scholarly journals Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks

10.2196/18072 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18072 ◽  
Author(s):  
Christine Jacob ◽  
Antonio Sanchez-Vazquez ◽  
Chris Ivory
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Technology Acceptance ◽  
Mobile Health ◽  
Data Privacy ◽  
Health Care Organizations ◽  
Organizational Factors ◽  
Multidisciplinary Teams ◽  
Theoretical Frameworks ◽  
Qualitative Review

Background Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology to involve other elements such as social, cultural, and organizational factors. Objective This review aimed to explore which frameworks are used the most, to understand clinicians’ adoption of mHealth as well as to identify potential shortcomings in these frameworks. Highlighting these gaps and the main factors that were not specifically covered in the most frequently used frameworks will assist future researchers to include all relevant key factors. Methods This review was an in-depth subanalysis of a larger systematic review that included research papers published between 2008 and 2018 and focused on the social, organizational, and technical factors impacting clinicians’ adoption of mHealth. The initial systematic review included 171 studies, of which 50 studies used a theoretical framework. These 50 studies are the subject of this qualitative review, reflecting further on the frameworks used and how these can help future researchers design studies that investigate the topic of mHealth adoption more robustly. Results The most commonly used frameworks were different forms of extensions of the Technology Acceptance Model (TAM; 17/50, 34%), the diffusion of innovation theory (DOI; 8/50, 16%), and different forms of extensions of the unified theory of acceptance and use of technology (6/50, 12%). Some studies used a combination of the TAM and DOI frameworks (3/50, 6%), whereas others used the consolidated framework for implementation research (3/50, 6%) and sociotechnical systems (STS) theory (2/50, 4%). The factors cited by more than 20% of the studies were usefulness, output quality, ease of use, technical support, data privacy, self-efficacy, attitude, organizational inner setting, training, leadership engagement, workload, and workflow fit. Most factors could be linked to one framework or another, but there was no single framework that could adequately cover all relevant and specific factors without some expansion. Conclusions Health care technologies are generally more complex than tools that address individual user needs as they usually support patients with comorbidities who are typically treated by multidisciplinary teams who might even work in different health care organizations. This special nature of how the health care sector operates and its highly regulated nature, the usual budget deficits, and the interdependence between health care organizations necessitate some crucial expansions to existing theoretical frameworks usually used when studying adoption. We propose a shift toward theoretical frameworks that take into account implementation challenges that factor in the complexity of the sociotechnical structure of health care organizations and the interplay between the technical, social, and organizational aspects. Our consolidated framework offers recommendations on which factors to include when investigating clinicians’ adoption of mHealth, taking into account all three aspects.

scholarly journals Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks (Preprint)

2020 ◽  
Author(s):  
Christine Jacob ◽  
Antonio Sanchez-Vazquez ◽  
Chris Ivory
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Technology Acceptance ◽  
Mobile Health ◽  
Data Privacy ◽  
Health Care Organizations ◽  
Organizational Factors ◽  
Multidisciplinary Teams ◽  
Theoretical Frameworks ◽  
Qualitative Review

BACKGROUND Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology to involve other elements such as social, cultural, and organizational factors. OBJECTIVE This review aimed to explore which frameworks are used the most, to understand clinicians’ adoption of mHealth as well as to identify potential shortcomings in these frameworks. Highlighting these gaps and the main factors that were not specifically covered in the most frequently used frameworks will assist future researchers to include all relevant key factors. METHODS This review was an in-depth subanalysis of a larger systematic review that included research papers published between 2008 and 2018 and focused on the social, organizational, and technical factors impacting clinicians’ adoption of mHealth. The initial systematic review included 171 studies, of which 50 studies used a theoretical framework. These 50 studies are the subject of this qualitative review, reflecting further on the frameworks used and how these can help future researchers design studies that investigate the topic of mHealth adoption more robustly. RESULTS The most commonly used frameworks were different forms of extensions of the Technology Acceptance Model (TAM; 17/50, 34%), the diffusion of innovation theory (DOI; 8/50, 16%), and different forms of extensions of the unified theory of acceptance and use of technology (6/50, 12%). Some studies used a combination of the TAM and DOI frameworks (3/50, 6%), whereas others used the consolidated framework for implementation research (3/50, 6%) and sociotechnical systems (STS) theory (2/50, 4%). The factors cited by more than 20% of the studies were usefulness, output quality, ease of use, technical support, data privacy, self-efficacy, attitude, organizational inner setting, training, leadership engagement, workload, and workflow fit. Most factors could be linked to one framework or another, but there was no single framework that could adequately cover all relevant and specific factors without some expansion. CONCLUSIONS Health care technologies are generally more complex than tools that address individual user needs as they usually support patients with comorbidities who are typically treated by multidisciplinary teams who might even work in different health care organizations. This special nature of how the health care sector operates and its highly regulated nature, the usual budget deficits, and the interdependence between health care organizations necessitate some crucial expansions to existing theoretical frameworks usually used when studying adoption. We propose a shift toward theoretical frameworks that take into account implementation challenges that factor in the complexity of the sociotechnical structure of health care organizations and the interplay between the technical, social, and organizational aspects. Our consolidated framework offers recommendations on which factors to include when investigating clinicians’ adoption of mHealth, taking into account all three aspects.

