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      Finnish experts' perceptions of digital healthcare forms in 2035 and the anticipated healthcare workforce impacts: a Delphi study

      research-article
      Liisa Lee , Mira Hammarén , Outi Kanste
      Journal of Health Organization and Management
      Emerald Publishing
      Digital health, Healthcare, Health workforce, Delphi, Future

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          Abstract

          Purpose

          To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and anticipated healthcare workforce impacts those forms will have.

          Design/methodology/approach

          A total of 17 experts representing relevant interest groups participated in a biphasic online Delphi study. The results for each round were analysed using descriptive statistical methods and inductive content analysis.

          Findings

          The forms of digital healthcare that the experts perceived as most likely to be utilised were those enabling patient participation, efficient organisation of services and automated data collection and analysis. The main impacts on the healthcare workforce were seen as being the redirection of workforce needs within the healthcare sector and need for new skills and new professions. The decrease in the need for a healthcare workforce was seen as less likely. The impacts were perceived as being constructed through three means: impacts within healthcare organisations, impacts on healthcare professions and impacts via patients.

          Research limitations/implications

          The results are not necessarily transferable to other contexts because the experts anticipated local futures. Patients' views were also excluded from the study.

          Originality/value

          Healthcare organisations function in complex systems where drivers, such as regional demographics, legislation and financial constraints, dictate how digital healthcare is utilised. Anticipating the workforce effects of digital healthcare utilisation has received limited attention; the study adds to this discussion.

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          Most cited references55

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          Delphi methodology in healthcare research: How to decide its appropriateness

          The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine. The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited, ethically/logistically difficult or evidence is conflicting. However, the attempts to assess the quality standard of Delphi studies have reported significant variance, and details of the process followed are usually unclear. We recommend systematic quality tools for evaluation of Delphi methodology; identification of problem area of research, selection of panel, anonymity of panelists, controlled feedback, iterative Delphi rounds, consensus criteria, analysis of consensus, closing criteria, and stability of the results. Based on these nine qualitative evaluation points, we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019. There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members, defining consensus, closing criteria for rounds, and presenting the results. We propose our evaluation points for researchers, medical journal editorial boards, and reviewers to evaluate the quality of the Delphi methods in healthcare research.
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            Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

            Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical processes (n=2), and staff turnover (n=1). Conclusions The reviewed literature suggested that, to increase the likelihood of success of eHealth interventions, future research must ensure a positive impact in the quality of care, with particular attention given to improved diagnosis, clinical management, and patient-centered care. There is a critical need to perform in-depth studies of the workflow(s) that the intervention will support and to perceive the clinical processes involved.
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              Delphi methodology in health research: how to do it?

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                Author and article information

                Contributors
                Journal
                JHOM
                10.1108/JHOM
                Journal of Health Organization and Management
                JHOM
                Emerald Publishing
                1477-7266
                20 February 2024
                18 April 2024
                : 38
                : 2
                : 192-208
                Affiliations
                [1]Research Unit of Health Sciences and Technology, University of Oulu; , Oulu, Finland
                [2] Medical Research Center; , Oulu University Hospital; , Oulu, Finland
                Author notes
                Outi Kanste can be contacted at: outi.kanste@oulu.fi
                Article
                717462 JHOM-02-2023-0044.pdf JHOM-02-2023-0044
                10.1108/JHOM-02-2023-0044
                6404863c-b4e7-4ac9-a3b3-01e0ef15e868
                © Liisa Lee, Mira Hammarén and Outi Kanste

                Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

                History
                : 21 February 2023
                : 16 December 2023
                : 23 January 2024
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 55, Pages: 17, Words: 7639
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                , Healthcare management
                Custom metadata
                Yes
                Yes
                Journal
                excluded

                Health & Social care
                Future,Delphi,Health workforce,Healthcare,Digital health
                Health & Social care
                Future, Delphi, Health workforce, Healthcare, Digital health

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