(EBSCO)—130 articles
(ELSEVIER Science Direct and Springer Link)—340 articles
Network analysis is considered a branch of graph theory. Our network analysis is based on the similarity of keywords found in identifying the eligible papers. We used visualisation of similarities (VOS) software, version 1.6.18, to construct graphical networks to understand the clustering of the keywords and their degree of dissimilarity. Our network analysis is based on the similarity of keywords found in identifying the eligible papers.
The search was performed on the following databases: Scopus, Science Direct, and PubMed, using the keywords “digital transformation”, “digitalisation”, “Ehealth or e-health”, “mhealth or m-health”, “healthcare” and “health economics”. We selected publications from the search of international journals and conference proceedings. We collected papers from 2008 until 2021. The documents sought belonged to strategy, management, computer science, medicine, and health professions. Finally, the published works were in English only. The total number of articles collected using the keywords as shown in Table 2 was 5847.
Search Strategy.
Database | Search within | Keywords | No Sources | |
---|---|---|---|---|
1. | Scopus | Article title, Abstract, Keywords | (Digital transformation or digitalization) AND (Ehealth or e-health or mhealth or m-health or healthcare) AND (health economics) | 408 |
Article title, Abstract, Keywords | (Digital transformation) AND (health) | 1.152 | ||
2. | Science Direct | Article title | (Digital transformation) AND (health) | 2.142 |
3. | PubMed | Article title, Abstract | (Digital transformation or digitalization) AND (Ehealth or e-health or mhealth or m-health or healthcare) AND (health economics) | 978 |
Article title | (Digital transformation) AND (health) | 1.167 | ||
Total | 5.847 |
We systematically checked the total number of papers 5847 by reading their titles, abstracts, and, whenever necessary, the article’s first page to conclude if each document was relevant as a first step as shown in the Figure 1 .
The diagram for the first phase of the selection process.
Then, we looked at the titles of the 378 articles, and after reading their summary, we accepted 321 articles. Further studies were rejected because their full text was not accessible. As a result, there were 255 articles in our last search. Of the selected 255 articles, 32 more were added based on backward and forward research. The investigation was completed by collecting common standards from all databases using different keyword combinations. According to the systematic literature review, we follow the standards of Webster and Watson (2002) to reject an article. Since then, we have collected the critical mass of the relevant publications, as shown in Figure 2 .
The diagram of the article selection process.
The categorisation of the articles was based on their content and the concepts discussed within them. As a result, we classify articles into the following categories: information technology in health, the educational impact on e-health, the acceptance of e-health, telemedicine, and e-health security.
Although researchers in Information and Communication Technology and digitalisation conducted studies almost two decades ago, most publications have been published in the last eight years. This exciting finding highlights the importance of this field and its continuous development. Figure 3 shows a clear upward trend in recent years. More specifically, the research field of Information and Communication Technology, in combination with digital transformation, appeared in 2008. However, the most significant number of articles was found in 2019, 2020 and 2021. The number of articles decreased to the lowest in 2009–2011 and 2013–2014. Due to the expansion of the field to new technologies, the researchers studied whether the existing technological solutions are sufficient for implementing digital transformation and what problems they may face.
Number of articles and citations per publication by year.
Figure 3 shows a combination of the articles per year and the number of citations per publication per year.
Of the document types, 59.51 per cent of the articles were categorised as “survey”, while a smaller percentage were in: “case study” (32.53%), “literature review” (5.88%) and “report” (2.08%). However, these documents focused on specific concepts: “information technology in health” (45%), “education impact of e-health” (11%), “acceptance of e-health” (19%), “telemedicine” (7%), “security of e-health” (18%).
As we can see from the following Figure 4 , we used network analysis, where the keywords related to digitalisation and digital transformation were identified in the research study. Network analysis, using keywords, came with VOSviewer software to find more breadth and information on healthcare digitalisation and transformation exploration. It was created by analysing the coexistence of keywords author and index. This analysis’s importance lies in the structure of the specific research field is highlighted. In addition, it helped map the intellectual structure of scientific literature. Keywords were obtained from the title and summary of a document. However, there was a limit to the number of individual words. The figure represents a grid focused on reproducing keywords in the literature on the general dimensions of digitalisation. The digitalisation network analysis showed that e-health, telemedicine, telehealth, mobile health, electronic health/medical record, and information systems were the main relevant backgrounds in the literature we perceived. In the healthcare literature, keywords such as “empowerment” and “multicenter study” usually do not lead to a bibliographic search on digitalisation. Figure 4 shows how e-health and telemedicine have gone beyond the essential and most crucial research framework on how they can affect hospitals and the health sector. The potentially small gaps in network analysis can be filled by utilising data in our research study, contributing to future research.
Bibliometric map of the digital transformation and healthcare.
Figure 5 shows the network analysis with the keywords concerning time publication. The yellow colour indicates keywords for most recent years.
Network visualisation of keywords per year.
Figure 6 presents the density visualisation of keywords.
Heat map of keywords.
Figure 7 shows the number of articles per each method (survey, literature review etc.) for each year.
The map of number of articles per method for each year.
It is evident from Figure 7 that the most used method paper is the survey type and that in the year 2021, we have a high number of surveys compared to previous years.
In Figure 2 , we have explained how we collected the critical mass of the 255 relevant publications. We added another 32 articles based on further research with the backward and research methods, which resulted in a total number of 287 articles.
Then, the articles were categorised according to their content. The concepts discussed in the papers are related to information technology in health, the educational impact of e-health, the acceptance of e-health, telemedicine, and e-health security. For this purpose, the following table was created, called the concept matrix table.
In this section, we provide the Concept matrix table. Academic resources are classified according to if each article belongs or not to any of the five concepts shown in Table 3 .
Concept Matrix Table.
No. | Author | Year | Method | Sample | Data Analysis | Concepts | ||||
---|---|---|---|---|---|---|---|---|---|---|
Information Technology in Health | Education Impact of E-Health | Acceptance of E-Health | Telemedicine | Security of E-Health | ||||||
