scholarly journals Identifying and Overcoming Policy-Level Barriers to the Implementation of Digital Health Innovation: Qualitative Study

10.2196/14994 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e14994 ◽  
Author(s):  
Laura Desveaux ◽  
Charlene Soobiah ◽  
R Sacha Bhatia ◽  
James Shaw
Keyword(s):  
Health System ◽  
Driving Forces ◽  
Digital Health ◽  
Critical Role ◽  
Qualitative Description ◽  
System Level ◽  
Health Innovation ◽  
Innovation Activities ◽  
Challenges And Opportunities ◽  
The Government

Background High-level policy barriers impede widespread adoption for even the most well-positioned innovations. Most of the work in this field assumes rather than analyzes the driving forces of health innovation. Objective: The aim of this study was to explore the challenges and opportunities experienced by health system stakeholders in the implementation of digital health innovation in Ontario. Objective The aim of this study was to explore the challenges and opportunities experienced by health system stakeholders in the implementation of digital health innovation in Ontario. Methods We completed semistructured interviews with 10 members of senior leadership across key organizations that are engaged in health care–related digital health activities. Data were analyzed using qualitative description. Results A total of 6 key policy priorities emerged, including the need for (1) a system-level definition of innovation, (2) a clear overarching mission, and (3) clearly defined organizational roles. Operationally, there is a need to (4) standardize processes, (5) shift the emphasis to change management, and (6) align funding structures. Conclusions These findings emphasize the critical role of the government in developing a vision and creating the foundation upon which innovation activities will be modeled.

scholarly journals Empirically evaluating the impact of adjudicative tribunals in the health sector: context, challenges and opportunities

2011 ◽  
Vol 7 (2) ◽  
pp. 147-174
Author(s):  
Steven J. Hoffman ◽  
Lorne Sossin
Keyword(s):  
Health System ◽  
Health Sector ◽  
Cost Effective ◽  
System Level ◽  
Challenges And Opportunities ◽  
External Impact ◽  
Health System Governance ◽  
Evaluation Matrix ◽  
The Impact ◽  
Methodological Difficulties

AbstractAdjudicative tribunals are an integral part of health system governance, yet their real-world impact remains largely unknown. Most assessments focus on internal accountability and use anecdotal methodologies; few, studies if any, empirically evaluate their external impact and use these data to test effectiveness, track performance, inform service improvements and ultimately strengthen health systems. Given that such assessments would yield important benefits and have been conducted successfully in similar settings (e.g. specialist courts), their absence is likely attributable to complexity in the health system, methodological difficulties and the legal environment within which tribunals operate. We suggest practical steps for potential evaluators to conduct empirical impact evaluations along with an evaluation matrix template featuring possible target outcomes and corresponding surrogate endpoints, performance indicators and empirical methodologies. Several system-level strategies for supporting such assessments have also been suggested for academics, health system institutions, health planners and research funders. Action is necessary to ensure that policymakers do not continue operating without evidence but can rather pursue data-driven strategies that are more likely to achieve their health system goals in a cost-effective way.

scholarly journals Accelerating Innovation in Health Care: Insights From a Qualitative Inquiry Into United Kingdom and United States Innovation Centers

10.2196/19644 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19644
Author(s):  
Kathrin Cresswell ◽  
Robin Williams ◽  
Narath Carlile ◽  
Aziz Sheikh
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Health System ◽  
Digital Health ◽  
Qualitative Inquiry ◽  
Health Science ◽  
Innovation Ecosystem ◽  
Center Staff ◽  
Innovation Activities

Background Digital health innovations are being prioritized on international policy agendas in the hope that they will help to address the existing health system challenges. Objective The aim of this study was to explore the setup, design, facilities, and strategic priorities of leading United Kingdom and United States health care innovation centers to identify transferable lessons for accelerating their creation and maximizing their impact. Methods We conducted qualitative case studies consisting of semistructured, audio-recorded interviews with decision makers and center staff in 6 innovation centers. We also conducted nonparticipant observations of meetings and center tours, where we took field notes. Qualitative data were analyzed initially within and then across cases facilitated by QSR International’s NVivo software. Results The centers had different institutional arrangements, including university-associated institutes or innovation laboratories, business accelerators or incubators, and academic health science partnership models. We conducted interviews with 34 individuals, 1 group interview with 3 participants, and observations of 4 meetings. Although the centers differed significantly in relation to their mission, structure, and governance, we observed key common characteristics. These included high-level leadership support and incentives to engage in innovation activities, a clear mission to address identified gaps within their respective organizational and health system settings, physical spaces that facilitated networking through open-door policies, flat managerial structures characterized by new organizational roles for which boundary spanning was key, and a wider innovation ecosystem that was strategically and proactively engaged with the center facilitating external partnerships. Conclusions Although innovation in health care settings is unpredictable, we offer insights that may help those establishing innovation centers. The key in this respect is the ability to support different kinds of innovations at different stages through adequate support structures, including the development of new career pathways.

