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      Failures and fallacies of eHealth initiatives: Are we finally able to overcome the underlying theoretical and practical orthodoxies?

      research-article
      Digital Health
      SAGE Publications
      Digitalization trends, healthcare sector, eHealth, failure, fallacy, evidence-based approach

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          Abstract

          The growing and ubiquitous digitalization trends embodied in eHealth initiatives have led to the widespread adoption of digital solutions in the healthcare sector. These initiatives have been heralded as a potent transformative force aiming to improve healthcare delivery, enhance patient outcomes and increase the efficiency of healthcare systems. However, despite the significant potential and possibilities offered by eHealth initiatives, the article highlights the importance of critically examining their implications and cautions against the misconception that technology alone can solve complex public health concerns and healthcare challenges. It emphasizes the need to critically consider the sociocultural context, education and training, organizational and institutional aspects, regulatory frameworks, user involvement and other important factors when implementing eHealth initiatives. Disregarding these crucial elements can render eHealth initiatives inefficient or even counterproductive. In view of that, the article identifies failures and fallacies that can hinder the success of eHealth initiatives and highlights areas where they often fall short of meeting rising and unjustified expectations. To address these challenges, the article recommends a more realistic and evidence-based approach to planning and implementing eHealth initiatives. It calls for consistent research agendas, appropriate evaluation methodologies and strategic orientations within eHealth initiatives. By adopting this approach, eHealth initiatives can contribute to the achievement of societal goals and the realization of the key health priorities and development imperatives of healthcare systems on a global scale.

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          Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis

          Background The field of eHealth has a history of more than 20 years. During that time, many different eHealth services were developed. However, factors influencing the adoption of such services were seldom the main focus of analyses. For this reason, organizations adopting and implementing eHealth services seem not to be fully aware of the barriers and facilitators influencing the integration of eHealth services into routine care. Objective The objective of this work is to provide (1) a comprehensive list of relevant barriers to be considered and (2) a list of facilitators or success factors to help in planning and implementing successful eHealth services. Methods For this study, a twofold approach was applied. First, we gathered experts’ current opinions on facilitators and barriers in implementing eHealth services via expert discussions at two health informatics conferences held in Europe. Second, we conducted a systematic literature analysis concerning the barriers and facilitators for the implementation of eHealth services. Finally, we merged the results of the expert discussions with those of the systematic literature analysis. Results Both expert discussions (23 and 10 experts, respectively) identified 15 barriers and 31 facilitators, whereas 76 barriers and 268 facilitators were found in 38 of the initial 56 articles published from 12 different countries. For the analyzed publications, the count of distinct barriers reported ranged from 0 to 40 (mean 10.24, SD 8.87, median 8). Likewise, between 0 and 48 facilitators were mentioned in the literature (mean 9.18, SD 9.33, median 6). The combination of both sources resulted in 77 barriers and 292 facilitators for the adoption and implementation of eHealth services. Conclusions This work contributes a comprehensive list of barriers and facilitators for the implementation and adoption of eHealth services. Addressing barriers early, and leveraging facilitators during the implementation, can help create eHealth services that better meet the needs of users and provide higher benefits for patients and caregivers.
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            New technologies, new disparities: The intersection of electronic health and digital health literacy

            Mobile health, or mHealth, is the implementation of digital health services with mobile and wearable devices, and has ample potential to enhance self-management of chronic conditions, especially cardiovascular risk factors (e.g., blood pressure control and supporting tobacco cessation and physical activity). It remains ambiguous, however, whether such technologies can improve cardiovascular outcomes. More importantly, mHealth carries the additional challenge of digital health literacy, which demands particular skills complementary to general and health literacy. Populations at risk for limited health literacy are similarly vulnerable to having challenges with digital health literacy. We identify such challenges and outline solutions to improve access to digital health services and their use for individuals with limited digital health literacy. We present an 18-point “Digital Universal Precautions” as a mandate for health care organizations committed towards addressing and facilitating eHealth literacy. As health care institutions increasingly advance mHealth through delivery of on-line material and patient portals, they face the challenge of ensuring that digital health services and content are available to all patients.
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              Disparities in Health Care and the Digital Divide

              Purpose of Review Disparities in health outcomes are a well documented and worrisome part of our health care system. These disparities persist in spite of, and are occasionally exacerbated by, new technologies that are intended to improve health care. This results in a “digital divide” in which populations that have poorer health outcomes continue to have poorer health outcomes despite technological improvements. Recent Findings In many ways, the digitical divide is already shrinking via improved access to internet and technology/process improvements. For example, people with schizophrenia, PTSD, and bipolar disorder have had their care successfully augmented by new technology. However, problems persist- being impoverished, female, and black all correlate with decreased probability of completing a telehealth visit, and millions of americans have insufficient internet access to complete telehealth visits. Summary We must continue to utilize new technology in health care to improve outcomes, but we must also be wary to ensure those outcomes are equitable across different populations.
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                Author and article information

                Journal
                Digit Health
                Digit Health
                DHJ
                spdhj
                Digital Health
                SAGE Publications (Sage UK: London, England )
                2055-2076
                15 May 2024
                Jan-Dec 2024
                : 10
                : 20552076241254019
                Affiliations
                [1-20552076241254019]Faculty of Public Administration, Ringgold 37663, universityUniversity of Ljubljana; , Ljubljana, Slovenia
                Author notes
                [*]Dalibor Stanimirovic, Faculty of Public Administration, University of Ljubljana, Gosarjeva 5, 1000 Ljubljana, Slovenia. Email: dalibor.stanimirovic@ 123456fu.uni-lj.si
                Author information
                https://orcid.org/0000-0003-0160-209X
                Article
                10.1177_20552076241254019
                10.1177/20552076241254019
                11100379
                38766362
                3975eb89-4154-4074-be40-29d7f35d0d08
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution-NoDerivs 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits any use, reproduction and distribution of the work as published without adaptation or alteration, provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 17 August 2023
                : 29 March 2024
                Categories
                Opinion Piece
                Custom metadata
                ts19
                January-December 2024

                digitalization trends,healthcare sector,ehealth,failure,fallacy,evidence-based approach

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