Background Until now, the use of technology in healthcare is driven mostly by the assumptions about the benefits of eHealth rather than the evidence of it. It is noticeable that the magnitude of evidence of effectiveness and efficiency of eHealth is not proportionate to the number of interventions that are regularly conducted. Reliable evidence generated through comprehensive evaluation of eHealth interventions may accelerate the growth of eHealth for long-term successful implementation and help to experience the benefits of eHealth in an enhanced way.
Background Summative eHealth evaluations frequently lack quality, which affects the generalizability of the evidence, and its use in practice and further research. To guarantee quality, a number of activities are recommended in the guidelines for evaluation planning. This study aimed to examine a case of an eHealth evaluation planning in a multi-national and interdisciplinary setting and to provide recommendations for eHealth evaluation planning guidelines. Methods An empirical eHealth evaluation process was developed through a case study. The empirical process was compared with selected guidelines for eHealth evaluation planning using a pattern-matching technique. Results Planning in the interdisciplinary and multi-national team demanded extensive negotiation and alignment to support the future use of the evidence created. The evaluation planning guidelines did not provide specific strategies for different set-ups of the evaluation teams. Further, they did not address important aspects of quality evaluation, such as feasibility analysis of the outcome measures and data collection, monitoring of data quality, and consideration of the methods and measures employed in similar evaluations. Conclusions Activities to prevent quality problems need to be incorporated in the guidelines for evaluation planning. Additionally, evaluators could benefit from guidance in evaluation planning related to the different set-ups of the evaluation teams.
In this paper, we critically assess the contribution of the operations management literature in creating pragmatic knowledge regarding how IT deployment can improve healthcare performance. A systematic literature review is conducted, and the following issues limiting knowledge generation have been identified: 1) IT deployment and healthcare performance are often conceptualised as black boxes; 2) existing theories are used inadequately, and emerging theories are lacking, which restricts the identification of the underlying mechanisms in the IT-performance relation; and 3) contextual factors are often overlooked. We develop a framework, arguing that to overcome these limitations, future studies require the following: 1) conceptualise IT in terms of its functionalities; 2) explain the reason(s) for selecting the performance attribute(s); 3) identify the mechanisms of the relationship of IT-performance by investigating and theorising the consequences of IT deployment on service operations; and 4) consider the contextual factors while explaining the IT-performance relation.
In this paper, we critically assess the contribution of the operations management literature in creating pragmatic knowledge regarding how IT deployment can improve healthcare performance. A systematic literature review is conducted, and the following issues limiting knowledge generation have been identified: 1) IT deployment and healthcare performance are often conceptualised as black boxes; 2) existing theories are used inadequately, and emerging theories are lacking, which restricts the identification of the underlying mechanisms in the IT-performance relation; and 3) contextual factors are often overlooked. We develop a framework, arguing that to overcome these limitations, future studies require the following: 1) conceptualise IT in terms of its functionalities; 2) explain the reason(s) for selecting the performance attribute(s); 3) identify the mechanisms of the relationship of IT-performance by investigating and theorising the consequences of IT deployment on service operations; and 4) consider the contextual factors while explaining the IT-performance relation.
Background Video consultation (VC) is increasingly seen as a cost-effective way of providing outpatient care in the face of dwindling resources and growing demand for health care worldwide. Therefore, the sustainable implementation of VC is a phenomenon of interest to medical practitioners, researchers, and citizens alike. Studies are often criticized for not being sufficiently robust because the research settings are mostly small-scale pilot projects and are unable to reflect long-term implementation. The COVID-19 pandemic has compelled clinicians worldwide to conduct remote consultation, creating a favorable context to study large-scale remote consultation implementation. Objective The aim of this study was to thoroughly investigate how clinicians reason their choice of different consultation modes in the routine of consultation and what the underlying reasons are for their choices. We posited that a deeper understanding of clinicians’ perceptions of remote consultation is essential to deduce whether and how remote consultation will be adopted on a large scale and sustained as a regular service. Methods A qualitative approach was taken, in which the unit of analysis was clinicians in one of the largest university hospitals in Norway. In total, 29 interviews were conducted and transcribed, which were used as the primary data source. Using the performative model of routine as the theoretical framework, data were analyzed using deductive content analysis. Results Clinicians have mixed opinions on the merits and demerits of VC and its position between in-person and telephone consultation. Totally, 6 different planning criteria were identified, and individual clinicians used different combinations of these criteria when choosing a mode of consultation. The ideals that clinicians hold for conducting consultation can be divided into three aspects: clinical, interpersonal, and managerial. VC engenders a new ideal and endangers the existing ideals. VC causes minor changes in the tasks the clinicians perform during a consultation; thus, these changes do not play a significant role in their choice of consultation. Clinicians could not identify any changes in the outcome of consultation as a result of incorporating a remote mode of consultation. Conclusions Clinicians feel that there is a lack of scientific evidence on the long-term effect of remote consultation on clinical efficacy and interpersonal and managerial aspects, which are crucial for consultation service. The absence of sufficient scientific evidence and a clear understanding of the merits and demerits of VC and standard practices and shared norms among clinicians regarding the use of video for consultation both create a void in the consultation practice. This void leads clinicians to use their personal judgments and preferences to justify their choices regarding the consultation mode. Thus, diverse opinions emerge, including some paradoxical ones, resulting in an uncertain future for sustainable large-scale implementation, which can reduce the quality of consultation service.
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