Hospital process performance and the adoption of medical devices: An organization-based view

Over the past two decades, there has been a growing scholarly interest in the adoption of technology in healthcare. While numerous studies have delved into the effects of specific technologies on the performance of different organizational units and medical specialties, the findings have often been divergent. Unlike the established literature, our approach focuses on the organization's perspective to analyze how technology impacts process performance in hospital settings. More precisely, we compiled a tailored dataset from 56 healthcare organizations in Italy and conducted a comprehensive analysis of panel data from 2016 to 2019, utilizing Ordinary Least Squares (OLS) regression as our main analytical tool. The data shows a clear relationship between an organization's use of medical devices and its overall process performance. Our research highlights the importance of achieving substantial improvements in process performance by strategically integrating new technologies and devices. Policymakers are encouraged to consider introducing incentives to drive hospitals to invest in innovative technologies. Furthermore, monitoring expenditures on new devices could serve as a valuable metric for assessing the extent of technology adoption within clinical practices.

[Digital Healthcare: Requirements for a Successful Transformation]

Digital transformation of healthcare is the dominating discussion topic for all healthcare stakeholders. Digital transformation encompasses all areas of healthcare and is far more than digital healthcare applications (DiGA), digital care applications (DiPA), telemedicine applications, telematics infrastructure activities, and applications from the fields of eHealth, mHealth, or Telehealth. All existing care processes and structures in the healthcare system are undergoing an inventory in order to transfer analog components of care into a digital context. The digital transformation is not taking place exclusively in economic sectors such as healthcare, but is a process of change throughout society in the collection, use, provision, linking and evaluation of information (=data). For the healthcare sector, it is clear that different technical concepts are used, while digital healthcare takes place in different places and at different times, may include different user (groups) and retains, expands or changes the healthcare context. Established healthcare functions such as diagnostics, therapy, documentation and the management of healthcare services are retained and transferred to a digital context. In addition, new application areas will emerge, such as the overarching access to health data by different actors, real-time-driven monitoring systems of holistic health data, (clinical) decision systems, or the provision of data for health services. Even if the majority of the digital transformation has not yet taken place, it is assumed that these functions and application areas of healthcare will serve to sustainably improve the quality of care and benefit the well-being of all (future) patients. For the transfer of existing processes into a digital context and the establishment of new application areas, there are prerequisites for healthcare institutions and the healthcare system itself.

Intelligent health in the IS area: A literature review and research agenda

As the global demand for healthcare services continues to grow, improving the efficiency and effectiveness of the healthcare ecosystem has become a pressing concern. Information systems are transforming the healthcare delivery process, shifting the focus of healthcare services from passive disease treatment to proactive health prevention and the healthcare management model from hospital-centric to patient-centric. This study focuses on reviewing research in IS journals on the topic of e-health and is dedicated to constructing a theoretical model of intelligent health to provide a research basis for future discussions in this field. In addition, as the innovation of intelligent healthcare services has led to changes in its elements (e.g., an increase in the number of stakeholders), there is an urgent need to sort out and analyze the existing research.

API integration and organisational agility outcomes in digital music platforms: A qualitative case study

Organisations deploy digital platforms to maximise value and transform their businesses. The success of most platforms is attributed to Application Programming Interfaces (APIs), the protocols enabling different software to communicate with each other. However, previous research on APIs has predominantly focused on the technical dimensions, such as design, and unintentionally neglected other social areas, such as organisational outcomes. This study seeks to advance organisational API research by adopting an agility perspective to explore the agility outcomes after API integration. Through rich qualitative data from a music digital firm, the findings revealed four primary agility outcomes: customer agility in the form of swift customer feedback, operational agility in the form of improved business process and delay reduction, partner agility in the form of embracing flexibility in processes and structures and expanding their ecosystem and decision agility in the form of fast decision making. A model showing the interplay and interdependencies of the agility outcomes was developed and provided depth and clarity to the findings. This study extends the literature by establishing how API integration influences organisational agility under conditions such as possessing capabilities and managing tensions during the integration process.

Sufficiency for PSS tracking gait disorders in multiple sclerosis: A managerial perspective

This study primarily aimed to explore the capabilities of digitalisation in the healthcare context, focusing on a specific disease. In this case, the study examined the potential of remote monitoring of gait to address the sensitivity of multiple sclerosis progression to gait characteristics by adopting a non-invasive approach to remotely quantify gait disturbances in a patient's daily life. To better understand the managerial aspects associated with this approach, the researchers conducted a literature review along with a set of semi-structured interviews. The target population included MS patients as well as the key agents involved in their care: patients' family members, neurologists, MS nurses, physiotherapists, medical directors, and pharmacist. The study identifies the perceived barriers and drivers that could contribute to the successful deployment of PSS remote gait monitoring as a healthcare service: i) At mega-level governance. Implications on privacy and security data are notable barriers missing on the speech. ii) At macro level, funding is highlighted as main barrier. The cost and lack of health system subsidies may render initiatives unsustainable, as emphasised by the interviewees. iii) At meso level, useable data is recognised as a driver. The data collection process can align with diverse interests to create value and business opportunities for the ecosystem actors, enhance care, attract stakeholders, such as insurers and pharma, and form partnerships. iv) At micro-level processes, we find two potential barriers: wearable device and app usability (comfort, navigation, efficiency) and organisational/behavioural aspects (training, digital affinity, skills), which are crucial for value creation in innovation ecosystems among patients and healthcare professionals. Finally, we find an interesting gap in the literature and interviews. Stakeholders' limited awareness of technological demands, especially from information technologies, for a successful long-term service, can be consider two key barriers for PSS.