1 | Kesavadev, J, et al., [ ] | 2021 | Case Study | Χ | ||||||
2 | Attila, SZ et al., [ ] | 2021 | Survey | Χ | ||||||
3 | Malachynska, M et al., [ ] | 2021 | Case Study | Χ | ||||||
4 | Lu, WC et al., [ ] | 2021 | Survey | Χ | ||||||
5 | Burmann, A et al., [ ] | 2021 | Case Study | Χ | ||||||
6 | Bogumil-Ucan, S et al., [ ] | 2021 | Case Study | Χ | ||||||
7 | Zanutto, O [ ] | 2021 | Survey | Χ | ||||||
8 | Alauddin, MS; et al., [ ] | 2021 | Survey | Χ | ||||||
9 | Alterazi, HA [ ] | 2021 | Survey | Χ | ||||||
10 | Schmidt-Kaehler, S et al., [ ] | 2021 | Case Study | Χ | ||||||
11 | Zhao, Y et al., [ ] | 2021 | Case Study | Χ | Χ | |||||
12 | Roth, CB et al., [ ] | 2021 | Systematic Literature Review | Χ | Χ | |||||
13 | Ali, NA et al., [ ] | 2021 | Case Study | Χ | ||||||
14 | Alimbaev, A et al., [ ] | 2021 | Case Study | Χ | ||||||
15 | Dick, H et al., [ ] | 2021 | Systematic Literature Review | Χ | Χ | |||||
16 | Alt, R et al., [ ] | 2021 | Survey | a Vice President | - | Χ | ||||
17 | Bartosiewicz, A et al., [ ] | 2021 | Survey | Χ | Χ | |||||
18 | Mussener, U [ ] | 2021 | Survey | Χ | ||||||
19 | Naumann, L et al., [ ] | 2021 | Case Study | 59 qualitative telephone interviews | The findings hinted at five priorities of e-health policy making: strategy, consensus-building, decision-making, implementation and evaluation that emerged from the stakeholders’ perception of the e-health policy. | Χ | ||||
20 | Saetra, HS et al., [ ] | 2021 | Case Study | Χ | ||||||
21 | Zoltan, V et al., [ ] | 2021 | Survey | Χ | Χ | |||||
22 | Hoch, P et al., [ ] | 2021 | Survey | Χ | ||||||
23 | De Vos, J [ ] | 2021 | Survey | Χ | ||||||
24 | Beaulieu, M et al., [ ] | 2021 | Survey | Χ | ||||||
25 | Dang, TH et al., [ ] | 2021 | Survey | Χ | Χ | Χ | ||||
26 | Kraus, S et al., [ ] | 2021 | Systematic Literature Review | Χ | Χ | Χ | ||||
27 | Gauthier, P et al., [ ] | 2021 | Survey | Χ | ||||||
28 | Zhang, JS et al., [ ] | 2021 | Survey | Χ | ||||||
29 | Mallmann, CA et al., [ ] | 2021 | Survey | 513 breast cancer patients from 2012 to 2020 | Statistical analysis | Χ | ||||
30 | Fons, AQ [ ] | 2021 | Survey | Χ | ||||||
31 | Chatterjee, S et al., [ ] | 2021 | Survey | Consumers of different age groups & people working in the healthcare sector (including doctors) | Qualitative analysis | Χ | Χ | |||
32 | Wasmann, JWA et al., [ ] | 2021 | Survey | Χ | ||||||
33 | Kanungo, RP et al., [ ] | 2021 | Survey | Χ | ||||||
34 | Fernandez-Luque, L et al., [ ] | 2021 | Survey | Χ | ||||||
35 | Wilson, A et al., [ ] | 2021 | Survey | Χ | ||||||
36 | Ziadlou, D [ ] | 2021 | Survey | US health care leaders | Qualitative analysis | Χ | Χ | |||
37 | Oh, SS et al., [ ] | 2021 | Survey | Χ | Χ | |||||
38 | Knitza, J et al., [ ] | 2021 | Survey | Χ | ||||||
39 | Sergi, D et al., [ ] | 2021 | Survey | Χ | ||||||
40 | Rosalia, RA et al., [ ] | 2021 | Case Study | Χ | ||||||
41 | [Anonymous] [ ] | 2021 | Survey | Χ | ||||||
42 | Prisyazhnaya, NV et al., [ ] | 2021 | Survey | Χ | ||||||
43 | Odone, A et al. [ ] | 2021 | Case Study | Variety of participants | Qualitative and quantitative analysis | Χ | ||||
44 | Balta, M et al., [ ] | 2021 | Case Study | Χ | Χ | |||||
45 | Mues, S et al., [ ] | 2021 | Survey | Χ | ||||||
46 | Frick, NRJ et al., [ ] | 2021 | Case Study | Physicians (nine female and seven male experts) | Thematic analysis | Χ | ||||
47 | Dendere, R et al., [ ] | 2021 | Survey | Χ | ||||||
48 | Neumann, M et al., [ ] | 2021 | Survey | The dean or the most senior academic individual responsible for the medical curriculum development | Descriptive statistics in Microsoft Excel (Version 16.38) | Χ | ||||
49 | Su, Y et al., [ ] | 2021 | Case Study | Χ | ||||||
50 | Masuda, Y et al., [ ] | 2021 | Survey | Χ | ||||||
51 | Frennert, S [ ] | 2021 | Survey | Χ | Χ | |||||
52 | Hasselgren, A et al., [ ] | 2021 | Survey | Χ | Χ | |||||
53 | Kim, HK et al., [ ] | 2021 | Survey | Χ | Χ | |||||
54 | Marchant, G et al., [ ] | 2021 | Survey | 569 adults | Statistical analysis | Χ | ||||
55 | Malfatti, G et al., [ ] | 2021 | Survey | Χ | ||||||
56 | Krasuska, M et al., [ ] | 2021 | Case Study | 628 interviews, observed 190 meetings and analysed 499 documents | Thematical analysis | Χ | ||||
57 | Piccialli, F et al., [ ] | 2021 | Survey | Χ | ||||||
58 | Kyllingstad, N et al., [ ] | 2021 | Survey | Χ | ||||||
59 | Frasquilho, D et al., [ ] | 2021 | Case Study | Χ | ||||||
60 | Leone, D et al., [ ] | 2021 | Case Study | Χ | ||||||
61 | Kwon, IWG et al., [ ] | 2021 | Report | Χ | ||||||
62 | Sim, SS et al., [ ] | 2021 | Systematic Literature Review | Χ | ||||||
63 | Christie, HL et al., [ ] | 2021 | Case Study | Experts (n = 483) in the fields of e-health, dementia, and caregiving were contacted via email | Qualitative analysis | Χ | ||||
64 | Eberle, C et al., [ ] | 2021 | Survey | 2887 patients | Qualitative analysis | Χ | ||||
65 | Popkova, EG et al., [ ] | 2021 | Survey | Χ | ||||||
66 | Reich, C et al., [ ] | 2021 | Survey | Χ | ||||||
67 | Hanrieder, T et al., [ ] | 2021 | Survey | Χ | ||||||
68 | Aleksashina, AA et al., [ ] | 2021 | Survey | Χ | Χ | |||||
69 | Haase, CB et al., [ ] | 2021 | Survey | Χ | ||||||
70 | Mishra, A et al., [ ] | 2021 | Survey | Χ | ||||||
71 | Kokshagina, O [ ] | 2021 | Survey | Χ | ||||||
72 | Loch, T et al., [ ] | 2021 | Survey | Χ | ||||||
73 | Cajander, A et al., [ ] | 2021 | Survey | 17 interviews with nurses ( = 9) and physicians ( = 8) | Thematical analysis | Χ | Χ | |||
74 | Botrugno, C [ ] | 2021 | Survey | Χ | ||||||
75 | Jacquemard, T et al., [ ] | 2021 | Survey | Χ | ||||||
76 | Behnke, M et al., [ ] | 2021 | Survey | Χ | ||||||
77 | Peltoniemi, T et al., [ ] | 2021 | Case Study | Χ | ||||||
78 | Glock, H et al., [ ] | 2021 | Survey | Χ | ||||||
79 | Weitzel, EC et al., [ ] | 2021 | Survey | Χ | ||||||
80 | Sullivan, C et al., [ ] | 2021 | Case Study | Χ | ||||||
81 | Luca, MM et al., [ ] | 2021 | Survey | Χ | ||||||
82 | Negro-Calduch, E et al., [ ] | 2021 | Systematic Literature Review | Χ | ||||||
83 | Werutsky, G et al.,Denninghoff, V et al., [ ] | 2021 | Survey | Χ | ||||||
84 | Piasecki, J et al., [ ] | 2021 | Survey | Χ | Χ | |||||
85 | Broenneke, JB et al., [ ] | 2021 | Survey | Χ | ||||||
86 | Faure, S et al., [ ] | 2021 | Survey | Χ | ||||||
87 | Ghaleb, EAA et al., [ ] | 2021 | Survey | Χ | Χ | |||||
88 | Verket, M et al., [ ] | 2021 | Survey | Χ | ||||||
89 | Lenz, S [ ] | 2021 | Survey | 15 interviews with persons from different areas of digital health care | Theoretical sampling | Χ | ||||
90 | De Sutter, E et al., [ ] | 2021 | Survey | 31 healthcare professionals active | Qualitative analysis | Χ | ||||
91 | Gevko, V et al., [ ] | 2021 | Survey | Χ | ||||||
92 | El Majdoubi, D et al., [ ] | 2021 | Survey | Χ | ||||||
93 | Thakur, A et al., [ ] | 2021 | Case Study | Χ | ||||||
94 | Persson, J et al., [ ] | 2021 | Survey | Χ | ||||||
95 | Zippel-Schultz, B et al., [ ] | 2021 | Survey | 49 patients and 33 of their informal caregivers. | Qualitative analysis | Χ | ||||
96 | Lam, K et al., [ ] | 2021 | Survey | Χ | ||||||
97 | Manzeschke, A [ ] | 2021 | Survey | Χ | ||||||
98 | Dyda, A et al., [ ] | 2021 | Case Study | Χ | Χ | |||||
99 | Beckmann, M et al., [ ] | 2021 | Case Study | Variety of participants | Qualitative and quantitative analysis | Χ | ||||
100 | Numair, T et al., [ ] | 2021 | Survey | Kenya: Interviewees included nurses, community health workers, and operators hired exclusively for data entry in the WIRE system. Laos: As no operators were hired in Lao PDR, interviewees included nurses, doctors, and midwives who used the WIRE system daily. (20 healthcare workers in Kenya & Laos PDR) | Qualitative and quantitative analysis | Χ | ||||
101 | Xiroudaki, S et al., [ ] | 2021 | Case Study | Χ | ||||||
102 | Droste, W et al., [ ] | 2021 | Survey | Χ | ||||||