Business model framework applications in health care: A systematic review

2017 ◽  
Vol 30 (4) ◽  
pp. 219-226 ◽  
Author(s):  
Jens Jacob Fredriksson ◽  
Pamela Mazzocato ◽  
Rafiq Muhammed ◽  
Carl Savage
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Business Model ◽  
Health Care Organizations ◽  
Model Description ◽  
Model Framework ◽  
Triple Aim ◽  
Financial Assessment ◽  
Constituent Elements ◽  
Synthesis Approach

It has proven to be a challenge for health care organizations to achieve the Triple Aim. In the business literature, business model frameworks have been used to understand how organizations are aligned to achieve their goals. We conducted a systematic literature review with an explanatory synthesis approach to understand how business model frameworks have been applied in health care. We found a large increase in applications of business model frameworks during the last decade. E-health was the most common context of application. We identified six applications of business model frameworks: business model description, financial assessment, classification based on pre-defined typologies, business model analysis, development, and evaluation. Our synthesis suggests that the choice of business model framework and constituent elements should be informed by the intent and context of application. We see a need for harmonization in the choice of elements in order to increase generalizability, simplify application, and help organizations realize the Triple Aim.

scholarly journals The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis

10.2196/17776 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17776 ◽  
Author(s):  
Ran Li ◽  
Ning Liang ◽  
Fanlong Bu ◽  
Therese Hesketh
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Mobile Health ◽  
Meta Analysis ◽  
Self Management ◽  
Narrative Synthesis ◽  
Management Behavior ◽  
Mhealth Intervention

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

scholarly journals A Systematic Review of Usability Challenges and Testing in Mobile Health

2015 ◽  
Vol 5 (2) ◽  
pp. 1 ◽  
Author(s):  
Tareq Ali Al-Saadi ◽  
Tamer Mohammed Aljarrah ◽  
Anahed Mudheher Alhashemi ◽  
Azham Hussain
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Mobile Health ◽  
Mobile Communications ◽  
Digital Libraries ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Smart Phones ◽  
Portable Devices ◽  
The Impact

Nowadays, the combining of advanced mobile communications and mobile account now in portable devices named "smart phones" has becomes more great uses. Among of these include health care professionals. Few studies in the challenge, blurred reality challenge facing the patient and developer alike in the usability of mobile health. Therefore, this paper aims to analyze the usability challenges in mobile health and usability testing. The systematic review was using for collecting the prior studies that relation with our study. This study concentrates on the three digital libraries Google scholar, ACM and IEEE, as well as, the researcher selected the studies between 2007 and 2015. The results from this systematic were selected 11 studies of 106 based on the inclusions criteria. In more details, the usability challenges found that 27% offered User Interface, 22% tasks and screen size, 16% insert media and 13% network. On the other hand, usability use found that, 46% of the selected studies the usability use of formal type of 45% informal and 9% mixed formal and informal. Sum up, the use of smart phones is getting more on health care and day out. Medical applications make smart phones useful tools in the practice of evidence-based medicine at the point of care, in addition to its use in mobile clinical communications. This study will making a contribution to the researchers to extract over the impact of the challenges on usability testing and the types of usability in mobile health.

scholarly journals The Impact for Implementing Balanced Scorecard in Health Care Organizations: A Systematic Review

2021 ◽  
Author(s):  
Faten Amer ◽  
Sahar Hammoud ◽  
Haitham Khatatbeh ◽  
Szimonetta Lohner ◽  
Imre Boncz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Satisfaction ◽  
Financial Performance ◽  
Balanced Scorecard ◽  
Health Care Organizations ◽  
Positive Impact ◽  
Methodological Approach ◽  
Google Search ◽  
The Impact

Aims: This systematic review aims to assess the impact of Balanced Scorecard (BSC) implementation at Health Care Organizations (HCOs) on Health Care Workers' (HCWs') satisfaction, patient satisfaction, and financial performance. Up to now, no previous systematic reviews have performed a comprehensive and rigorous methodological approach to figure out the impact of BSC implementation in HCOs. Methods: This systematic review was prepared according to PRISMA guidelines. PubMed, Embase, Cochrane, and Google Scholar databases, as well as Google search engine, were inspected to find all BSC implementations at HCOs until 20 September 2020. Then the resulted articles were screened to find the implementations which measured the impact of BSC on HCWs' satisfaction, patient satisfaction, and financial performance. Quality assessment was performed using the Standards for Reporting Implementation Studies: (StaRI) checklist. Results: Out of 4031 records, 20 articles were finally included for measuring one or more of the three impact types. 17 measured the impact of BSC on patient satisfaction, 7 on HCWs' satisfaction, and 12 on financial performance. Studies with higher quality had a higher positive impact. Conclusion: This paper offers evidence to HCOs and policymakers on the benefits of implementing BSC. BSC implementations showed a positive impact on patient satisfaction and financial performance in HCOs. However, less impact was found on HCWs' satisfaction, which should be given better consideration in future BSC implementations. High and medium-quality BSC studies were associated with higher positive impacts than low ones. BSC can be utilized as an effective tool to improve HCOs' performance during the COVID-19 pandemic.