The digital transformation in pharmacy: embracing online platforms and the cosmeceutical paradigm shift

In the face of rapid technological advancement, the pharmacy sector is undergoing a significant digital transformation. This review explores the transformative impact of digitalization in the global pharmacy sector. We illustrated how advancements in technologies like artificial intelligence, blockchain, and online platforms are reshaping pharmacy services and education. The paper provides a comprehensive overview of the growth of online pharmacy platforms and the pivotal role of telepharmacy and telehealth during the COVID-19 pandemic. Additionally, it discusses the burgeoning cosmeceutical market within online pharmacies, the regulatory challenges faced globally, and the private sector's influence on healthcare technology. Conclusively, the paper highlights future trends and technological innovations, underscoring the dynamic evolution of the pharmacy landscape in response to digital transformation.

Exploring the relationship between digital transformation and green innovation: The mediating role of financing modes

Green innovation is important and beneficial for the green development of enterprises. The development of digital technology could improve the asymmetry of information and affect the enterprise's financing modes. Currently, a definitive conclusion about the relationship between the digital transformation and green technology innovation has not reached. Additionally, studies have not yet fully explored the impact pathways of corporate digital transformation on green innovation through corporate financing modes. To fill this void, this study collected data of Chinese A-share listed companies from 2010 to 2020. The empirical analysis results showed that digital transformation significantly enhanced enterprises' green innovation abilities. Furthermore, mediating models were utilized to explore how enterprise financing modes mediate the impact of digital transformation on the enterprise green innovation. Results indicated that through internal financing and bank loans as "bridges", digital transformation promoted enterprise green innovation. However, digital transformation did not have a significant impact on enterprise green innovation through venture capital. Moreover, heterogeneity analyses revealed significant differences among different groups of enterprises. This study expands the research field related to digital transformation and enterprise green innovation by providing empirical evidence to uncover the impact of digital transformation on enterprise green innovation. Findings of this study contribute not only to enterprise managerial decision-makers to better leverage digital transformation through corporate financing to accelerate green innovation, but also to government policymakers to design policies to stimulate enterprise green innovation.

Scholarly communication between health informatics and information systems: A bibliometric study

The challenges of IT adoption in the healthcare sector have generated much interest across a range of research communities, including Information Systems (IS) and Health Informatics (HI). Given their long-standing interest in IT design, development, implementation, and adoption to improve productivity and support organisational transformation, the IS and HI fields are highly correlated in their research interests. Nevertheless, the two fields serve different academic audiences, have different research foci, and theorise IT artifacts differently. We investigate the dyadic relationship between health information systems (HIS) research in IS and HI through the communication patterns between the two fields. We present the citation analysis results of HIS research published in IS and HI journals between 2000 and 2020. The results revealed that despite the two fields sharing a common interest, communication between them is limited and only about specific topics. Potentially relevant ideas and theories generated in IS have not yet been sufficiently recognised by HI scholars and incorporated into the HI literature. However, the upward trend of HIS publications in IS indicates that IS has the potential to contribute more to HI.

Unveiling the affecting mechanism of digital transformation on total factor productivity of Chinese firms

The importance of digital transformation (DGT) for increasing productivity cannot be negated and Chinese firms are rapidly embracing the digital transformation for their sustainability. But the mechanism and impact of digital transformation on total factor productivity (TFP) of firms is still unclear and this study is intended to fill this gap using the data of 3112 listed firms of China during 2011 to 2022. We applied various econometric techniques like stepwise regression analysis, instrumental variable approach, differences in difference approach, and mediating analysis to determine the relationship between digital transformation and TFP and robustness of estimated findings. The findings indicate that DGT has a positive impact on overall TFP of firms in China while operating efficiency, cheaper costs, and a stronger capacity for innovation mediates this relationship. Moreover, it is explored that conventional information and communication technologies have not significant impact on TFP of firms. The findings of the study remain valid even applying many robustness checks and attempts to control the issue of endogeneity. To fully leverage the potential benefits of digital transformation on TFP, it is essential to focus on enhancing digital literacy and skills among the workforce. Governments and relevant stakeholders should prioritize and invest in comprehensive digital literacy and skills training programs to empower the workforce with the knowledge and expertise needed to navigate the digital age effectively.

Smart hospital definition: Academic and industrial perspective

BACKGROUNDS

Healthcare is a social and economic challenge in many countries, exacerbated by today's increasing demand. Many studies demonstrate that hospitals that move towards smartness, and some of their processes are smart, can provide more appropriate treatments and deal with problems more flexibly. It is axiomatic that implementing smart hospitals and healthcare tools requires a clear objective. However, the concept of a smart hospital lacks a comprehensive and broadly accepted definition, leading to varied interpretations and misconceptions. Many developments touted as 'smart' merely digitize existing hospital environments without truly embracing the full potential of smart technology. Furthermore, research studies have neglected to consider industrial perspectives, which will soon cause a gap between industry and academics in this concept.

OBJECTIVES

This research aims to explore the attributes of a smart hospital and use them to propose a definition for it, considering both scholarly and industrial viewpoints.

METHOD AND RESULTS

The PRISMA method is employed to select academic and practical papers providing definitions and insights into smart hospitals or healthcare. 17 studies are analyzed, and a total, 83 characteristics are identified to describe the smart hospital. These features are categorized into three primary categories: "technologies", "services", and "goals". The most important features are determined by analyzing the frequencies of these characteristics across all the studies. In the results section, these data are presented in graphical form, highlighting both academic and industrial perspectives separately, as well as a combined analysis. Furthermore, an attempt is made to uncover trends in smart hospitals from 2015 to 2023.

CONCLUSION

A comprehensive definition of the smart hospital, encompassing both academic and industrial perspectives, is proposed using the investigated characteristics. This study also presents research opportunities and discusses the existing gap between academia and industry concerning smart hospitals.

