International Journal of Healthcare Technology and Management (6 papers in press)
Personal healthcare records research: past, present and new dimensions
by Konstantinos Koumaditis, Tajammal Hussain
Abstract: When designed and managed properly, Personal Health Records (PHRs) are valuable tools that can reform healthcare systems. Yet while the PHR literature covers multidiscipline cases on design requirements, implementations, and early positive results, it also echoes concerns related to the undelivered potential and challenges tied to PHRs. Consequently, a vast body of literature exists with unclear themes and blurred lines between perception, realisation, and outcome. This paper exposes dominant research themes in PHR research and aids the understanding of this developing field. Our bibliographic analysis of 524 papers published from 2000 to 2015 revealed a core set of 61 publications. Interesting identified themes include the operation of PHRs with emphasis on innovation, prototypes, and governance, as well as the impact of PHRs on specific medical conditions, healthcare processes, and sociotechnical issues. Design issues were also exposed focusing on user requirements, design elements and technologies, and lessons learned through empirical cases.
Keywords: personal healthcare records; medical systems; healthcare technology; lessons learned; bibliometric analysis; multidimensional scaling.
Management of techno-psychological factors influencing the patient-physician electronic relationship
by Jamil Razmak, Charles Bélanger
Abstract: Focusing on the patient-physician electronic relationship, this empirical study was conducted to explore certain personal traits and psychological factors that can influence behavioural attitude toward adopting a patient portal. Statistical tests were used to compare the answers of physicians and patients and to test patients dispositions toward technology. The results revealed significant differences among physicians and patients with respect to the purpose of website referrals. With the exception of the education level, the findings indicated that age, sex, and ethnicity did not significantly influence participants attitudes. The three psychological factors used in the regression model turned out to be significant predictors of participants behavioural attitude toward adopting the patient portal. Based on these results, e-health applications require a long-term investment in technology generation to develop a new education system that supports these online platforms; this strategy, along with adequate support from healthcare providers, will produce the most effective results.
Keywords: website referrals; computer self-efficacy; computer anxiety; e-health literacy; patient portal.
SERVQUAL impact on overall satisfaction and brand loyalty: an empirical study in Delhi NCR hospitals
by Bhawna Singh, Rushina Singhi
Abstract: This paper analyses the impact of SERVQUAL on overall satisfaction and brand loyalty in the healthcare industry. SERVQUAL is a standard instrument consisting of five dimensions, namely reliability, empathy, responsiveness, tangibility and assurance, for measuring functional service quality. The study has been initiated by conducting a survey of various hospitals of Delhi NCR. A conceptual model is designed and confirmatory test of the model is done by using the confirmatory factor analysis technique. Structural Equation Modelling (SEM) using AMOS 4.0 is used to analyse the causal relationship between SERVQUAL, overall satisfaction and brand loyalty. The outcome shows that SERVQUAL has a positive effect on overall satisfaction, and overall satisfaction also has a positive effect on brand loyalty.
Keywords: service quality; overall satisfaction; brand loyalty; SERVQUAL.
Learning from failure: inadequate value propositions in an innovative approach to patient safety using a handwashing compliance auditing system
by Ryan DeForge, Anne Snowdon, Mark MacLeod
Abstract: This study examined how a handwashing compliance auditing system affects physician handwashing compliance and rates of hospital acquired infections. Ultimately, data collection was significantly impaired by low recruitment and compliance rates. To learn from this projects failure, medical residents were invited to participate in an interview to discuss the project, its merits and shortcomings. Beyond existing resistance to such surveillance, study procedures, confounding contextual variables and insufficient value propositions seem to account for the projects failure. Use of a handwashing compliance auditing system is likely to fail if is not optimally integrated into existing clinical workflows and hospital infrastructure, or if auditing seems to take the form of surveillance. Beyond the establishment of proof of concept, proof of relevance and value for all stakeholder groups must be established to embed an innovation such as this handwashing compliance auditing system.
Keywords: health innovation; demonstration project; failure; hand washing; hand hygiene.
Examining the state level heterogeneity of public health expenditure in India: empirical evidence from panel data
by Deepak Behera, Umakant Dash
Abstract: This study explores the relationship over an extended period of time between an increase in per capita public health expenditure and per capita states domestic product (per capita income) of 16 states of India from 1980 to 2014. We consider eight panels of states based on geographical region and levels of economic development for examining the level of heterogeneity in the share of public health expenditure with respect to states domestic product by using panel unit root, panel co-integration, and panel Granger causality techniques. The empirical result shows that public health expenditure and states domestic product are co-integrated in the long-run. The result also shows a positive and significant effect of per capita income in the growth of public health expenditure in the long-run. It finds that there is a bi-directional Granger causality between per capita income and public health expenditure in the short-run while the causality is unidirectional in the long-run. The overall result implies the existence of inequalities in the share of government health expenditure with respect to states level of economic development in India. This study would offer effective fiscal policy instruments to minimising geographical inequity of health finance for achieving universal health coverage of Indian states.
Keywords: public health expenditure; Indian states; heterogeneity; panel data; universal health coverage; Westerlund co-integration; VECM Granger causality.
Emerging product-process archetypes in oncology: informing the sustainable provision of next-generation medicines
by Tomás S. Harrington, Jagjit Singh Srai, Ismail Najim
Abstract: The emergence of more targeted molecular therapies has contributed to accelerated growth within the oncology market, with forecast spends expected to be in the range of $74-84 billion by 2018. Coupled with its many specificities around pricing, insurance implications, and ethics, we argue that the oncology segment may best inform future pharmaceutical value network design characteristics. Through exploration of future state scenarios and opportunity areas, driven by the adoption of emerging process and digital technologies, a base framework is extended to enable a systematic assessment of candidates representative of the wider oncology market. These include niche, low volume drugs on-patent, through to higher volume generics with a history of supply shortages. Oncology archetypes are proposed classified as New Niche, Old Niche and Established Generics matching emerging process capabilities to future adaptive supply requirements, informing the potential for economies of drug repurposing, and associated models for reconfiguration based on benefits clustering.
Keywords: pharmaceuticals; oncology; value networks; sustainable industrial systems; futures.