103 | Lee, JY et al., [ ] | 2021 | Systematic Literature Review | Χ | ||||||
104 | Giovagnoli, et al., [ ] | 2021 | Survey | Χ | ||||||
105 | Daguenet, et al., [ ] | 2021 | Survey | Χ | ||||||
106 | Hubmann, et al., [ ] | 2021 | Survey | Χ | ||||||
107 | Vikhrov, et al., [ ] | 2021 | Survey | Χ | ||||||
108 | Jahn, HK et al., [ ] | 2021 | Survey | 198 complete and 45 incomplete survey responses from physicians | Statistical analysis | Χ | ||||
109 | Low et al., [ ] | 2021 | Survey | Χ | ||||||
110 | Levasluoto, et al., [ ] | 2021 | Case Study | 23 interviews | Thematical analysis | Χ | ||||
111 | Verma, et al., [ ] | 2021 | Survey | Χ | ||||||
112 | Leung, PPL et al., [ ] | 2021 | Case Study | Χ | ||||||
113 | Weber, S et al., [ ] | 2021 | Survey | Χ | ||||||
114 | Hogervorst, S et al., [ ] | 2021 | Survey | Patients (11), group HCPs (5 + 6), interviews HCPs (4) | Thematical analysis | Χ | ||||
115 | Khan, ich et al., [ ] | 2021 | Systematic Literature Review | Χ | ||||||
116 | Cherif, et al., [ ] | 2021 | Survey | Χ | ||||||
117 | Bingham, et al., [ ] | 2021 | Survey | 19 registered nurses | Descriptive statistics | Χ | ||||
118 | Broich, et al., [ ] | 2021 | Survey | Χ | ||||||
119 | Klemme, et al., [ ] | 2021 | Survey | The study consisted of 15 semi-structured interviews with academic staff ( = 7 professors and postdoctoral researchers, three female, four male) in the field of intelligent systems and technology in healthcare and staff at practice partners ( = 8 heads of department, two female, six male) in healthcare technology and economy (a hospital, a digital innovation and engineering company and a manufacturer of household appliances) and social institutions (foundations and aid organisations for people with disabilities). | Qualitative analysis | Χ | Χ | |||
120 | Dillenseger, et al., [ ] | 2021 | Survey | Χ | ||||||
121 | Wangler, et al., [ ] | 2021 | Survey | Χ | ||||||
122 | Kuhn, et al., [ ] | 2021 | Survey | Students (35) | Qualitative analysis | Χ | ||||
123 | Aldekhyyel, et al., [ ] | 2021 | Survey | Χ | ||||||
124 | Christlein, et al., [ ] | 2021 | Survey | Χ | ||||||
125 | Bergier, et al., [ ] | 2021 | Survey | Χ | ||||||
126 | Sitges-Macia, et al., [ ] | 2021 | Survey | Χ | ||||||
127 | Rani, et al., [ ] | 2021 | Survey | Χ | ||||||
128 | Fredriksen, et al., [ ] | 2021 | Case Study | Healthcare employees from a volunteer centre and from municipality healthcare units in three municipalities | Qualitative analysis | Χ | ||||
129 | Caixeta, et al., [ ] | 2021 | Survey | Χ | ||||||
130 | Gupta, et al., [ ] | 2021 | Survey | Χ | ||||||
131 | Dobson, et al., [ ] | 2021 | Survey | Χ | ||||||
132 | Choi, K et al., [ ] | 2021 | Survey | Χ | ||||||
133 | Muller-Wirtz, et al., [ ] | 2021 | Case Study | Χ | ||||||
134 | Sembekov, et al., [ ] | 2021 | Survey | Χ | ||||||
135 | Aulenkamp, et al., [ ] | 2021 | Survey | Χ | Χ | |||||
136 | Paul, et al., [ ] | 2021 | Survey | 16 key stakeholders | Thematical analysis | Χ | ||||
137 | Lemmen, et al., [ ] | 2021 | Survey | 62 citizens and 13 patients | Qualitative analysis | Χ | ||||
138 | Golz, et al., [ ] | 2021 | Survey | Χ | ||||||
139 | Tarikere, et al., [ ] | 2021 | Survey | Χ | ||||||
140 | Li, et al., [ ] | 2021 | Case Study | Χ | ||||||
141 | Rouge-Bugat, et al., [ ] | 2021 | Case Study | Χ | ||||||
142 | Iodice, et al., [ ] | 2021 | Survey | Χ | ||||||
143 | Kulzer, B [ ] | 2021 | Survey | Χ | ||||||
144 | Khosla, et al., [ ] | 2021 | Survey | Χ | ||||||
145 | Dantas, et al., [ ] | 2021 | Survey | Χ | ||||||
146 | Gaur, et al., [ ] | 2021 | Survey | Χ | ||||||
147 | Khodadad-Saryazdi, A [ ] | 2021 | Case Study | Χ | Χ | Χ | ||||
148 | Bellavista, et al., [ ] | 2021 | Case Study | Χ | ||||||
149 | Laukka, et al., [ ] | 2021 | Case Study | Χ | Χ | |||||
150 | Singh, et al., [ ] | 2021 | Survey | Χ | ||||||
151 | Patalano, et al., [ ] | 2021 | Survey | Χ | ||||||
152 | Mantel-Teeuwisse, et al., [ ] | 2021 | Survey | Χ | ||||||
153 | Mues, et al., [ ] | 2021 | Survey | Χ | ||||||
154 | Bosch-Capblanch, et al., [ ] | 2021 | Survey | Χ | ||||||
155 | Jaboyedoff, et al., [ ] | 2021 | Survey | 336 common data elements (CDEs) | Qualitative analysis | Χ | ||||
156 | Nadhamuni, et al., [ ] | 2021 | Survey | Χ | ||||||
157 | Hertling, et al., [ ] | 2021 | Survey | Χ | ||||||
158 | Khan, et al., [ ] | 2021 | Survey | Χ | ||||||
159 | Mun, et al., [ ] | 2021 | Survey | Χ | Χ | |||||
160 | Xi, et al., [ ] | 2021 | Survey | Χ | ||||||
161 | Weichert, et al., M [ ] | 2021 | Survey | Χ | ||||||
162 | Liang, et al., [ ] | 2021 | Survey | Χ | ||||||
163 | Williams, et al., [ ] | 2021 | Survey | 508 interviews, 163 observed meetings, and analysis of 325 documents. | Qualitative analysis—Sociotechnical principles, combining deductive and inductive methods | Χ | ||||
164 | Feroz, et al., [ ] | 2021 | Case Study | Χ | ||||||
165 | Huser, et al., [ ] | 2021 | Case Study | Χ | ||||||
166 | Apostolos, K [ ] | 2021 | Survey | Χ | ||||||
167 | Simsek, et al., [ ] | 2021 | Survey | Χ | Χ | |||||
168 | Khamisy-Farah, et al., [ ] | 2021 | Survey | Χ | ||||||
169 | Egarter, et al., [ ] | 2021 | Case Study | Χ | ||||||
170 | Can, et al., [ ] | 2021 | Survey | Χ | ||||||
171 | Sung, et al., [ ] | 2021 | Survey | 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analysed. Interviews with 12 e-logbook users found overall satisfaction. | Statistical analysis | Χ | Χ | |||
172 | Zoellner, et al., [ ] | 2021 | Survey | Χ | ||||||
173 | Oliveira, et al., [ ] | 2021 | Case Study | Recipients numbering 151 (21% of the universe) completed the questionnaire: trade (49), industry (41), services (28), health (15), and education (18). | Quantitative analysis | Χ | ||||
174 | Goudarzi, et al., [ ] | 2021 | Survey | Χ | ||||||
175 | Li, et al., [ ] | 2021 | Survey | Χ | Χ | |||||
176 | Klimanov, et al., [ ] | 2021 | Case Study | Χ | ||||||
177 | Nadav, et al., [ ] | 2021 | Survey | Eight focus group interviews were conducted with 30 health and social care professionals | Qualitative analysis | Χ | ||||
178 | Spanakis, et al., [ ] | 2021 | Survey | Χ | ||||||
179 | Polyakov, et al., [ ] | 2021 | Survey | Χ | ||||||
180 | Fristedt, et al., [ ] | 2021 | Survey | Intervention group ( = 80) & control group ( = 80) | Data will be coded and manually entered in SPSS | Χ | ||||
181 | Mandal, et al., [ ] | 2021 | Survey | Χ | ||||||
182 | Ozdemir, V [ ] | 2021 | Survey | Χ | ||||||
183 | Eberle, et al., [ ] | 2021 | Survey | Χ | ||||||
184 | Iakovleva, et al., [ ] | 2021 | Case Study | Χ | ||||||
185 | von Solodkoff, et al., [ ] | 2021 | Survey | In the questionnaire, the participants ( = 217). A total of 27 subjects (mean age 51 years, min: 23 years, max: 86 years) participated in the interviews. | Statistical analysis | Χ | ||||
186 | Khuntia, et al., [ ] | 2021 | Survey | Χ | Χ | |||||
187 | Ochoa, et al., [ ] | 2021 | Survey | Χ | ||||||
188 | Masłoń-Oracz, et al., [ ] | 2021 | Case Study | X | X | |||||
189 | Abrahams, et al., [ ] | 2020 | Survey | X | X | |||||
190 | Agnihothri, et al., [ ] | 2020 | Survey | X | ||||||
191 | Bukowski, et al., [ ] | 2020 | Survey | X | X | |||||
192 | Chiang, et al., [ ] | 2020 | Survey | X | X | |||||
193 | Cobelli, et al., [ ] | 2020 | Survey | Pharmacists (82) | Qualitative content analysis | X | ||||
194 | Crawford, et al., [ ] | 2020 | Survey | X | X | |||||
195 | Gjellebæk, et al., [ ] | 2020 | Case Study | Employees and middle managers | Thematic analysis | X | ||||
196 | Nascimento, et al., [ ] | 2020 | Case Study | X | ||||||
197 | Geiger, et al., [ ] | 2020 | Case Study | Specialist in neurosurery & resident (296) | Statistical Analysis | X | X | |||
198 | Eden, et al., [ ] | 2020 | Survey | Medical, nursing, allied health, administrative and executive roles (92) | Analysis of Cohen’s kappa (k) | X | X | |||
199 | Gochhait, et al., [ ] | 2020 | Case Study | X | X | |||||