A Sustainable Model for Healthcare Systems: The Innovative Approach of ESG and Digital Transformation

In recent years, the globe has faced a series of topics of growing concern, such as the COVID-19 pandemic, the international financial crisis, rising socio-economic inequalities, the negative outcomes of greenhouse gas emissions, which resulted in climate change, and many others. Organizations worldwide have confronted these new challenges of sustainable finance by incorporating environmental, social, and corporate governance (ESG) factors and digital transformation (DT) in their innovation business strategies. The healthcare sector represents a large share of the global economy (about 10% of global economic output), employs a large number of workers, and needs to rely more on an open innovation model where interested parties, especially patients, are going to have a say in their own well-being. Thus, it is imperative that healthcare providers be efficient, effective, resilient, and sustainable in the face of significant challenges and risks. At the same time, they must offer sustainable development goals and digital transformation to healthcare users through limited governmental resources. This study investigates the role, importance, and correlation of ESG factors and digital transformation to the sustainable finance of healthcare systems through an innovative model. The main purpose of the paper is to present the already implemented ESG and DT factors in the healthcare sector and to propose a mutual and combined implementation strategy based on common evaluation tools, methods, and actions. A set of proposed actions and strategies are presented for the sustainability and resilience of the healthcare sector.

Healthcare professionals' intention to adopt mobile phone-based SMS and its predictors for adherence support and care of TB patients in a resource-limited setting: a structural equation modelling analysis

OBJECTIVE

To assess healthcare providers' intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region of southwest Ethiopia.

STUDY DESIGN

An institutional-based cross-sectional study was conducted from October to November 2022.

STUDY SETTING

The study was conducted in public hospitals which include Mettu Karl referral hospital, Dembi Hospital, Bedelle Hospital, Darimu Hospital and Chora Hospital in Ilu Aba Bor and Buno Bedelle zones.

PARTICIPANTS

A total of 625 (54.9% male and 45.1% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All health professionals permanently working in Ilu Aba Bor and Buno Bedelle zone hospitals were included in this study. However, health professionals with less than 6 months of experience and those who were not present during the data collection period were excluded from this study.

OUTCOME MEASURE

The intention to use mobile phone-based SMS to support TB patients.

RESULTS

Healthcare professionals' intention to use mobile SMS was 54.4%. Effort expectancy had a significant direct effect on attitude (β=0.162, p<0.01) and intention towards using mobile phone SMS (β=0.329, p<0.001). The intention to use mobile phone SMS was directly influenced by facilitating conditions (β=0.104, p<0.01) and attitude (β=0.26, p<0.001). The relationship between effort expectancy and intention to use SMS was mediated by attitude (β=0.043, p<0.01).

CONCLUSIONS

Overall, intention to use of mobile-based SMS was high. Effort expectancy, attitude and facilitating conditions were significant factors that determined healthcare professionals' behavioural intention to use mobile phone SMS. Effort expectancy had a more significant prediction power than others. As a result, system forms that are easily interactive and applicable should be implemented to improve capacity building and support the adherence and care of TB patients.

Quantifying the impact of green growth and digital transformation on health: new insights from Asian economies

In today's global landscape, a paradigm shift from closed systems to open and digital networks is underway, with digital transformation and green growth permeating every facet of society, including healthcare. Therefore, our study attempts to explore the impact of digital transformation and green growth on the health outcomes of Asian economies. Employing the ARDL-PMG methodology, we delve into the long-run and short-run correlations between digital transformation, green growth, and health. Digital transformation is captured through patent technology, internet, and research and development. The findings report the significant and positive impact of digital transformation on health in the long and short run. Furthermore, the study reveals a substantial and favorable impact of green growth on health in both the short and long run. The findings of the study highlight the need for digital transformation and green growth particularly in the field of healthcare in order to improve quality of life and life expectancy.

What are barriers and facilitators in sustaining lean management in healthcare? A qualitative literature review

BACKGROUND

Lean management (LM) is a continuous improvement methodology originating from manufacturing and is widely adopted in healthcare to improve processes. LM shows promising results in healthcare and research on the topic is increasing. However, it can be difficult to sustain LM over time, and an overview of facilitators or barriers that influence the sustainment of LM in a healthcare context is unavailable.

METHODS

Prior to search, five inclusion and exclusion criteria were defined to establish suitability of identified articles for our research question. This study was based on 24 selected peer-reviewed studies that reported on the sustainment of LM in healthcare organisations, published in the last five years. Following the Preferred Reporting Items for Systemtic Reviews and Meta-Analyses (PRISMA) guidelines, all articles were scanned, retrieved for full-text and analysed thematically.

RESULTS

Following thematic analysis, we identified four overarching themes: Mobilising Employees, Guiding Change Efforts, Methods, and Local Context. Key facilitators for supporting LM are fostering an improvement culture and learning culture, providing professional development opportunities, assigning more responsibilities to employees in decision making processes and appointing change agents to act as local LM leaders. Key barriers for sustaining LM include overburdening employees with responsibilities, omitting staff involvement during LM implementation, lack of patient engagement, lack of resources to engage with LM, a lack of leadership commitment and follow-up on projects, and a lack of knowledge of LM among leaders.

CONCLUSION

Overall, studies emphasise the importance of actively involving and engaging the workforce to embed LM into organisational culture. Reflecting on the origins of LM, healthcare organisations can find inspiration in the virtue of respecting people in their journey to sustain and cultivate an improvement culture. LM provides potential to change healthcare for the better and could help healthcare organisations to cope with increasing external pressures.

[Digital transformation of German healthcare organizations : Current status and existing challenges from the perspective of quality management]

INTRODUCTION

Digital transformation includes, among other things, the project planning and implementation of digital applications, technologies, and measures and currently represents the day-to-day business of all organizations and institutions in the healthcare sector. In this article, the current activities of digital transformation in healthcare facilities from the perspective of quality management are presented.

