer value co-creation; cyber–physical systems and ERP for quality assurance and control. This paper also tried to understand if there is a definition of Quality 4.0 based on determined methods.

Research limitations/implications

Systematic literature review could have introduced some limitations in terms of the number and reliability of reviewed papers. Probably some interesting papers had been not intentionally missed.

Practical implications

Consultants and managers in developing and implementing their own Quality 4.0 models could use many practical and discussed implications concerning I4.0 technologies and quality management.

Originality/value

This is one of the first papers which employed the systematic literature review for researching Industry 4.0, quality management and TQM relationships.