200 | Kernebeck, et al., [ ] | 2020 | Case Study | X | ||||||
201 | Klinker, et al., [ ] | 2020 | Survey | Staff of health care facilities (14) | Microsoft HoloLens, Vuzix m100 | X | ||||
202 | Krasuska, et al., M.; Williams, R.; Sheikh, A.; Franklin, B. D.; Heeney, C.; Lane, W.; Mozaffar, H.; Mason, K.; Eason, et al., [ ] | 2020 | Survey | Staff of health care facilities (113) | Qualitative analysis | X | ||||
203 | Leigh, et al., [ ] | 2020 | Survey | X | ||||||
204 | Minssen, et al., [ ] | 2020 | Survey | X | ||||||
205 | Mueller, et al., [ ] | 2020 | Case Study | Staff of health care facilities (20) | Qualitative analysis | X | X | |||
206 | Nadarzynski, et al., [ ] | 2020 | Case Study | Patients (257) | Statistical analysis | X | X | |||
207 | Pekkarinen, et al., [ ] | 2020 | Case Study | Variety of participants (24) | The analytical framework is based on Nardi and O’Day’s five components of information ecology: system, diversity, co-evolution, keystone species, and locality. | X | ||||
208 | Rajamäki, et al., [ ] | 2020 | Survey | X | ||||||
209 | Salamah, et al., [ ] | 2020 | Case Study | X | ||||||
210 | Stephanie, et al., [ ] | 2020 | Survey | X | ||||||
211 | Sultana, et al., [ ] | 2020 | Survey | X | X | |||||
212 | Visconti, et al., [ ] | 2020 | Case Study | X | ||||||
213 | Yousaf et al., [ ] | 2020 | Case Study | X | ||||||
214 | Asthana, et al., [ ] | 2019 | Survey | X | ||||||
215 | Astruc, B. [ ] | 2019 | Case Study | X | X | |||||
216 | Baltaxe, et al., [ ] | 2019 | Report | X | ||||||
217 | Caumanns, J. [ ] | 2019 | Case Study | X | ||||||
218 | Diamantopoulos, et al., [ ] | 2019 | Case Study | X | X | |||||
219 | Diviani, et al., [ ] | 2019 | Survey | Variety of participants (165) | Qualitative analysis | X | ||||
220 | EYGM [ ] | 2019 | Survey | X | ||||||
221 | Hatzivasilis, et al., [ ] | 2019 | Survey | X | ||||||
222 | Go Jefferies, et al., [ ] | 2019 | Case Study | X | X | |||||
223 | Kivimaa, P., et al., [ ] | 2019 | Systematic Literature Review | X | ||||||
224 | Klocek, A., et al., [ ] | 2019 | Case Study | Variety of people (153) | Statistical analysis | X | ||||
225 | Kohl, S., et al., [ ] | 2019 | Survey | X | ||||||
226 | Kouroubali, et al., [ ] | 2019 | Case Study | X | X | |||||
227 | Manard, et al., [ ] | 2019 | Case Study | X | ||||||
228 | Mende M. [ ] | 2019 | Survey | X | ||||||
229 | Mishra et al., [ ] | 2019 | Systematic Literature Review | X | X | X | ||||
230 | Niemelä, et al., [ ] | 2019 | Survey | Health professionals, child patients’ parents, and the healthcare industry | Systematically analysed according to the process structure (pre-, intra-, post-surgery, and home care). | X | ||||
231 | Nittas, V., et al. [ ] | 2019 | Survey | X | ||||||
232 | Noor, A. [ ] | 2019 | Case Study | Students and Staff in colleges and universities | Qualitative analysis | X | ||||
233 | Pape, L., et al. [ ] | 2019 | Case Study | X | ||||||
234 | Patrício, et al., [ ] | 2019 | Survey | X | ||||||
235 | Russo Spena, T., Cristina, M. [ ] | 2019 | Survey | X | ||||||
236 | Rydenfält, C., et al., [ ] | 2019 | Case Study | Variety of people (264) | NVivo 10 (QSR International, Melbourne, Australia) | X | ||||
237 | Savikko, et al., [ ] | 2019 | Case Study | X | ||||||
238 | Vial, G [ ] | 2019 | Systematic Literature Review | X | ||||||
239 | Wangdahl, J.M., et al., [ ] | 2019 | Case Study | Variety of people (600) | Binary logistic regression analysis | X | ||||
240 | Watson, et al., [ ] | 2019 | Systematic Literature Review | X | ||||||
241 | Weigand, et al., [ ] | 2019 | Survey | X | ||||||
242 | Zanutto, A. [ ] | 2019 | Survey | Staff of health care facilities (6836) | Qualitative analysis | X | ||||
243 | Eden, et al., [ ] | 2018 | Systematic Literature Review | X | ||||||
244 | Goh, W., et al. [ ] | 2018 | Survey | X | ||||||
245 | Kayser, L., et al., [ ] | 2018 | Survey | X | ||||||
246 | Poss-Doering, R. et al., [ ] | 2018 | Case Study | Patients (11) & Doctors (3) | Statistical analysis | X | X | X | ||
247 | Khatoon, et al., [ ] | 2018 | Survey | X | X | |||||
248 | Melchiorre, M.G., et al., [ ] | 2018 | Case Study | X | ||||||
249 | Ngwenyama, et al., [ ] | 2018 | Survey | X | ||||||
250 | Öberg, U.A.-O., et al., [ ] | 2018 | Survey | Primary healthcare nurses (20) | Qualitative analysis | X | ||||
251 | Parkin, et al., [ ] | 2018 | Report | X | ||||||
252 | Tuzii, J., [ ] | 2018 | Case Study | X | ||||||
253 | Brockes, C., et al., [ ] | 2017 | Survey | Students (28) | Mann–Whitney U-Test | X | X | |||
254 | Cavusoglu, et al., [ ] | 2017 | Survey | X | ||||||
255 | Cerdan, et al., [ ] | 2017 | Case Study | Patients (29) | Qualitative analysis | X | ||||
256 | Coppolino, et al., [ ] | 2017 | Survey | X | ||||||
257 | Geiger, et al., [ ] | 2017 | Survey | X | ||||||
258 | Giacosa, et al., [ ] | 2017 | Survey | X | ||||||
259 | Hong, et al., [ ] | 2017 | Survey | X | ||||||
260 | Hüsers, J., et al., [ ] | 2017 | Case Study | Nurses (534) | All data were analysed using R (Version 3.2.1) | X | ||||
261 | Parviainen, et al., [ ] | 2017 | Survey | X | ||||||
262 | Paulin, A. [ ] | 2017 | Survey | X | ||||||
263 | Schobel, J., et al. [ ] | 2017 | Survey | X | ||||||
264 | Seddon, et al., [ ] | 2017 | Survey | X | ||||||
265 | Thorseng, et al., [ ] | 2017 | Survey | Variety of participants | Qualitative analysis | X | ||||
266 | Tuzii, J. [ ] | 2017 | Case Study | X | ||||||
267 | Amato, F., et al., [ ] | 2016 | Survey | X | ||||||
268 | Bongaerts, et al., [ ] | 2016 | Survey | X | ||||||
269 | Cucciniello, et al., [ ] | 2016 | Survey | X | ||||||
270 | Evans, R.S. [ ] | 2016 | Survey | X | ||||||
271 | Faried, et al., [ ] | 2016 | Report | X | ||||||
272 | Harjumaa, M., et al., [ ] | 2016 | Survey | Various organisations (12) | Interview data was then analysed thematically. | X | ||||
273 | Mattsson, T., [ ] | 2016 | Case Study | X | ||||||
274 | Mazor, et al., [ ] | 2016 | Survey | X | ||||||
275 | Anwar, et al., [ ] | 2015 | Survey | X | X | |||||
276 | Kostkova, P., [ ] | 2015 | Survey | X | ||||||
277 | Laur, A., [ ] | 2015 | Survey | X | ||||||
278 | Sultan, N., [ ] | 2015 | Survey | X | X | |||||
279 | Nudurupati, et al., [ ] | 2015 | Survey | X | ||||||
280 | Sanders, K., et al., [ ] | 2015 | Survey | Healthcare professionals (17) | Qualitative analysis | X | ||||
281 | Cook, et al., [ ] | 2012 | A Systematic Literature Review | X | ||||||
282 | Khan, et al., [ ] | 2012 | Survey | X | ||||||
283 | Agarwal, R., et al., [ ] | 2010 | Survey | X | ||||||
284 | Thomas, et al., [ ] | 2009 | Case Study | X | ||||||
285 | Buccoliero, et al., [ ] | 2008 | Survey | X | ||||||
286 | Hikmet, et al., [ ] | 2008 | Case Study | Variety of participants | Quantitive analysis | X | ||||
287 | Zdravković, S. [ ] | 2008 | Survey | Χ | X |
From the articles included in the present study between 2008 and 2021, they were grouped into five categories identified: (i) information technology in health, (ii) acceptance of e-health, (iii) telemedicine, (iv) security of e-health, and (v) education impact of e-health.
Researchers have studied several factors to maximise the effectiveness and success of adopting new technology to benefit patients. Hospitals can benefit from information technology when designing or modifying new service procedures. Health units can use information and communication technology applications to analyse and identify patients’ needs and preferences, enhancing their service innovation processes. Previous findings conclude that technological capability positively influences patient service and innovation in the service process [ 301 ]. These results have significant management implications as managers seek to increase technology resources’ efficiency to achieve patient-centred care as the cornerstone of medical practice [ 207 ].