METHODS

A Germany-wide survey among 141 members of the Society for Quality Management in Healthcare (physicians in private practice, hospitals, health insurers, and other healthcare institutions) was conducted on all fields of digital technologies, existing projects, and digital technologies that are currently being implemented. Based on six thematic modules, the participants evaluated the chronological sequence and the relevance of the content for their organization.

RESULTS

Of the survey participants, 82% stated that digital transformation influences or changes their everyday workplace. The most frequent projects include topics from process and interface management (53%) and improving patient safety (52%). The most frequent concrete projects are electronic patient files and topics that were commissioned as part of the Krankenhauszukunftsgesetz.

DISCUSSION

According to the respondents, digital transformation is changing the structures and processes of healthcare facilities and requires additional competencies so that digital technologies can be implemented in a targeted and sustainable manner. A structured coordination of the competencies of all professions in a healthcare facility is required to anchor digital technologies in the everyday life of healthcare facilities.

Factors Reducing the Use of a Persuasive mHealth App and How to Mitigate Them: Thematic Analysis

BACKGROUND

Studies on which persuasive features may work for different users in health contexts are rare. The participants in this study were microentrepreneurs. We built a persuasive mobile app to help them to recover from work. Representatives of this target group tend to be very busy due to work, which was reflected in their use of the app during the randomized controlled trial intervention. Microentrepreneurs also often have dual roles; they are professionals in their line of work as well as entrepreneurs managing their own business, which may add to their workload.

OBJECTIVE

This study aimed to present users' views on the factors that hinder their use of the mobile health app that we developed and how these factors could be mitigated.

METHODS

We interviewed 59 users and conducted both data-driven and theory-driven analyses on the interviews.

RESULTS

Factors reducing app use could be divided into 3 categories: use context (problem domain-related issues, eg, the lack of time due to work), user context (user-related issues, eg, concurrent use of other apps), and technology context (technology-related issues, eg, bugs and usability). Due to the nature of the participants' entrepreneurship, which often interferes with personal life, it became clear that designs targeting similar target groups should avoid steep learning curves and should be easy (quick) to use.

CONCLUSIONS

Personalized tunneling-guiding the user through a system via personalized solutions-could help similar target groups with similar issues better engage with and keep using health apps because of the easy learning curve. When developing health apps for interventions, background theories should not be interpreted too strictly. Applying theory in practice may require rethinking approaches for adaptation as technology has evolved rapidly and continues to evolve.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03648593; https://clinicaltrials.gov/ct2/show/NCT03648593.

Development of an Evidence-Based Conceptual Model of the Health Care Sector Under Digital Transformation: Integrative Review

BACKGROUND

Digital transformation is currently one of the most influential developments. It is fundamentally changing consumers' expectations and behaviors, challenging traditional firms, and disrupting numerous markets. Recent discussions in the health care sector tend to assess the influence of technological implications but neglect other factors needed for a holistic view on the digital transformation. This calls for a reevaluation of the current state of digital transformation in health care. Consequently, there is a need for a holistic view on the complex interdependencies of digital transformation in the health care sector.

OBJECTIVE

This study aimed to examine the effects of digital transformation on the health care sector. This is accomplished by providing a conceptual model of the health care sector under digital transformation.

METHODS

First, the most essential stakeholders in the health care sector were identified by a scoping review and grounded theory approach. Second, the effects on these stakeholders were assessed. PubMed, Web of Science, and Dimensions were searched for relevant studies. On the basis of an integrative review and grounded theory methodology, the relevant academic literature was systematized and quantitatively and qualitatively analyzed to evaluate the impact on the value creation of, and the relationships among, the stakeholders. Third, the findings were synthesized into a conceptual model of the health care sector under digital transformation.

RESULTS

A total of 2505 records were identified from the database search; of these, 140 (5.59%) were included and analyzed. The results revealed that providers of medical treatments, patients, governing institutions, and payers are the most essential stakeholders in the health care sector. As for the individual stakeholders, patients are experiencing a technology-enabled growth of influence in the sector. Providers are becoming increasingly dependent on intermediaries for essential parts of the value creation and patient interaction. Payers are expected to try to increase their influence on intermediaries to exploit the enormous amounts of data while seeing their business models be challenged by emerging technologies. Governing institutions regulating the health care sector are increasingly facing challenges from new entrants in the sector. Intermediaries increasingly interconnect all these stakeholders, which in turn drives new ways of value creation. These collaborative efforts have led to the establishment of a virtually integrated health care ecosystem.

CONCLUSIONS

The conceptual model provides a novel and evidence-based perspective on the interrelations among actors in the health care sector, indicating that individual stakeholders need to recognize their role in the system. The model can be the basis of further evaluations of strategic actions of actors and their effects on other actors or the health care ecosystem itself.

The drivers of the digital transformation in the healthcare industry: An empirical analysis in Italian hospitals

In recent years, driven by the spread of the COVID-19 pandemic, digital transformation in the healthcare sector is becoming increasingly important. Digital healthcare technologies, if adopted in a targeted manner and implemented in a cost-effective way, make it possible to reduce healthcare inequalities, improve the quality of healthcare provided and increase the well-being of citizens. The importance of digital transformation in healthcare is also attracting interest from academics. However, at present, there are few studies aimed at examining the degree of digital transformation in healthcare and the drivers of the adoption and implementation of digital solutions by healthcare facilities. This study aims to fill this gap by analysing the level of digital transformation of Italian hospitals and the factors that can affect this level of digital transformation. The analysis, conducted on a sample of 103 hospitals, shows a positive and significant impact of the hospital size, hospital age and hospital teaching status on the level of digital transformation. Furthermore, in relation to hospital complexity, it shows a positive effect of the presence of the emergency room and a non-significant influence of the number of hospital departments on the level of digital transformation.