Evaluation of Technological Innovations and the Industrial Ecosystem of Science Parks in Shanghai: An Empirical Study

2020 ◽  
Vol 25 (3) ◽  
pp. 482-504
Author(s):  
Min-Ren Yan ◽  
Haiyan Yan ◽  
Lingyun Zhan ◽  
Xinyue Yan ◽  
Mengen Xu
Keyword(s):  
Empirical Study ◽  
Driving Forces ◽  
Policy Implications ◽  
Technological Innovations ◽  
Science Parks ◽  
Loop Analysis ◽  
Innovation Ecosystem ◽  
Science Park ◽  
Innovation Activities ◽  
The Government

Science parks and innovation policies have a major mission in driving innovative resources and nurturing emerging industries, while the government-academia-industry collaborations and the establishment of an ecosystem are essentials. To investigate the key driving forces for sustainable development of the collaborative ecosystem, this article evaluates the technological innovations and the ecosystem of Science Parks in Shanghai based on historical data obtained from Shanghai Zhangjiang Science Park (Zhangjiang Park in short). Systems thinking and causal loop analysis are adopted to explore the structure of the collaborative ecosystem and reflections of the policy impact on the science park. The role of the government in science parks and innovation ecosystems is identified with systems mapping and empirical study. The economic impact of Zhangjiang Park policies and the performance of innovation activities in Shanghai are further evaluated. Lessons learnt from the benchmarked science parks and policy implications for facilitating the innovation ecosystem are addressed.

scholarly journals Digital health Systems in Kenyan Public Hospitals: a mixed-methods survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Mike English ◽  
Hamish Fraser ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
New Technologies ◽  
Digital Health ◽  
Structured Interview ◽  
Public Hospitals ◽  
Adoption Process ◽  
Efficient System ◽  
Wide Range ◽  
The Government

Abstract Background As healthcare facilities in Low- and Middle-Income Countries adopt digital health systems to improve hospital administration and patient care, it is important to understand the adoption process and assess the systems’ capabilities. This survey aimed to provide decision-makers with information on the digital health systems landscape and to support the rapidly developing digital health community in Kenya and the region by sharing knowledge. Methods We conducted a survey of County Health Records Information Officers (CHRIOs) to determine the extent to which digital health systems in public hospitals that serve as internship training centres in Kenya are adopted. We conducted site visits and interviewed hospital administrators and end users who were at the facility on the day of the visit. We also interviewed digital health system vendors to understand the adoption process from their perspective. Semi-structured interview guides adapted from the literature were used. We identified emergent themes using a thematic analysis from the data. Results We obtained information from 39 CHRIOs, 58 hospital managers and system users, and 9 digital health system vendors through semi-structured interviews and completed questionnaires. From the survey, all facilities mentioned purchased a digital health system primarily for administrative purposes. Radiology and laboratory management systems were commonly standalone systems and there were varying levels of interoperability within facilities that had multiple systems. We only saw one in-patient clinical module in use. Users reported on issues such as system usability, inadequate training, infrastructure and system support. Vendors reported the availability of a wide range of modules, but implementation was constrained by funding, prioritisation of services, users’ lack of confidence in new technologies and lack of appropriate data sharing policies. Conclusion Public hospitals in Kenya are increasingly purchasing systems to support administrative functions and this study highlights challenges faced by hospital users and vendors. Significant work is required to ensure interoperability of systems within hospitals and with other government services. Additional studies on clinical usability and the workflow fit of digital health systems are required to ensure efficient system implementation. However, this requires support from key stakeholders including the government, international donors and regional health informatics organisations.

scholarly journals Barriers to Creating Scalable Business Models for Digital Health Innovation in Public Systems: Qualitative Case Study (Preprint)

2020 ◽  
Author(s):  
Leah Taylor Kelley ◽  
Jamie Fujioka ◽  
Kyle Liang ◽  
Madeline Cooper ◽  
Trevor Jamieson ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Business Models ◽  
Digital Health ◽  
Digital Technologies ◽  
Economic Incentives ◽  
Barriers To Entry ◽  
Health Innovation ◽  
Health Technologies