scholarly journals Technology Acceptance in Mobile Health: Scoping Review of Definitions, Models, and Measurement (Preprint)

2019 ◽  
Author(s):  
Camille Nadal ◽  
Corina Sas ◽  
Gavin Doherty
Keyword(s):  
Health Care ◽  
Technology Acceptance ◽  
Mobile Health ◽  
Patient Acceptance ◽  
Medical Subject Headings ◽  
Common Definition ◽  
Measurement Framework ◽  
Pubmed Database ◽  
Measurement Tools ◽  
Concept Usage

BACKGROUND Designing technologies that users will be interested in, start using, and keep using has long been a challenge. In the health domain, the question of technology acceptance is even more important, as the possible intrusiveness of technologies could lead to patients refusing to even try them. Developers and researchers must address this question not only in the design and evaluation of new health care technologies but also across the different stages of the user’s journey. Although a range of definitions for these stages exists, many researchers conflate related terms, and the field would benefit from a coherent set of definitions and associated measurement approaches. OBJECTIVE This review aims to explore how technology acceptance is interpreted and measured in mobile health (mHealth) literature. We seek to compare the treatment of acceptance in mHealth research with existing definitions and models, identify potential gaps, and contribute to the clarification of the process of technology acceptance. METHODS We searched the PubMed database for publications indexed under the Medical Subject Headings terms “Patient Acceptance of Health Care” and “Mobile Applications.” We included publications that (1) contained at least one of the terms “acceptability,” “acceptance,” “adoption,” “accept,” or “adopt”; and (2) defined the term. The final corpus included 68 relevant studies. RESULTS Several interpretations are associated with technology acceptance, few consistent with existing definitions. Although the literature has influenced the interpretation of the concept, usage is not homogeneous, and models are not adapted to populations with particular needs. The prevalence of measurement by custom surveys suggests a lack of standardized measurement tools. CONCLUSIONS Definitions from the literature were published separately, which may contribute to inconsistent usage. A definition framework would bring coherence to the reporting of results, facilitating the replication and comparison of studies. We propose the Technology Acceptance Lifecycle, consolidating existing definitions, articulating the different stages of technology acceptance, and providing an explicit terminology. Our findings illustrate the need for a common definition and measurement framework and the importance of viewing technology acceptance as a staged process, with adapted measurement methods for each stage.

Treating Somatic Symptom Disorder and Illness Anxiety in Integrated Care Settings

2017 ◽  
Author(s):  
Alla Landa ◽  
Marina Makous ◽  
Brian A. Fallon
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Somatic Symptom ◽  
Health Care Organizations ◽  
Systems Approach ◽  
Multidisciplinary Teams ◽  
Team Approach ◽  
Organization Of Care ◽  
Illness Anxiety ◽  
Care Culture

Somatic symptom and illness anxiety disorders are highly prevalent conditions that are not adequately recognized and treated in many countries around the world. This chapter reviews the best world practices in diagnosing and treating these conditions in integrated care settings. The authors suggest that a paradigm shift in the health care culture and organizational structure toward the abandonment of mind–body dualism and establishment of a biopsychosocial model of care is essential for successful identification and treatment of these challenging disorders. This includes the integration of medical, psychiatric, and special psychosomatic treatments; a multidisciplinary team approach; and stepped organization of care. Targeting the multidisciplinary teams of clinicians and health care organizations and using a systems approach to health care reorganization, this chapter highlights treatment approaches and care pathways for these conditions that have been shown to be clinically effective and to reduce costs and inefficient use of health care resources.

Organizational culture and performance in health care for older people: a systematic review

2012 ◽  
Vol 22 (3) ◽  
pp. 218-234 ◽  
Author(s):  
Julian Hunt ◽  
Antonio Sanchez ◽  
Win Tadd ◽  
Sinead O'Mahony
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Organizational Culture ◽  
Older People ◽  
Health Care Organizations ◽  
Clear Relationship ◽  
Health Care Provision ◽  
Care Provision ◽  
And Performance ◽  
Care For Older People

AbstractIn recent years, there has been a growing understanding that organizational culture is an important characteristic that may influence the effectiveness of health care provision, not least for the growing numbers of older people needing care. The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that organizational culture in health care organizations is related, in terms of activity and outcome, to their performance. Searches identified 20 relevant papers published between 1993 and 2010. A number of studies reviewed claims to have uncovered evidence of a relationship in terms of activity, while others failed to find a clear relationship. None of the studies found much evidence against. In terms of outcomes, none of the studies reviewed found evidence of a relationship between culture and performance. It is clear that any relationship between culture and performance is highly unlikely to be simple: such relationships are more likely to be multiple, complex, contingent and dynamic.

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