Digital “x”—Charting a Path for Digital-Themed Research

We live in a time when digital technologies reshape most aspects of business and social life. This challenges received assumptions about modes of operation in organizations. As a result, scholars and practitioners increasingly use the label “digital” to signify that something has changed to the extent that a plethora of long-established management concepts are expressed in a new formulaic form of “digital x,” and x can stand for innovation, strategy, transformation, infrastructure, etc. In the information systems discipline and beyond, “digital” has emerged as an oft-used conceptual label to characterize age-long phenomena hitherto described by the IT (or x) label. There is a sense among academic and practitioner communities that digital and IT are not mere synonyms, but beyond the hype, something fundamentally different is being signaled when the “digital” label is invoked. This paper traces the intellectual roots and foundations of the growing use of “digital” as a conceptual label, identifies when the label use is warranted as well as outlines implications that the moniker holds for future scholarship, policy, and practice. In particular, the paper offers actionable guidance that enables more reflective use of the term “digital” as we move forward.

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.

Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs

The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.

Digital transformation: A meta-review and guidelines for future research

The emergence of digital transformation has changed the business landscape for the foreseeable future. As scholars advance their understanding and digital transformation begins to gain maturity, it becomes necessary to develop a synthesis to create solid foundations. To do so, significant steps need to be taken to critically, rigorously, and transparently examine the existing literature. Therefore, this article uses a meta-review with the support of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Protocol. As a result, we identified six dimensions and seventeen categories related to digital transformation. The organizational, technological, and social dimensions are still pivotal in digital transformation, while two new dimensions (sustainability and smart cities) still need to be explored in the existing literature. The need to deepen knowledge in digital transformation and refine the dimensions found is of paramount importance, as it involves some complexity due to organizational dynamics and the development of new technologies. It was also possible to identify opportunities, challenges, and future directions.

A systematic review of telemedicine systems use barriers: primary health care providers' perspective

Purpose

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

Design/methodology/approach

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Findings

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

Originality/value

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

From research to market: correlation between publications, patent filings, and investments in development and production of technological innovations in biosensors

As the global population grows and science and technology development evolve, fulfilling basic human needs has been even more linked to technological solutions. In this review, we present an overview of the biosensor market and discuss the factors that make certain countries more competitive than others in terms of technology and innovation and how this is reflected in the trends in publication and patent filling. Additionally, we expose briefly how the COVID-19 pandemic acts as a catalyst for the integration of research and development, business, and innovation sectors to bring solutions and ideas that have been predicted as tendencies for the future.

Health IT in our daily life: impact of mobile phone use on the emotions and compliance of diabetes patients

Purpose

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

Design/methodology/approach

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

Findings

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

Originality/value

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.

Evaluation of organizational variables of quality 4.0 in digital transformation: the study of an Indian manufacturing company

Purpose

The study aims to identify organizational variables of quality 4.0 for an Indian manufacturing company in the case of digital transformation. Furthermore, the organization enhances its quality 4.0 performances to its success based on the degree of relevance of these variables, insight into these variables and sub-factors to prioritize them.

Design/methodology/approach

Initially, two rounds of the survey were conducted with 11 decision-makers from the company made to receive organizational variables scores and prioritize the factors and sub-factors. Analytic Hierarchy Process (AHP) based research methodology has been proposed to assign the criterion weights and prioritize the identified variables.

Findings

The results of this AHP model demonstrate that “Committed Leadership” is recognized as the top positioned variable and most significant organizational variable, followed by Collaboration and Quality culture, which are developed at the next level. These essential organizational variables with their sub-categories' priorities are identified as contributing attributes.

Research limitations/implications

The findings facilitate quality 4.0 in the digitalization era, which take into contemplating the current state of the business. Furthermore, the understanding of variables provides insightful guidance to analyze, solve complex problems and assess the efficacy of quality 4.0 in digital transformation.

Originality/value

The novelty of this study is to pinpoint, and evaluate the responsible organizational variables and prioritize them that lead to high productivity and competitive advantage considering the AHP method.

Reaping the benefits of digital transformation through Public-Private Partnership: A service ecosystem view applied to healthcare

The ongoing digital transformation ushers unprecedented challenges for publicly owned healthcare organizations. Collaborative governance models, such as Public Private Partnerships (PPPs), advance their readiness to address such challenges, paving the way for the establishment of a viable service ecosystem. However, little is known about how PPPs enhance the publicly owned healthcare organizations’ ability to thrive amidst the digital transformation. The article investigates this issue, drawing on the exploratory case of “Lab@AOR”, a PPP established between Loccioni and the University Hospital of Marche (Italy) which focused on the robotization of a critical component of healthcare services’ delivery. Three ingredients have been found to nurture the PPP’s cohesiveness and success: (1) the alignment between the public partner’s needs and the private partner’s competences, (2) knowledge contamination, and (3) the adoption of patient-centeredness as the inspiring principle of the collaboration. The PPP represents an initial step of the transition towards a service ecosystem, entailing a fully-fledged partners’ integration for value co-generation.

Corporate Digital Transformation and Green Innovation: A Quasi-Nature Experiment from Integration of Informatization and Industrialization in China

In the era of the digital economy, the rise and application of digital technologies have led to a series of systematic changes and disruptive innovations within enterprises. Based on the quasi-natural experiment of "Integration of Informatization and Industrialization", this paper examines the economic consequences of digital transformation from the standpoint of corporate green innovation, utilizing China's listed manufacturing firms as the research object. Using the DID model, it is discovered that through the implementation of corporate digital transformation, the output of green innovation increases significantly. The conclusions are still robust when using the parallel trend test, PSM-DID, placebo test, and the test of deleting the sample entering the pilot in the current year. Extended analyses find that corporate digital transformation has a greater effect on green innovation in regions with weaker digital economy, in industries with less rivalry, and in firms with larger size. The conclusions of this paper not only advance research on digital transformation and its economic consequences, but also provides theoretical proof and practical insights for advancing corporate digital transformation and enhancing the green development system.

