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Challenges on Radical Health Redesign to Reconfigure the Level of e-Health Adoption in EU Countries.

ABSTRACT: The recent worldwide COVID-19 pandemic has highlighted the importance of a performant public sector in terms of health. To achieve greater use and efficiency of health information and communication technology (ICT), the whole community of European states needs a model to develop a common strategy to support the implementation of e-health and reduce decision-making difficulties. Our research suggests such a model, starting from the level of adoption to the implementation of e-health and points out the existing disparities in the European countries regarding the difficulties of adopting e-health. We draw a composite index to assess the inequalities present in the quality of life, the public health system, and the adoption of e-health. Furthermore, to return to a hierarchy of European countries, the relative distance method (RDM) is applied by combining various classification criteria. The results identify the European countries with the highest levels of adoption (Denmark, Estonia, Spain, Sweden, Finland, and the United Kingdom), where e-health is routine, and the countries with the lowest levels of adoption (Greece, Lithuania, Luxembourg, Malta, Romania, and Slovakia), where e-health is not widespread. These results reveal critical implications in identifying solutions to reduce the gaps between countries, identifying public policies to support the adoption of e-health, and reducing difficulties in decision-making.

SUBMITTER: Luca MM

PROVIDER: S-EPMC8329364 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:The potential benefit of mobile health (M-Health) in developing countries for improving the efficiency of health care service delivery, health care quality, and patient safety, as well as reducing cost, has been increasingly recognized and emphasized in the last few years. OBJECTIVE:Limited research has investigated the facilitators and barriers for the adoption of M-Health in developing countries to secure successful implementation of the technology. To fill this knowledge gap, we propose an integrative model that explains the patient's adoption behavior of M-Health in developing countries grounded on the unified theory of acceptance and use of technology, dual-factor model, and health belief model. METHOD:We empirically tested and evaluated the model based on data collected using a survey method from 280 patients living in a developing country. Partial least squares (PLS-SEM) technique was used for data analysis. RESULTS:The results showed that performance expectancy, effort expectancy, social influence, perceived health threat, M-Health app quality, and life quality expectancy have a direct positive effect on patients' intention to use M-Health. The results also showed that security and privacy risks have a direct negative effect on the patient's intention to use M-Health. However, resistance to change was found to have an indirect negative effect on patients' intention to use M-Health through the performance expectancy. CONCLUSION:The research contributes to the existing literature of health information systems and M-Health by better understanding how technological, social, and functional factors are associated with digital health applications and services use and success in the context of developing countries. With the widespread availability of mobile technologies and services and the growing demand for M-Health apps, this research can help guide the development of the next generation of M-Health apps with a focus on the needs of patients in developing countries. The research has several theoretical and practical implications for the health care industry, government, policy makers, and technology developers and designers.

Project description:BackgroundLittle is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.MethodsA situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.ResultsThe PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.ConclusionsThe low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care.

Project description:IntroductioneHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics.Materials and methodsIn 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country).Results85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development.ConclusionsAlthough in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Challenges on Radical Health Redesign to Reconfigure the Level of e-Health Adoption in EU Countries.

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