Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis

Abstract

Background Technological advancements have opened the path for many technology providers to easily develop and introduce eHealth tools to the public. The use of these tools is increasingly recognized as a critical quality driver in health care; however, choosing a quality tool from the myriad of tools available for a specific health need does not come without challenges. Objective This review aimed to systematically investigate the literature to understand the different approaches and criteria used to assess the quality and impact of eHealth tools by considering sociotechnical factors (from technical, social, and organizational perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the PubMed, Cochrane, Web of Science, Scopus, and ProQuest databases for studies published between January 2012 and January 2022 in English, which yielded 675 results, of which 40 (5.9%) studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with a thematic analysis and narrative synthesis of emergent themes. Results Similar measures from the different papers, frameworks, and initiatives were aggregated into 36 unique criteria grouped into 13 clusters. Using the sociotechnical approach, we classified the relevant criteria into technical, social, and organizational assessment criteria. Technical assessment criteria were grouped into 5 clusters: technical aspects, functionality, content, data management, and design. Social assessment criteria were grouped into 4 clusters: human centricity, health outcomes, visible popularity metrics, and social aspects. Organizational assessment criteria were grouped into 4 clusters: sustainability and scalability, health care organization, health care context, and developer. Conclusions This review builds on the growing body of research that investigates the criteria used to assess the quality and impact of eHealth tools and highlights the complexity and challenges facing these initiatives. It demonstrates that there is no single framework that is used uniformly to assess the quality and impact of eHealth tools. It also highlights the need for a more comprehensive approach that balances the social, organizational, and technical assessment criteria in a way that reflects the complexity and interdependence of the health care ecosystem and is aligned with the factors affecting users’ adoption to ensure uptake and adherence in the long term.

Under the Tech Umbrella: Assessing the Landscape of Telemedicine Innovations (Telemechron Study)

“…The overviewed studies collectively contribute to a nuanced understanding of the evolving landscape of digital health interventions with a focus on technology assessment, although not always very markedly [ 17 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. They emphasize the critical importance of systematically technologically assessing eHealth tools [ 28 ], considering TA stakeholder preferences [ 29 ], and recognizing the broader impact on well-being [ 30 ].…”

“…The overviewed studies collectively contribute to a nuanced understanding of the evolving landscape of digital health interventions with a focus on technology assessment, although not always very markedly [ 17 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. They emphasize the critical importance of systematically technologically assessing eHealth tools [ 28 ], considering TA stakeholder preferences [ 29 ], and recognizing the broader impact on well-being [ 30 ]. Specific evaluations of TA in some domains, such as the effectiveness of telehealth-based cancer rehabilitation [ 31 ] and the integration of tools for peer-to-peer interactions in digital interventions for psychotic disorders [ 40 ], shed light on targeted healthcare areas.…”

“…These studies are as follows: [ 17 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

A Sociotechnical Framework to Assess Patient-Facing eHealth Tools: Results of a Modified Delphi Process

“…Narrative synthesis was used to analyze the interview transcripts, using NVivo (QSR International), a computer-assisted qualitative data analysis software. Data coding began with a preliminary data extraction grid that included themes based on the expert comments received in the Round 1 survey and informed by our previous work that aggregated the factors impacting adoption from patients' and clinicians' perspectives, as well as the initial list of criteria for eHealth assessment [20,[54][55][56]. More codes were added as they emerged during the analytical process.…”

Energy Efficient Real-Time E-Healthcare System Based on Fog Computing

“…Their study identified the key elements influencing an efficient e-health policy framework and discovered a gap in the context of developing nations, and proposed a fourstep e-health policy implementation guideline for effective e-health implementation in the context of developing countries. A review conducted by Jacob et al [41] added to the expanding body of research that explored the standards used to evaluate the effectiveness and implications of e-health tools. It proved that different frameworks are employed in different ways to evaluate the effectiveness and value of e-health solutions.…”