Optimal Allocation of Enterprise Resources Based on the Intelligent Algorithm from the Perspective of Multidimensional Dynamic Innovation

Faced with the upsurge of digital technology, many small and medium-sized startups are aware of the opportunities and challenges it brings and are actively responding to digital transformation. Digital transformation is a type of strategic change with certain risks. On the one hand, this requires business leaders to have a sense of change, and on the other hand, it also requires certain resources to be invested. As a result, in the real world, not all small and medium-sized entrepreneurial firms have the ability or inclination to implement digital transformation. SMEs' digital transformation has become a key factor in promoting the national economy's transition from new and old kinetic energy and providing new prospects for development of small and medium firms. As a starting point, this study devises an index system for assessing the digital maturity of small and medium-sized businesses. Based on the AHP method in the multicriteria framework, a hierarchical structure is established for each index, a three-layer basic framework is established, and the weight of the evaluation index is calculated. Second, this work establishes a BP network model for digital transformation maturity assessment of startups based on AHP and establishes a three-layer BP network structure. This work aims to optimize BP network using the improved ISFLA algorithm. It improves the adaptive step size update formula in the SFLA algorithm by using the mutation operator and improves the evolution method of the worst individual of the frog to the simultaneous evolution of multiple poor individuals. The constructed ISFLA-BP algorithm is then used to evaluate the digital transformation maturity of small and medium-sized startups. Finally, systematic and comprehensive experiments are carried out to verify superiority as well as feasibility of the method.

Reliability of Using a Smartphone Application to Objectify Skull Deformation

PURPOSE

To establish intrarater and interrater reliability of photographs made in a newly developed smartphone app to determine the severity of infantile skull deformation by taking a cranial photograph of an infant's head.

METHODS

Using the app, 1 pediatric physical therapist and 2 pediatric physical therapy master students photographed heads of 30 infants aged up to 12 months receiving treatment for asymmetric or delayed motor development. Modified Cranial Vault Asymmetry Index and Cranial Index determined the severity of skull deformation.

RESULTS

Intrarater reliability was excellent both for mCVAI and CI, with an ICC(3,1) = 0.97, and ICC(3,1) = 0.98, respectively. Interrater reliability with an ICC(2,1) = 0.97 for the mCVAI, and ICC(2,1) = 0.99 for the CI was excellent too.

CONCLUSION

The reliability of the Skully Care App proved to be excellent when used by pediatric physical therapists.Supplemental Digital Content 1. Video Abstract available at: http://links.lww.com/PPT/A399 .

Digital Future of Emergency Medical Services: Envisioning and Usability of Electronic Patient Care Report System

Despite the efforts of emerging technologies in the healthcare system, there is still a slower rate of acceleration in prehospital settings compared with the hospitals in digital transformation adaptation. The acknowledgment that digital transformation is significant to healthcare is reflected in planning for the future of digital healthcare. Thus, this study aimed to measure the usability of the electronic patient care report (ePCR) system among emergency medical services (EMS) staff who work in prehospital settings. A descriptive cross-sectional correlation study was used. Two hundred fifty EMS staff who are working in the prehospital setting at Saudi Red Crescent Authority in the Kingdom of Saudi Arabia were surveyed, and the response rate was 79.2% (198). An adapted tool of the Computer System Usability Questionnaire survey was used to collect data. The data were coded numerically and subjected to descriptive and inferential statistical analysis including Pearson’s correlation coefficient using the statistical software (SPSS 21). The majority of the participants rate their ePCR system as “useable” at a high level with a score of 3.41 (SD = 1.021). The overall mean of the ePCR system’s three subscales: system usefulness, information quality, interface quality, and overall satisfaction were 3.39 (SD = 1.152), 3.30 (SD = 1.052), 3.57 (SD = 1.064), and 3.37 (SD = 1.239), respectively. The least liked aspect of ePCR system software was information quality 81 (40.9%). Furthermore, there was a significant correlation between the age of EMS staff and the usability of the ePCR system (r = −0.150 ${\hspace{0.17em}}^{\ast }$ , $P=0.035$ ). The results suggest that healthcare institutions’ policy and decision-makers pay close attention to performing standardized training for the staff on their ePCR system before going to the field to increase efficiency and productivity. Furthermore, the users in this study identified other system features that, if included, could have enhanced usability, and improved functions and capabilities of the design to meet the EMS staff’s expectations.

Pushing Yourself Harder: The Effects of Mobile Touch Modes on Users’ Self-Regulation

Mobile health interventions are widely used to facilitate individuals’ management of their health behavior. A notable issue is that health interventions with obvious persuasive intent may cause negligence and reactance. In this study, we propose a subtle but powerful way to bolster self-regulation in maintaining healthy behavior by leveraging embodied interaction design. Our study shows that bodily actions in interacting with digital devices can trigger thoughts about prior associated experiences and, thus, be strategically designed to affect individuals’ judgments, decisions, and behavior. Specifically, in three experiments, we find that firmly pressing a touchscreen during mobile interaction (as compared with gently tapping a touchscreen) can activate users’ approach motivation and, thus, induce their preference for a healthy over a tasty beverage, lead to more challenging exercise goals and more exercise, and reduce personal hygiene lapses after receiving hygiene education. Hence, designers of digital health products may consider designing interaction with pressing gestures to facilitate users’ self-regulation and attainment of health-related goals. Policymakers can also encourage the adoption of relevant app designs to improve citizens’ health wellbeing.