Informatics facilitates the exchange of knowledge necessary for creating ideas and the development process. The internet supports health organisations in developing and distributing their services more efficiently [ 206 ]. Also, Information Technology improves the quality of services, reduces costs, and helps increase patient satisfaction. As new technologies have created opportunities for companies developing high-tech services, healthcare units can increase customer value, personalise services and adapt to their patient’s needs [ 209 ]. To this end, the “smart hospitals” should represent the latest investment frontiers impacting healthcare. Their technological characteristics are so advanced that the public authorities need know-how for their conception, construction, and operation [ 228 ].
A new example is reshaping global healthcare services in their infancy, emphasising the transition from sporadic acute healthcare to continuous and comprehensive healthcare. This approach is further refined by “anytime and everywhere access to safe eHealth services.” Recent developments in eHealth, digital transformation and remote data interchange, mobile communication, and medical technology are driving this new paradigm. Follow-up and timely intervention, comprehensive care, self-care, and social support are four added features in providing health care anywhere and anytime [ 289 ]. However, the healthcare sector’s already precarious security and privacy conditions are expected to be exacerbated in this new example due to the much greater monitoring, collection, storage, exchange, and retrieval of patient information and the cooperation required between different users, institutions, and systems.
The use of mobile telephony technologies to support health goals contributes to the transformation of healthcare benefits worldwide. The same goes for small and medium-sized healthcare companies, such as pharmacies. A potent combination of factors between companies and customers is the reason for creating new relationships. In particular, mobile technology applications represent new opportunities for integrating mobile health into existing services, facilitating the continued growth of quality service management. Service-based, service-focused strategies have changed distribution patterns and the relationship between resellers and consumers in the healthcare industry, resulting in mobile health and significant pharmacy opportunities. It has been an important research topic in the last decade because it has influenced and changed traditional communication between professionals and patients [ 211 ]. An example of a mobile healthcare platform is “Thymun”, designed and developed by Salamah et al. aiming to create intelligent health communities to improve the health and well-being of autoimmune people in Indonesia [ 225 ].
In a long-term project and a population study (1999–2002), Hsu et al. evaluated e-health usage patterns [ 302 ]. The authors conclude that access to and use of e-health services are rapidly increasing. These services are more significant in people with more medical needs. Fang (2015) shows that scientific techniques can be an essential tool for revealing patterns in medical research that could not be apparent with traditional methods of reviewing the medical literature [ 303 ]. Teleradiology and telediagnosis, electronic health records, and Computer-Aided Diagnosis (CAD) are examples of digital medical technology. France is an example of a country that invests and leads in electronic health records, based on what is written by Manard S. et al. [ 243 ]. However, the impact of technological innovation is reflected in the availability of equipment and new technical services in different or specialised healthcare sectors.
On the other hand, Mariusz Duplaga (2013) argues that the expansion of e-health solutions is related to the growing demand for flexible, integrated and cost-effective models of chronic care [ 304 ]. The scope of applications that can support patients with chronic diseases is broad. In addition to accessing educational resources, patients with chronic diseases can use various electronic diaries and systems for long-term disease monitoring. Depending on the disease and the symptoms, the devices used to assess the patient’s condition vary. However, the need to report symptoms and measurements remains the same. According to Duplaga, the success of treatments depends on the patient’s involvement in monitoring and managing the disease. The emphasis on the role of the patient is parallel to the general tendency of people and patients to participate in decisions made about their health. Involving patients in monitoring their symptoms leads to improved awareness and ability to manage diseases. Duplaga argues that the widespread use of e-health systems depends on several factors, including the acceptance and ability to use information technology tools, combined with an understanding of disease and treatment.
Sumedha Chauhan & Mahadeo Jaiswal (2017) are on the same wavelength. They claim that e-health applications provide tools, processes and communication systems to support e-health practices [ 305 ]. These applications enable the transmission and management of information related to health care and thus contribute to improving patient’s health and physicians’ performance. The human element plays a critical role in the use of e-health, according to the authors. In addition, researchers have studied the acceptance of e-health applications among patients and the general public, as they use services such as home care and search for information online. The meta-analysis they use combines and analyzes quantitative findings of multiple empirical studies providing essential knowledge. However, the reason for their research was the study of Holden and Karsh (2010) [ 306 ].
To provide a comprehensive view of the literature acceptance of e-health applications, Holden and Karsh reviewed 16 studies based on healthcare technology acceptance models [ 306 ]. Findings show them that the use and acceptance of technological medical solutions bring improvements but can be adopted by those involved in the medical field.
On the other hand, telemedicine is considered one of the most important innovations in health services, not only from a technological but also from a cultural and social point of view. It benefits the accessibility of healthcare services and organisational efficiency [ 215 ]. Its role is to meet the challenges posed by the socio-economic change in the 21st century (higher demands for health care, ageing population, increased mobility of citizens, need to manage large volumes of information, global competitiveness, and improved health care provision) in an environment with limited budgets and costs. Nevertheless, there are significant obstacles to its standardisation and complete consolidation and expansion [ 300 ].
At present, there are Telemedicine centres that mediate between the patient and the hospital or doctor. However, many factors make this communication impossible [ 300 ]. Such factors include equipment costs, connectivity problems, the patient’s trust or belief in the system or centre that applies telemedicine, and resistance to new and modern diagnostics, especially in rural and island areas. Therefore, telemedicine would make it easier to provide healthcare systems in remote areas than having a specialist in all the country’s remote regions [ 300 ]. Analysing the concept further, one can easily argue that the pros outweigh the disadvantages. Therefore, telemedicine must be adopted in a concerted effort to resolve all the obstacles we are currently facing. Telemedicine centres and services such as teleradiology, teledermatology, teleneurology, and telemonitoring will soon be included. This means that a few years from now, the patient will not have to go to a central hospital and can benefit remotely from the increased quality of health services. This will save valuable time, make good use of available resources, save patient costs, and adequately develop existing and new infrastructure.
In 2007, the World Health Organisation adopted the following broad description of telemedicine: “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities ” [ 307 ]
According to the Wayback Machine, Canadian Telehealth Forum, other terms similar to telemedicine are telehealth and e-health, which are used as broader concepts of remote medical therapy. It is appropriate to clarify that telemedicine refers to providing clinical services. In contrast, telehealth refers to clinical and non-clinical services, including education, management and research in medical science. On the other hand, the term eHealth, most commonly used in the Americas and Europe, consists of telehealth and other elements of medicine that use information technology, according to the American Telemedicine Association [ 308 ].
The American Telemedicine Association divides telemedicine into three categories: storage-promotion, remote monitoring, and interactive services. The first category includes medical data, such as medical photographs, cardiograms, etc., which are transferred through new technologies to the specialist doctor to assess the patient’s condition and suggest the appropriate medication. Remote monitoring allows remote observation of the patient. This method is used mainly for chronic diseases like heart disease, asthma, diabetes, etc. Its interactive services enable direct communication between the patient and the treating doctor [ 309 ].
Telemedicine is a valuable and efficient tool for people living or working in remote areas. Its usefulness lies in the health access it provides to patients. In addition, it can be used as an educational tool for learning students and medical staff [ 310 ].
Telemedicine is an open and constantly evolving science, as it incorporates new technological developments and responds to and adapts to the necessary health changes within societies.
According to J.J. Moffatt, the most common obstacles to the spread of telemedicine are found in the high cost of equipment, the required technical training of staff and the estimated time of a meeting with the doctor, which can often be longer than the use of a standard doctor [ 311 ]. On the other hand, the World Health Organisation states that telemedicine offers excellent potential for reducing the variability of diagnoses and improving clinical management and the provision of health care services worldwide. The World Health Organisation claims, according to Craig et al. and Heinzelmann PJ, that telemedicine improves access, quality, efficiency and cost-effectiveness [ 312 , 313 ]. In particular, telemedicine can help traditionally under-served communities by overcoming barriers to the distance between healthcare providers and patients [ 314 ]. In addition, Jennett PA et al. highlight significant socio-economic benefits for patients, families, health professionals and the health system, including improved patient-provider communication and educational opportunities [ 315 ].
On the other hand, Wootton R. argues that telemedicine applications have achieved different levels of success. In both industrial and developing countries, telemedicine has yet to be used consistently in the healthcare system, and few pilot projects have been able to be maintained after the end of their initial funding [ 316 ].
However, many challenges are regularly mentioned and responsible for the need for more longevity in many efforts to adopt telemedicine. One such challenge is the complexity of human and cultural factors. Some patients and healthcare workers resist adopting healthcare models that differ from traditional approaches or home practices. In contrast, others need to have the appropriate educational background in Information and Communication Technologies to make effective use of telemedicine approaches [ 314 ]. The need for studies documenting telemedicine applications’ economic benefits and cost-effectiveness is also a challenge. Strong business acumen to persuade policymakers to embrace and invest in telemedicine has contributed to a need for more infrastructure and program funding [ 312 ]. Legal issues are also significant obstacles to the adoption of telemedicine. These include the need for an international legal framework that allows health professionals to provide services in different jurisdictions and countries. Furthermore, the lack of policies governing data confidentiality, authentication and the risk of medical liability for health professionals providing telemedicine services [ 314 ]. In any case, the technological challenges are related to legal issues. In addition, the systems used are complex, and there is a possibility of malfunction, which could cause software or hardware failure. The result is an increase in patient morbidity or mortality as well as the liability of healthcare providers [ 317 ].
