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The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective.

ABSTRACT: BACKGROUND:Research on the development and functioning of technology platforms specifically for health applications in sub-Saharan Africa (SSA), is limited. The healthcare sector has also been resistant to platform adoption due to characteristics such as sensitive data and high cost of failure. A framework for the design, development and implementation of technology platforms in the South African health context could therefore contribute to the gap in research as well as provide a practical tool that platform owners could use to potentially increase the adoption of platforms in this context. METHODS:The research design for this study was based on the Grounded Theory Conceptual Framework Analysis process. The process focused on mapping and investigating data sources, categorising and integrating concepts, synthesising these concepts into a framework and iteratively evaluating the framework. The first stage of the evaluation process was a preliminary evaluation exploring an existing Health platform in South Africa (MomConnect). The second evaluation stage included local and international interviews with nine experts to identify any missing concepts in the framework. Stage three included a case study and case study interviews which led to the formulation of the final framework and management tool. RESULTS:The developed and evaluated framework comprised three components, namely the pre-use component, which includes considerations the platform owner should be aware of prior to using the framework. The framework comprises of two dimensions, 1) an ecosystem dimension to guide the platform owner to consider different ecosystem actors before embarking on designing a platform 2) a platform development dimension that include typical platform development components and presents an interpretation of the viewpoints included in the ecosystem levels. CONCLUSIONS:The final framework can be used by platform owners as a management tool. A unique contribution of this study is that the framework draws from two platform perspectives, namely the engineering and the economic perspectives to provide a holistic understanding of platforms. Finally, a contribution of this article is the tailoring of the framework for the South African health context.

SUBMITTER: Herman H

PROVIDER: S-EPMC7068897 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective.

Herman Hilde H Grobbelaar Sara S SS Pistorius Calie C

BMC medical informatics and decision making 20200312 1

<h4>Background</h4>Research on the development and functioning of technology platforms specifically for health applications in sub-Saharan Africa (SSA), is limited. The healthcare sector has also been resistant to platform adoption due to characteristics such as sensitive data and high cost of failure. A framework for the design, development and implementation of technology platforms in the South African health context could therefore contribute to the gap in research as well as provide a practi ...[more]

PMID: 32164680

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Project description:As an emerging form of medical organization, Chinese mobile healthcare (mHealth) platforms are inherently linked to the continuous use of users, which depends on the quality of the health information provided. However, improving the health information quality of mHealth platforms is still a problem that needs to be studied and solved in order to make the platforms sustainable. Based on the reputation mechanism, this study creates a behavioral evolutionary game model for health information providers (physicians) and managers (mHealth platforms), explores the evolution process and evolutionarily stable strategy of the behaviors in various situations, and uses numerical simulation technology to analyze mHealth platforms' constraints and the influencing factors of health information quality. This study presents three key findings. First, considering reputation, health information managers and mHealth platform providers should not unilaterally optimize health information. Instead, mHealth platforms should have active quality control, and physician groups should provide high-quality health information, which is the ideal evolution of the model. Second, the rewards that physicians receive from patients and mHealth platforms for providing quality health information, the reputation benefits, the penalties that physicians suffer for providing low-quality health information, and the increased probability and cost of rent-seeking behavior that physicians may choose can effectively promote the choice of physicians to provide high-quality health information. Third, the reputation gain of mHealth platforms, the probability of mHealth platforms being exposed, and increased losses suffered from exposure can effectively promote the choice of mHealth platforms to control the quality of health information. This study can provide a theoretical basis for mHealth platforms' health information quality control, which is conducive to the healthy and sustainable development of mHealth platforms and the improvement of user satisfaction.

Project description:Background:E-health technology applications are essential tools of modern information technology that improve quality of healthcare delivery in hospitals of both developed and developing countries. However, despite its positive benefits, studies indicate that the rate of the e-health adoption in some developing countries is either low or underutilized. This is due in part, to barriers such as resistance from healthcare professionals, poor infrastructure, and low technical expertise among others. Objective:The aim of this study is to investigate, identify and analyze the underlying factors that affect healthcare professionals decision to adopt and use e-health technology applications in developing countries, with particular reference to hospitals in Nigeria. Methods:The study used a cross sectional approach in the form of a close-ended questionnaire to collect quantitative data from a sample of 465 healthcare professionals randomly selected from 15 hospitals in Nigeria. We used the modified Technology Acceptance Model (TAM) as the dependent variable and external factors as independent variables. The collected data was then analyzed using SPSS statistical analysis such as frequency test, reliability analysis, and correlation coefficient analysis. Results:The results obtained, which correspond with findings from other researches published, indicate that perceived usefulness, belief, willingness, as well as attitude of healthcare professionals have significant influence on their intention to adopt and use the e-health technology applications. Other strategic factors identified include low literacy level and experience in using the e-health technology applications, lack of motivation, poor organizational and management policies. Conclusion:The study contributes to the literature by pinpointing significant areas where findings can positively affect, or be found useful by, healthcare policy decision makers in Nigeria and other developing countries. This can help them understand their areas of priorities and weaknesses when planning for e-health technology adoption and implementation.

Project description:BACKGROUND: Experimental designs constitute a vital component of all Stated Choice (aka discrete choice experiment) studies. However, there exists limited empirical evaluation of the statistical benefits of Stated Choice (SC) experimental designs that employ non-zero prior estimates in constructing non-orthogonal constrained designs. This paper statistically compares the performance of contrasting SC experimental designs. In so doing, the effect of respondent literacy on patterns of Attribute non-Attendance (ANA) across fractional factorial orthogonal and efficient designs is also evaluated. The study uses a 'real' SC design to model consumer choice of primary health care providers in rural north India. A total of 623 respondents were sampled across four villages in Uttar Pradesh, India. METHODS: Comparison of orthogonal and efficient SC experimental designs is based on several measures. Appropriate comparison of each design's respective efficiency measure is made using D-error results. Standardised Akaike Information Criteria are compared between designs and across recall periods. Comparisons control for stated and inferred ANA. Coefficient and standard error estimates are also compared. RESULTS: The added complexity of the efficient SC design, theorised elsewhere, is reflected in higher estimated amounts of ANA among illiterate respondents. However, controlling for ANA using stated and inferred methods consistently shows that the efficient design performs statistically better. Modelling SC data from the orthogonal and efficient design shows that model-fit of the efficient design outperform the orthogonal design when using a 14-day recall period. The performance of the orthogonal design, with respect to standardised AIC model-fit, is better when longer recall periods of 30-days, 6-months and 12-months are used. CONCLUSIONS: The effect of the efficient design's cognitive demand is apparent among literate and illiterate respondents, although, more pronounced among illiterate respondents. This study empirically confirms that relaxing the orthogonality constraint of SC experimental designs increases the information collected in choice tasks, subject to the accuracy of the non-zero priors in the design and the correct specification of a 'real' SC recall period.

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The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective.

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The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective.

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