Measuring the Impact of Virtual Communities on the Intention to Use Telemedicine Services

Digital marketing has given new life to healthcare services by enhancing their visibility in the online space. People choose online healthcare services because they can receive instant answers and communicate with specialists in their comfortable environment at the right time. The purpose of this study was to understand the impact of virtual communities on the intention to use telemedicine. The model is based on a combination of consumer desire (psychological objective) and loyalty through promotional formats (economic objective), as well as data collected from 442 respondents analyzed using structural equation modeling. The research results show that by analyzing target groups in social networks, content can be individualized, and an accurate measurement of e-patient satisfaction must be conducted in order to improve the experience of future consumers of telemedicine services. The results of this study explain what makes people want to use digital healthcare services and can serve as a guide for people who run virtual communities and help digital healthcare service providers figure out how to market their services.

A Bitter Pill to Swallow? The Consequences of Patient Evaluation in Online Health Question-and-Answer Platforms

Online health question-and-answer platforms (OHQPs), where patients post health-related questions, evaluate advice from multiple doctors and select their most preferred answer, are a prominent channel for patients to receive medical advice in China. They are gaining traction globally and have the potential to circumvent resource-based, geographic, or circumstantial barriers that limit access to care. At the same time, they are underregulated in contrast to brick-and-mortar points of care. Ours is the first study to evaluate the quality of healthcare advice promoted by these platforms and to provide insight into how patients respond to advice. We found that, though advice is generally good, patients cannot discern good advice from bad, choose poor advice (when offered) as often as good advice, and do so to a greater extent in vulnerable categories such as pediatrics, cancers/tumors, and internal medicine. Moreover, we found that OHQPs exacerbate care avoidance. Our findings suggest that platform owners and policymakers should ensure that signals of expert consensus are provided to patients to better assist their choices on OHQPs. We also unveiled bad actors on OHQPs, including drug promoters and spammers, indicating that stronger oversight and accountability mechanisms are needed. Physician peer reviewing and auditing can address both problems.

BUSINESS MODEL CONFIGURATIONS IN DIGITAL HEALTHCARE–A GERMAN CASE STUDY ABOUT DIGITAL TRANSFORMATION

Digital ventures are flooding the healthcare market in Germany and setting new standards for innovative digital health systems and tools. A key challenge in this sector from both academic and practitioner perspectives remains the intransparency of business model configurations applied by digital health. We tackle this problem by conducting a comparative case study of 237 digital health ventures. These ventures are examined on the business model level, exploring the digital technology components of each company and relating them to the identified areas of activity. The resulting dominant combinations of the two dimensions highlight four key areas of activity and two technological core elements. Within these dominant combinations we identify intriguing configurations of business model activities. The dominant Software(-as-a-Service) logic supports the criteria of interoperability on different levels. This research contributes to the growing academic literature stream of digital technology and entrepreneurship in healthcare.

Operationalization of Critical Success Factors to Manage the Industry 4.0 Transformation of Manufacturing SMEs

As an increasing number of manufacturing small and medium enterprises (SMEs) tackle their digital transformation toward Industry 4.0, the need for a methodology to manage this transformation, tailored to their particular context, becomes apparent. Since recent studies have identified critical success factors (CSFs) for the Industry 4.0 transformation of manufacturing SMEs, this paper aims to operationalize these CSFs and propose an Industry 4.0 transformation management methodology. This research is based on an extensive literature review on CSFs for Industry 4.0 transformation, followed by a Delphi–Régnier survey with a panel of Industry 4.0 experts. For each CSF, specific actions to perform at different stages of the Industry 4.0 transformation were defined and validated by experts. Based on a proposed Industry 4.0 transformation process, not all CSFs have to be managed at every phase and step of the transformation process. Each CSF must be supported by different actions positioned within each Industry 4.0 transformation process step. The results of this research are particularly relevant for manufacturing SME managers and consultants managing Industry 4.0 transformation. By performing these actions, they can ensure the achievement of multiple CSFs during their digital transformation projects and, thus, ensure their success. This research combines the academic and professional domains by proposing a way for theoretical findings to be translated into clear actions. The proposed model allows all the actors involved in manufacturing SMEs’ digital transformation projects to understand the actions needed to achieve a successful transformation.

Towards the Use of Big Data in Healthcare: A Literature Review

The interest in new and more advanced technological solutions is paving the way for the diffusion of innovative and revolutionary applications in healthcare organizations. The application of an artificial intelligence system to medical research has the potential to move toward highly advanced e-Health. This analysis aims to explore the main areas of application of big data in healthcare, as well as the restructuring of the technological infrastructure and the integration of traditional data analytical tools and techniques with an elaborate computational technology that is able to enhance and extract useful information for decision-making. We conducted a literature review using the Scopus database over the period 2010–2020. The article selection process involved five steps: the planning and identification of studies, the evaluation of articles, the extraction of results, the summary, and the dissemination of the audit results. We included 93 documents. Our results suggest that effective and patient-centered care cannot disregard the acquisition, management, and analysis of a huge volume and variety of health data. In this way, an immediate and more effective diagnosis could be possible while maximizing healthcare resources. Deriving the benefits associated with digitization and technological innovation, however, requires the restructuring of traditional operational and strategic processes, and the acquisition of new skills.

Self-Regulation and External Influence: The Relative Efficacy of Mobile Apps and Offline Channels for Personal Weight Management

On the basis of a novel panel data set on customers enrolled in an actual weight loss program that delivers services through a mobile app and offline stores, this study shows that use of the mobile app is positively associated with weight management by both free and paid users. For paid users, who have access to the mobile app and office visits, usage of both channels is associated with short-term weight loss. Furthermore, the two channels function as substitutes for one another, with users able to compensate for infrequent offline store visits through more intense mobile app usage. In the long term, however, only mobile app usage (and not offline store visits) contributes to the sustainability of weight loss. Additional empirical analyses further reveal that frequency and granularity of mobile app usage are positively associated with weight loss. We also find that individuals exposed to low performance pressure benefit more fully from mobile app usage. Overall, the empirical results, together with qualitative evidence gleaned from interviews with actual customers, suggest that mobile app usage and the self-regulation that it enables exert a relatively greater impact on personal weight management compared with the external influence stemming from human experts in offline channels.