According to Stanberry B., to overcome these challenges, telemedicine must be regulated by definitive and comprehensive guidelines, which are ideally and widely applied worldwide [ 318 ]. At the same time, legislation must be enacted governing health confidentiality, data access, and providers’ responsibility [ 314 ].
The possibility of the patients looking at the electronic patient folder in a cloud environment, through mobile devices anytime and anywhere, is significant. On the one hand, the advantages of cloud computing are essential, and on the other hand, a security mechanism is critical to ensure the confidentiality of this environment. Five methods are used to protect data in such environments: (1) users must encrypt the information before storing it; (2) users must transmit information through secure channels; (3) the user ID must be verified before accessing data; (4) the information is divided into small portions for handling and storage, retrieved when necessary; (5) digital signatures are added to verify that a suitable person has created the file to which a user has access. On the other hand, users of these environments will implement self-encryption to protect data and reduce over-reliance on providers [ 210 ].
At the same time, Maliha S. et al. [ 227 ] proposed the blockchain to preserve sensitive medical information. This technology ensures data integrity by maintaining a trace of control over each transaction. At the same time, zero trusts provide that medical data is encrypted and that only certified users and devices interact with the network. In this way, this model solves many vulnerabilities related to data security [ 227 ]. Another alternative approach is the KONFIDO project, which aims at the safe cross-border exchange of health data. A European H2020 project aims to address security issues through a holistic example at the system level. The project combines various cutting-edge technologies in its toolbox (such as blockchain, photonic Physical Unclonable Functions, homomorphic encryption, and trusted execution) [ 234 ]. Finally, Coppolino L. et al. [ 271 ] proposed using a SIEM framework for an e-healthcare portal developed under the Italian National eHealth Net Program. This framework allows real-time monitoring of access to the portal to identify potential threats and anomalies that could cause significant security issues [ 271 ].
But all this would only be feasible with the necessary education of both users and patients [ 11 ]. As the volume and quality of evidence in medical education continue to expand, the need for evidence synthesis will increase [ 295 ]. On the other hand, Brockers C. et al. argued that digitalisation changes jobs and significantly impacts medical work. The quality of medical data provided for support depends on telemedicine’s medical specialisation and knowledge. Adjustments to primary and further education are inevitable because physicians are well trained to support their patients satisfactorily and confidently in the increasingly complex digitalisation of healthcare. The ultimate goal of the educational community is the closest approach of students to the issues of telemedicine and e-health, the creation of a spirit of trust, and the acceptance and transmission of essential knowledge [ 268 ].
Noor also moved in this direction, seeking to discover the gaps in Saudi education for digital transformation in health [ 248 ]. The growing complexity of healthcare systems worldwide and the growing reliance of the medical profession on information technology for precise practices and treatments require specific standardised training in Information Technology (IT) health planning. Accreditation of core Information Technology (IT) is advancing internationally. Noor A. examined the state of Information Technology health programmes in the Kingdom of Saudi Arabia (KSA) to determine (1) how well international standards are met and (2) what further development is required in the light of recent initiatives of the Kingdom of Saudi Arabia on e-health [ 248 ]. Of the 109 institutions that participated in his research, only a few offered programmes specifically in Health Information Technology. As part of Saudi Vision 2030, Saudi digital transformation was deemed an urgent need. This initiative calls for applying internationally accepted Information Technology skills in education programmes and healthcare practices, which can only happen through greater collaboration between medical and technology educators and strategic partnerships with companies, medical centres and government agencies.
Another study by Diviani N. et al. adds to the knowledge of e-health education, demonstrating how online health information affects a person’s overall behaviour and enhances patients’ ability to understand, live and prepare for various health challenges. The increasing digitalisation of communication and healthcare requires further research into the digital divide and patients’ relationships with health professionals. Healthcare professionals must recognise the online information they seek and engage with patients to evaluate online health information and support joint healthcare-making [ 235 ].
The selected studies comprise a conceptual model based on bibliographic research. Using an open-ended technique, we analyse the selected 287 articles, which are grouped into categories based on their context. This methodology provides readers with a good indication of issues concerning the timeliness of health digitalisation. A limitation of the methodology is that selected criteria of the method might be subjective in terms of the search terms and how the papers are selected. The articles indicate that this field is initial, and further research is needed. Although several articles have created a theoretical basis for corporate sustainability and strategic digital management, only limited studies provided guidelines on the strategic digital transformation process and its health implementation stages. However, studies have also developed sustainable models, software or applications in this area. This is also the reason for creating opportunities for future researchers, who will be closed to investigate this gap and improve the viability of digital health strategies. In addition, any work carried out in case studies provides fruitful results by facilitating researchers through deep penetration into sustainable digitalisation. No generalised frameworks are available to guide the wording and implementation of digital action plans. Thus, the need for quantitative or qualitative research is created, providing conclusions on the impact of internal or external factors in the sustainability process, implementation, adoption, planning, and challenges of digital health solutions in general, as well as the impact of digital transformation. Most existing studies explore the issue of digitalisation in a particular part of a nursing institution or a disease rather than the management strategy perspective. In this way, researchers ignore a debate on obstacles and problems that often face in practice during integration. Such an analysis could lead to more profound knowledge.
In conclusion, our research observed a timeless analysis of systematised studies focusing on digital health developments. These studies broaden the researchers’ vision and provide vital information for further investigation. This article focuses on understanding digitalisation in healthcare, including, for the most part, the digitalisation of information and adopting appropriate parameters for further development. To build a more holistic view of digital health transformation, there is a great need for research on the management implications of digitalisation by different stakeholders. Finally, the development of telemedicine, the further enhancement of digital security and the strengthening of technological information systems will contribute to the universal acceptance of the digital health transformation by all involved.
This research received no external funding.
Conceptualisation, A.I.S., F.K. and M.A.T.; methodology, F.K. and M.A.T.; software, A.I.S.; validation, A.I.S.; data curation, A.I.S.; writing—original draft preparation, A.I.S. and M.A.T.; writing—review and editing, A.I.S. and M.A.T.; visualisation, A.I.S.; supervision, M.A.T.; project administration, M.A.T. All authors have read and agreed to the published version of the manuscript.
Informed consent statement, data availability statement, conflicts of interest.
The authors declare no conflict of interest.
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Intended for healthcare professionals
Read our collection on the future of nursing.
Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues
Digital technologies increasingly affect nursing globally. Examples include the growing presence of artificial intelligence (AI) and robotic systems; society’s reliance on mobile, internet, and social media; and increasing dependence on telehealth and other virtual models of care, particularly in response to the covid-19 pandemic.
Despite substantial advances to date, challenges in nursing’s use of digital technology persist. A perennial concern is that nurses have generally not kept pace with rapid changes in digital technologies and their impact on society. This limits the potential benefits they bring to nursing practice and patient care. To respond to these challenges and prepare for the future, nursing must begin immediate transformation into a digitally enabled profession that can respond to the complex global challenges facing health systems and society.
Many exemplars show how digital technologies already bring benefit to nursing practice and education. 1 For instance, telehealth programs where nurses provide daily monitoring, coaching, and triage of patients with several chronic diseases have helped reduce emergency department admissions. 2 Mobile devices, in particular smartphones and health applications, are enabling nurses to offer remote advice on pain management to adolescent patients with cancer 3 4 and supplement aspects of nursing education by providing innovative pedagogical solutions for content delivery and remote learning opportunities. 5
The development and application to nursing of systems based on AI are still in their infancy. But preliminary evidence suggests virtual chatbots could play a part in streamlining communication with patients, and robots could increase the emotional and social support patients receive from nurses, while acknowledging inherent challenges such as data privacy, ethics, and cost effectiveness. 6
Digital technologies may, however, be viewed as a distraction from, or an unwelcome intrusion into, the hands-on caring role and therapeutic relationships that nurses have with patients and families. 7 This purported incompatibility with traditional nursing ideals, such as compassionate care, may explain some nurses’ reluctance to adopt digital approaches to healthcare. 8 9 In addition, nursing’s history was as structurally subordinate to other healthcare disciplines, 10 and the profession is still cementing its relationship and leadership in health systems.
The specialty of nursing informatics has long advocated for the integration of technology to support the profession, but it has comparatively few practitioners globally. Nursing informaticians are predominantly based in the United States, where the discipline seems to have originated, but many other countries and regions are expanding their digital nursing workforce and involvement with informatics. 11 12
Slow progress in some areas has been due to a lack of leadership and investment that supports nurses to champion and lead digital health initiatives. Globally, uncertainty remains regarding the next steps the nursing profession should take to increase and optimize its use of digital technology. This challenge is exacerbated by the global diversity of the profession, including unequal access to resources such as technological infrastructure maturity and expertise. Huge differences exist among countries and regions of the world in terms of the digitalization of healthcare processes, access to internet connectivity, and transparency of health information processes.
The nursing literature contains many analyses of digital technologies used to support or extend the profession, including practice (eg, hospital information systems, electronic health records, monitoring systems, decision support, telehealth); education (eg, e-Learning, virtual reality, serious games); and, rehabilitative and personalized healthcare approaches (eg, assistive devices sensors, ambient assisted living). 1 T able 1 summarizes the potential benefits, challenges, and implications of emerging innovations to practice.
