Toward digital transformation in healthcare: a framework for remote monitoring adoption

Abstract

PurposeDigital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.Design/methodology/approachThe authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).FindingsAccording to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.Research limitations/implicationsThe authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.Practical implicationsThe paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.Social implicationsRM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.Originality/valueThe study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.

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

“…Hence, the implementation of the innovative technology fostered by the PPP should be accompanied by the creation of an inter-organizational culture which encourages and sustains individual action towards innovation, promoting the integration of partners’ efforts. This is consistent with the findings of recent studies showing the importance of sticking to a digital culture, having a flexible structure, and being able to react to change in order to adopt innovative technologies in the healthcare context (Binci et al, 2021 ). It also stresses the need for aligning macro (inter-organizational), meso (organizational), and micro (individual) levels in steering the digital transformation of healthcare institutions (Kokshagina, 2021 ).…”

“…Extant studies have primarily looked at the dyadic relationship between health professionals and patients in the adoption of innovative technologies (Binci et al, 2021 ). Scholars have tried to shed light on the factors influencing patients’ willingness to accept technologies in the provision of care (Palumbo et al, 2022 ).…”

Therapies go digital. What drives physicians’ acceptance?

“…Also, relying on past literature, 12 control variables were included to enhance the validity and reliability of research outcomes [48]. Control variables include gender [39,49,50], age [24,49,51], years of experience, role, sense of belonging to the institution, geographical location [52], level of digitalization of the institution [53], innovation propensity [54], risk propensity [55,56], digital competencies [22,51], interest towards digital technology [57,58], and opinion of the patients' competencies [59,60].…”

Scaling Digital Solutions in Healthcare: Paradoxical Tensions in Provider–Customer Relations and Coping Strategies

“…However, various factors-such as dominant reimbursement schemes, legacy IT systems, disparate data sources, limited adoption of data standards, data security, and privacy concernsimpede the adoption of digital solutions among hospitals [12], [35], [47], [68]. At the same time, many medical technology and healthcare companies struggle to develop new offerings and business models [8], [78]. Recent research has started to study the paradoxical tensions that organizations face when they seek to adopt smart solutions [22], [23], [79], [81].…”