Patient Expectation in China: Exploring Patient Satisfaction in Online and Offline Patient-Provider Communication

Introduction

Online patient-provider communication (OPPC) has become an alternative approach to seek medical advice and contact health professionals. However, its penetration rate remains low, and the underlying mechanisms of patient satisfaction with OPPC are underexamined. This study investigates the role of patient expectancy and the expectancy violation of patient-centered communication (PCC) in patient satisfaction in emerging OPPC scenarios by integrating the concepts of PCC and expectancy violation theory (EVT).

Method

An online survey was conducted in October 2019 among Chinese respondents who experienced OPPC and offline medical services.

Results

The 471 qualified participants reported high satisfaction with OPPC (mean [M] = 3.63, standard deviation [SD] = 0.81). However, patient satisfaction with OPPC was lower than that in offline medical encounters (M = 3.75, SD = 0.80), and patients suffered a higher expectancy violation of PCC in OPPC scenarios (M = 0.45, SD = 0.76) than in offline medical encounters (M = 0.27, SD = 0.69). Nevertheless, patients' satisfaction with OPPC significantly increased as the frequency of OPPC usage increased (β = 0.209, p < 0.001). This positive relationship was partially mediated by the decrease in the expectancy violation of PCC in OPPC scenarios.

Discussion

The study can contribute to increasing the adoption of OPPC and reducing the burden of offline medical resources.

Exploring the Equity Impact of Current Digital Health Design Practices: Protocol for a Scoping Review

Background

The field of digital health has grown rapidly in part due to digital health tools’ potential to reduce health inequities. However, such potential has not always been realized. The design approaches used in digital health are one of the known aspects that have an impact on health equity.

Objective

The aim of our scoping review will be to understand how design approaches in digital health have an impact on health equity.

Methods

A scoping review of studies that describe how design practices for digital health have an impact on health equity will be carried out. The scoping review will follow the methodologies laid out by Arksey and O’Malley, the Joanna Briggs Institute, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The PubMed, Embase, Web of Science, and ACM Digital Library databases will be searched for peer-reviewed papers. The ProQuest Dissertations and Theses and Global Index Medicus databases will be searched for gray literature. The results will be screened against our inclusion and exclusion criteria. Subsequently, the data extracted from the included studies will be analyzed.

Results

As of March 2022, a preliminary search of the peer-reviewed databases has yielded over 4900 studies, and more are anticipated when gray literature databases are searched. We expect that after duplicates are removed and screening is completed, a much smaller number of studies will meet all of our inclusion criteria.

Conclusions

Although there has been much discussion about the importance of design for lowering barriers to digital health participation, the evidence base demonstrating its impacts on health equity is less obvious. We hope that our findings will contribute to a better understanding of the impact that design in digital health has on health equity and that these findings will translate into action that leads to stronger, more equitable health care systems.

Big data analysis for decision-making processes: challenges and opportunities for the management of health-care organizations

Purpose

This study aims to provide a picture of the current state of art in the use of big data for decision-making processes for the management of health-care organizations.

Design/methodology/approach

A systematic literature review was carried out. The research uses two analyses: descriptive analysis, describing the evolution of citations; keywords; and the ten most influential papers, and bibliometric analysis, for content evaluation, for which a cluster analysis was performed.

Findings

A total of 48 articles were selected for bibliographic coupling out of an initial sample of more than 5,000 papers. Of the 48 articles, 29 are linked on the basis of their bibliography. Clustering the 29 articles on the basis of actual content, four research areas emerged: quality of care, quality of service, crisis management and data management.

Originality/value

Health-care organizations believe strongly that big data can become the most effective tool for correctly influencing the decision-making processes. Thus, more and more organizations continue to invest in big data analytics, and the literature on this topic has expanded rapidly. This study seeks to provide a comprehensive picture of the different streams of literature existing, together with gaps in research and future perspectives. The literature is mature enough for an analysis to be made and provide managers with useful insights on opportunities, criticisms and perspectives on the use of big data for health-care organizations. However, to date, there is no comprehensive literature review on the big data analysis in health care. Furthermore, as big data is a “sexy catchphrase,” more clarity on its usage may be needed. It represents an important tool to be investigated and its great potential is often yet to be discovered. This study thus sheds light on emerging issues and suggests further research that may be needed.

Health information technology adoption and acceptance of Turkish physicians-A model proposal and empirical assessment

Health Information Technology (HIT) systems are receiving increasing attention in recent years. Yet, individual adoption research in health care settings, especially in developing countries are quite limited. Moreover, large body of Information Systems research has focused on user perceptions to form intentions to use a particular technology. However, the antecedents and consequences of perceptions remained largely unanswered in existing research. This study aims to fill this gap by proposing and testing a research model based on a modified Technology Acceptance Model (m - TAM) which incorporates socio psychological and cognitive factors to assess the HIT's adoption level of Turkish physicians. To do so, two different methods were used to collect data from head physicians, assistant head physicians, and physicians: face to face and online survey. Total 212 useful responses were returned. 174 of them were face-to-face surveys which were administrated to all the first level and some second and third level health organizations. The rest of the surveys were administrated to the second and third level healthcare organizations via online participation. Data were analyzed by Structural Equation Modelling via SmartPLS software program. Results present that commitment is a strong predictor of HIT usage, whereas neither motivation nor resistance has a significant impact on HIT usage.