Benefits, challenges, and implications of selected digital technologies in nursing
The table is not exhaustive, but the diversity of topics researched shows the profession recognizes the value and challenges of digital technologies. Given the evidence, for the profession to make further progress we recommend five areas for focused and immediate action. These recommendations should be qualified in light of regional context and professional background owing to global heterogeneity in nursing and the inclusion of digital technologies into healthcare.
We must urgently create educational opportunities at undergraduate and graduate levels in informatics, digital health, co-design, implementation science, and data science. 39 These should include opportunities to work with and learn from computing, engineering, and other interdisciplinary colleagues. For instance, nursing will need a critical mass of practitioners who understand how to use data science to inform the creation of nursing knowledge to support practice. 40 These practitioners will also need savviness and courage to lead the development of new models of patient care enabled by digital technologies. 41 42
Determining how, where, and why technology like AI should be used to support practice is of immediate interest and a growing competency requirement in health sciences and informatics education. 43 Nursing education should evolve its competencies and curriculums proactively for the increasing use of digital technologies in all areas of practice 39 while incorporating novel pedagogical approaches—for example, immersive technologies such as virtual and augmented reality—to deliver aspects of simulation based education. 44 45
Recently, the American Association of Colleges of Nursing released core competencies for nursing education, explicitly identifying informatics, social media, and emergent technologies and their impact on decision making and quality as critical to professional practice. 46
All levels of nursing leadership must advocate more actively for, and invest resources in, a profession that is both complemented and extended by digital technology. The profession needs to evolve its use of digital technology by continuing to champion and support nurses to become knowledgeable in, and generate new scientific knowledge on, data analytics, virtual models of care, and the co-design of digital solutions with patients, differences across contexts and regions permitting.
Advancement of leadership competencies in existing informatics technologies, such as clinical decision support systems, electronic health records, and mobile technologies, is also essential: these kinds of systems will undoubtedly come with increasing levels of AI functionality. Possessing a critical mass of nursing leaders who understand the intended and unintended consequences as well as opportunities of these kinds of technologies is vital to ensure the quality and safety of nursing.
The increasing presence and recognition of the importance of chief nursing informatics officers is a step in the right direction. 47 Further, providing opportunities for nurses of all specialties to contribute to the development and implementation of digital health policies, locally and nationally, could increase future use of digital technologies in nursing.
The influence of AI on human decision making and labor are areas in need of immediate inquiry to support nursing practice for the next decade and beyond. AI technologies could provide the profession with huge benefits in data analytics and advanced clinical decision support.
Although many of the purported potential benefits of AI (eg, improved patient outcomes, streamlined workflow, improved efficiency) have yet to be fully shown in nursing research, 6 it is inevitable that AI technologies will be used more regularly to support and extend nurses’ cognitive, decision making, and potentially labor functions. 15
These opportunities bring new and dynamic practice considerations for nursing and interprofessional expertise. One example relates to the potential automation of inequity and injustice within systems and decision support tools containing AI 48 49 : self-evolving algorithms in systems sometimes unintentionally reinforce systemic inequities found in society.
Increased use of AI also brings novel policy, regulatory, legal, and ethical implications to the fore. The nursing profession must examine its role, processes, and knowledge against emerging ethical frameworks that explore the opportunities and risks that AI and similar innovations bring, while advocating for patient involvement in AI development and application. Floridi and colleagues offer tenets regarding AI development and the ethical considerations in using such innovations in their call to develop AI technology that “secures people’s trust, serves the public interest, and strengthens shared social responsibility.” 50 They also advocate that as guiding principles, AI should be used to enhance human agency, increase societal capacities, cultivate societal cohesion, and enable human self-realization, with an emphasis on instilling and reinforcing human dignity. 50 Further research, funding, and thought leadership in this domain are needed to help support the development of new practice policy, regulatory frameworks, and ethical guidelines to guide nursing practice.
The profession must reframe how nurses interact with and care for patients in a digital world. The sheer variety of “do-it-yourself” health and wellness applications (eg, personalized genetic testing services, virtual mental health support), mobile and social media applications (eg, mHealth, wearables, online communities of practice) and other virtual healthcare (eg, telemedicine, virtual consultations) options available to consumers is impressive.
All this may seem antithetical toward the traditionally espoused nursing role—therapeutic relationships in physical interactions—but patients are increasingly empowered, connected to the internet, and demanding personalized or self-management healthcare models that fit their busy and varied lifestyles.
To maximize its impact on patient care, the profession should continue to develop virtual care modalities that exploit internet and mobile technology, drawing on its experiences with telehealth and remote models of care. 51 These care models might also be extended through virtual or augmented reality technologies or integrated with assisted living or “smart home” systems, 52 and potentially other precision and personalized healthcare solutions that leverage genomic and other biometric data.
Care approaches, interpretations of privacy, and technological interoperability functionalities should be co-designed among the interprofessional healthcare team, patients, and carers 53 and available where patients want them, ideally in both physical and digital realms. Deeper discussions and scientific research regarding access, cost, electronic resource use or wastage, and equity implications of the increasing digitalization of nurse-patient relationships will also need to be thoroughly explored.
The profession requires a cultural shift. Its membership and leadership must demand the evolution of digital systems better to meet contemporary and emerging needs.
Too often, technology to support nursing is poorly configured, resourced, or not upgraded to respond to practice and societal trends. Nurses still commonly use practice systems that are lacking basic usability (eg, contributing to alert fatigue, reinforcing disruptive workflow processes) or generate added documentation burdens because of poor configuration and optimization. 54
There is huge variation globally in access to, integration of, and sustainability of digital technology. 55 56 57 Solutions vary and are context specific. Renewed awareness of digital technology’s use brought about by the covid-19 pandemic offers an impetus for change that nurses should embrace.
Tasks undertaken by nurses that do not add enough value to patient care present opportunities for partial or full divestment, 58 and may be better integrated into future technology enabled processes or delivered by other care providers.
The profession should revisit cultural interpretations of how technology such as drones, robots, and other AI enabled systems can be considered complementary to nursing practice and process, rather than as competition or adversaries. Collaboration with technology developers, providers, and patients will be essential to ensure success.
Although some outdated nursing activities and processes made redundant or less relevant will likely be missed by some in the profession, digital technology provides opportunities to support new models of care and approaches to nursing practice. We must not allow cultural and historical interpretations of nursing to upend or impede progress.
Nurses entering the profession today will undoubtedly witness substantive disruption and change from digital technology by the time they are mid-career. 59 Without immediate action, the nursing profession stands to miss a remarkable opportunity to generate new roles, knowledge, and relationships within future health systems and societies saturated by digital technologies.
Nursing will continue to offer value and importance to healthcare systems in the coming decades. However, the profession must consider its role, knowledge, and relationships with technologies and patients to remain relevant in digitally enabled societies and healthcare systems and continue to provide compassionate care in a digital world. Without proactive strategic self-reflection, planning, and action, nursing will fail to control its trajectory across the chasm separating the past, present, and future of practice.
Nursing must accelerate the transformation to a digitally enabled profession by investing in informatics education, research, and practice
Nurses should upskill in data science and other digital health topics to ensure emerging technologies such as AI are developed appropriately and safe for nursing practice and patient care
Nursing must invest in and lead digital health developments and collaborate with others to develop and deliver digital tools that patients and the public need
Nurses should champion informatics across all areas of professional practice, create leadership opportunities in digital health, and inform health policy in this area
Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
Provenance and peer review: Commissioned; not externally peer reviewed.
This article is part of a series commissioned by The BMJ for the World Innovation Summit for Health (WISH). The BMJ peer reviewed, edited, and made the decision to publish. The series, including open access fees, is funded by WISH.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .
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The ADAPT Research Ireland Centre for AI-Driven Digital Content Technology released its latest impact report today, showcasing the Centre’s significant contributions to the Irish economy and society valued at over €1.1 billion. Minister for Finance, Jack Chambers, officially launched the report, praising ADAPT for its groundbreaking research and collaboration across diverse sectors and acknowledged the Centre’s role as a key player in defending democracy in a digital age.
ADAPT has become a key player in addressing societal challenges, fostering innovation, and driving economic growth in Ireland through its multidisciplinary research platform. Leveraging €42 million in Government investment, ADAPT has delivered a 27.5 fold return, translating into over €1.1 billion in economic impact, solidifying its position as a leading global hub for AI research.
Launching the report, Minister for Finance, Jack Chambers TD , said: “This report clearly demonstrates ADAPT’s remarkable impact to the Irish economy and society more generally, in less than a decade. In a time where misinformation spreads rapidly, ADAPT’s work on AI and digital content is vital in combating this challenge. By advancing AI literacy and developing tools to detect deep fakes and misleading content, ADAPT ensures that technology strengthens trust and transparency in society. Their research equips individuals and institutions with the means to critically assess information, making them a key player in defending democracy in a digital world.”
Headquartered at the School of Computer Science and Statistics at Trinity College Dublin, ADAPT is one of Ireland’s flagship research centres funded by the Irish Government through Taighde Éireann – Research Ireland, and formerly funded under Science Foundation Ireland.
