This Might Be Quite An Important Attempt At Thinking About E-Health.

I noticed this a few days ago.

A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies

Julia EWC van Gemert-Pijnen^1*, PhD; Nicol Nijland^1*, PhD; Maarten van Limburg¹, MSc, BEng; Hans C Ossebaard², MA; Saskia M Kelders¹, MSc; Gunther Eysenbach³, MD, MPH, FACMI; Erwin R Seydel¹, PhD

¹Department of Psychology, Health and Technology/Center for eHealth Research and Disease Management, Faculty of Behavioural Sciences, University of Twente, Enschede, Netherlands
²National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
³Centre for Global eHealth Innovation, Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
^*these authors contributed equally

Corresponding Author:

Julia EWC van Gemert-Pijnen, PhD

Department of Psychology, Health and Technology/Center for eHealth Research and Disease Management
Faculty of Behavioural Sciences
University of Twente
Drienerlolaan 5
PO Box 217
Enschede, 7500 AE
Netherlands
Phone: 31 534896050
Fax: 31 534892388
Email: j.e.w.c.vangemert-pijnen [at] utwente.nl

ABSTRACT

Background: Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders.

Objective: The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector.

Methods: To identify the potential and limitations of current eHealth frameworks (1999–2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework.

Results: A total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a rather conceptual approach that focuses on the rationale behind the frameworks rather than on practical guidelines. In addition, the Web 2.0 technologies that call for a more stakeholder-driven approach are beyond the scope of current frameworks. To overcome these limitations, we composed a holistic framework based on a participatory development approach, persuasive design techniques, and business modeling.

Conclusions: To demonstrate the impact of eHealth technologies more effectively, a fresh way of thinking is required about how technology can be used to innovate health care. It also requires new concepts and instruments to develop and implement technologies in practice. The proposed framework serves as an evidence-based roadmap.

(J Med Internet Res 2011;13(4):e111)
doi:10.2196/jmir.1672

KEYWORDS

eHealth; design; participation; implementation; evaluation; multidisciplinary approach; Health 2.0; Wiki; e-collaboration

The full paper is found here (and is freely available):

http://www.jmir.org/2011/4/e111/

There is a huge amount more about the group’s thinking at their wiki.

http://www.ehealthresearchcenter.org/wiki/index.php/Main_Page

I have to confess this is by no means easy stuff to get your head around but as I said to a friend.

“It seemed to me to be smart. Putting e-Health in context and seeking value - iteratively first and then really starting to implement in stages again with feedback.

Probably requires tooling we don't have - but seems to be starting out the right way.”

This work needs more than one read I reckon!

David.