BACKGROUND Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging. OBJECTIVE This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs. METHODS This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women’s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation. RESULTS A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system’s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs’ business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals. CONCLUSIONS There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients’ well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.

scholarly journals Challenges and opportunities of integration of community based Management of Acute Malnutrition into the government health system in Bangladesh: a qualitative study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Santhia Ireen ◽  
Mohammad Jyoti Raihan ◽  
Nuzhat Choudhury ◽  
M. Munirul Islam ◽  
Md Iqbal Hossain ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Acute Malnutrition ◽  
Community Based ◽  
Government Health ◽  
Challenges And Opportunities ◽  
The Government

Pilot Research to Develop a Nursing Digital Health Capability Framework in Chile

2021 ◽  
Author(s):  
Antonia Benavente ◽  
Eugenia Urra ◽  
Carol Hullin ◽  
Helen Almond
Keyword(s):  
Health System ◽  
Workforce Development ◽  
Health Workforce ◽  
Digital Health ◽  
National Level ◽  
Quality And Safety ◽  
Health Innovation ◽  
Health Strategy ◽  
Health Workforce Development ◽  
Sustainable Health

The Global Digital Health Strategy emphasizes digital health workforce development to reach a sustainable health system. In Chile, a digital health capability framework to support the transition towards digital health and workforce development is still missing. A survey will be applied at a national level. The Development of a Chilean Nursing Digital Health Capability Framework will identify the capabilities of nurses in digital health innovation and improve the quality and safety of healthcare nationwide.

scholarly journals Accelerating Innovation in Health Care: Insights From a Qualitative Inquiry Into United Kingdom and United States Innovation Centers (Preprint)

2020 ◽  
Author(s):  
Kathrin Cresswell ◽  
Robin Williams ◽  
Narath Carlile ◽  
Aziz Sheikh
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Health System ◽  
Digital Health ◽  
Qualitative Inquiry ◽  
Health Science ◽  
Innovation Ecosystem ◽  
Center Staff ◽  
Innovation Activities

BACKGROUND Digital health innovations are being prioritized on international policy agendas in the hope that they will help to address the existing health system challenges. OBJECTIVE The aim of this study was to explore the setup, design, facilities, and strategic priorities of leading United Kingdom and United States health care innovation centers to identify transferable lessons for accelerating their creation and maximizing their impact. METHODS We conducted qualitative case studies consisting of semistructured, audio-recorded interviews with decision makers and center staff in 6 innovation centers. We also conducted nonparticipant observations of meetings and center tours, where we took field notes. Qualitative data were analyzed initially within and then across cases facilitated by QSR International’s NVivo software. RESULTS The centers had different institutional arrangements, including university-associated institutes or innovation laboratories, business accelerators or incubators, and academic health science partnership models. We conducted interviews with 34 individuals, 1 group interview with 3 participants, and observations of 4 meetings. Although the centers differed significantly in relation to their mission, structure, and governance, we observed key common characteristics. These included high-level leadership support and incentives to engage in innovation activities, a clear mission to address identified gaps within their respective organizational and health system settings, physical spaces that facilitated networking through open-door policies, flat managerial structures characterized by new organizational roles for which boundary spanning was key, and a wider innovation ecosystem that was strategically and proactively engaged with the center facilitating external partnerships. CONCLUSIONS Although innovation in health care settings is unpredictable, we offer insights that may help those establishing innovation centers. The key in this respect is the ability to support different kinds of innovations at different stages through adequate support structures, including the development of new career pathways.

Shared Access to Patient Portals and Digital Health Equity (Preprint)

2021 ◽  
Author(s):  
Jennifer Wolff ◽  
Vadim Dukhanin ◽  
Julia Burgdorf ◽  
Cait DesRoches
Keyword(s):  
Health System ◽  
Health Equity ◽  
Care Delivery ◽  
Digital Health ◽  
Patient Portal ◽  
Patient Portals ◽  
Information Transparency ◽  
Care Partners ◽  
Challenges And Opportunities ◽  
Role Based

UNSTRUCTURED Growing reliance on the patient portal as a mainstream modality in health system interactions necessitates prioritizing digital health equity through systems-level strategies that acknowledge and support all persons. Older adults with physical, cognitive, sensory, and socio-economic vulnerabilities often rely on the involvement of family and friend care partners when navigating health system demands, but their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules that promote information transparency. We describe implementation considerations, and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.

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