Celine Fitzgerald , CEO of Research Ireland, welcomed the report, saying: “In a competitive global landscape, research centres must show their value across a wide range of areas. This internationally peer-reviewed Centre Network has had a transformative economic and societal impact on Ireland. ADAPT exemplifies this by combining world-class research with a strong commitment to societal good, as demonstrated by award winning engaged research and their public engagement programme, which has connected with over 507,000 people.”
ADAPT has made a global impact through collaborations with 260 partners across 38 countries, positioning Ireland as a leader in AI research and innovation. The Centre has hosted 64 international conferences, which attracted nearly 24,000 delegates from around the world to Ireland. These conferences showcased cutting edge AI research and generated €38 million in economic activity through delegate spending on accommodation, dining, transport, and local services.
The Centre employs over 300 highly skilled professionals and has supported the creation of 1039 new research jobs in Ireland. It has nurtured 22 high-potential startups such as MoovAhead, SoapBox Labs, and Biologit, which have collectively generated more than 144 jobs and attracted over €340 million in multinational investment. These companies are boosting Ireland’s tech ecosystem and are at the forefront of fields such as immersive learning, digital mental health support, and voice AI.
Professor John D Kelleher, Professor of Computer Science & Director of the ADAPT Centre at Trinity College Dublin , said: “The potential of generative AI to reshape our world is limitless, but the path it takes depends on the choices we make now. At ADAPT, we’re fortunate to have a diverse community of researchers examining both the opportunities and risks of this technology. By drawing on world-class Irish-based researchers from a range of disciplines such as data science, AI, clinical sciences, and the humanities, our research focuses on how AI will shape critical areas such as work, education, culture, and healthcare.”
Key highlights of the report published today include:
Total Economic Impact : ADAPT’s activities from 2015 to 2023 generated an economic impact of over €1.1 billion, reflecting a 27.5-fold return on the Government’s investment.
Research Funding Success : ADAPT researchers secured over €177 million in competitive funding, including €50 million from EU sources, boosting Ireland’s standing in international research.
Government Investment Leverage : For every €1 invested by the State, ADAPT secured an additional €4.18 of inward investment from external sources such as industry and EU funding, demonstrating efficient leveraging of public funds.
Spin-Out Companies : ADAPT researchers have successfully spun out 22 companies, creating 144 new jobs and attracting over €340 million in foreign investment, which further strengthens Ireland’s economy.
Scientific Excellence: ADAPT researchers have authored more than 2,600 peer reviewed articles since January 2015 with over 60 of these papers earning prestigious best paper or presentation awards.
Talent Development: ADAPT has trained a total of 337 alumni, 40% of whom work in industry, while 49% are employed in academia. ADAPT’S alumni (since 2015) represent 39 different nationalities.
Industry Collaboration : ADAPT has engaged in over 60 collaborative projects with 72 industry partners across 32 countries, driving innovation and enhancing Ireland’s global competitiveness.
Commercialisation: ADAPT inventors have signed 77 licence agreements with companies in both Ireland and internationally.
Foreign Direct Investment (FDI ): ADAPT’s world-class research has influenced the decisions of 19 multinational companies to invest or expand their operations in Ireland, creating 591 new research jobs and bringing €172 million in investment.
International Conferences: Between 2015 and 2023, ADAPT hosted 64 international conferences. These conferences were attended by almost 24,000 delegates. The estimated impact of these conferences on the Irish economy is €38.1m.
AI Literacy and Public Engagement : ADAPT has reached over 507,000 members of the public, helping to build a greater understanding of AI and its influence on our everyday lives, including educating and building AI literacy for over 67,000 citizens through the #DiscussAI campaign.
ADAPT’s initial funding from the Irish Government currently extends through 2026, ensuring continued contributions to Ireland’s economy and the global AI research landscape.
The full Impact Report is available to download .
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Practical example of a quick adaptation from the past is the best answer. Saying that you adapt quickly to changes, or new technologies, without elaborating on it, won't take you far in the interviews. You should say something that demonstrates your ability to do so. For example, you can narrate a story from your last job.
The achievements of humanity over the last century have only been made possible by the development of modern technology. Driven by the need to discover, people have created countless innovations in fields such as electronics, medicine and engineering which have improved the lives of billions. Additionally, many key discoveries throughout ...
Another method of adapting to new technology includes taking advantage of mostly advanced technology, including software and computers in all classrooms. This is much better than having a single computer lab for a large number of students to share. The main benefit is more time with the technology for each student, as well as a.
A crucial part of understanding how technology has created global change and, in turn, how global changes have influenced the development of new technologies is understanding the technologies themselves in all their richness and complexity—how they work, the limits of what they can do, what they were designed to do, how they are actually used.
Introduction. Technological change improves the quality of life; supports the development of new products, industries, opportunities and experiences; increases productivity and leads to increased wages. Last century saw the impact of steam power, electricity, the filament light bulb, radio, television, the telephone, aeroplanes and the telegraph.
Google Classroom: Jordan Mittler, a sophomore at The Ramaz Upper School in New York City and a participant in the Wharton Global Youth Summer Program, is the founder of Mittler Senior Technology, a company that helps senior citizens adapt to the world of technology. In this student essay, Jordan shares the story of how he started his business ...
The advancement of technology ensures that communication is quicker and that more people remain connected. There has been an evolution in interpersonal skills with the advancement of technology, and users should always be keen on adapting to new ways of communication. Technology has continually brought new methods of communication leading to ...
Get a custom essay on New Technology's Influence on the Future---writers online . ... AI has the ability to analyze and understand complex data, make predictions, and adapt to new situations. AI technology is being applied in many industries, from healthcare to finance to transportation, to improve efficiency and decision-making (Costello ...
The onset of the fourth industrial revolution (Industry 4.0) presages far-reaching changes in the nature of work. Footnote 1 New occupations are likely to be concentrated in the nonroutine and cognitive category requiring higher-order cognitive and soft or socio-emotional skills (hereafter, referred to as 'soft skills'). Rising demand for high skills combined with shrinking shelf life of ...
Already, we have seen many companies move to new geographies to tap new talent pools. For example, a large technology company recently announced some roles could remain remote indefinitely, allowing them to leverage talent from around the country. Others, such as a large financial company that is planning on having 60 desks per 100 employees ...
Disruptive changes, understood as changes in a company and its operating environment caused by digitalization, possibly leading to the current business becoming obsolete (Parviainen et al., 2017), trigger DT in different environments due to rapid or disruptive innovations in digital technologies.These changes create high levels of uncertainty, and industries and companies try to adapt to these ...
Why is true tech adoption so difficult to achieve? Based on the authors' experience working on these issues, they see five key actions business leaders can take to create a culture that will ...
COVID-19 dramatically influenced students' and staff's learning and teaching experiences and approaches to learning. While many papers examined individual experiences in the context of higher education, synthesising these papers to determine enabling and hindering influences of digital adaptation was needed to guide the next phase of online learning reforms. This study explored the main ...
Another method of adapting to new technology includes taking advantage of mostly advanced technology, including software and computers in all classrooms. This is much better than having a single computer lab for a large number of students to share. ... essay The Effects of New Technology in Human Lives; essay Internet and New Technology;
Collaboration with technology developers, providers, and patients will be essential to ensure success. Although some outdated nursing activities and processes made redundant or less relevant will likely be missed by some in the profession, digital technology provides opportunities to support new models of care and approaches to nursing practice.
And if your employees thrive, your business will too. This article will outline eight proven strategies to help employees adapt to new technology in the workplace.: 1. Ask employees for their input. Let's start by tackling the first reason workers resist new technology: feeling excluded from the decision-making process.
Staff should also understand how the new technology will benefit them individually, he says. This creates the all-essential buy-in that can mitigate a chief roadblock to adoption and learning: resistance. In the Ouellette & Associates book Leading IT Transformation, managers are cautioned that "depending on the severity of the change ...
Research on the relationship between technology and an ageing society, on the one hand, points out the impact of technologies on older people, such as how older people use assistive technology to remain independent and care for themselves and use communication technology to build interactions (Czaja, 2017); on the other hand, it describes new ...
Also, Information Technology improves the quality of services, reduces costs, and helps increase patient satisfaction. As new technologies have created opportunities for companies developing high-tech services, healthcare units can increase customer value, personalise services and adapt to their patient's needs . To this end, the "smart ...
Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues Digital technologies increasingly affect nursing globally. Examples include the growing presence of artificial intelligence (AI) and robotic systems; society's reliance on mobile, internet, and social media; and increasing dependence on telehealth and other ...
Check out this FREE essay on Adapting to New Technology ️ and use it to write your own unique paper. New York Essays - database with more than 65.000 college essays for A+ grades ... Another method of adapting to new technology includes taking advantage of mostly advanced technology, including software and computers in all classrooms. This is ...
The ADAPT Research Ireland Centre for AI-Driven Digital Content Technology released its latest impact report today, showcasing the Centre's significant contributions to the Irish economy and society valued at over €1.1 billion. Minister for Finance, Jack Chambers, officially launched the report, praising ADAPT for its groundbreaking research and collaboration across diverse sectors and ...