Healthcare costs’ reduction through the integration of Healthcare 4.0 technologies in developing economies

Hospital Investment Decisions and Prioritization of Clinical Programs

Making investment decisions in hospitals and prioritizing clinical programs are crucial to ensure optimal healthcare delivery, responsible use of resources, and long-term sustainability of an organization. This review examines the existing literature to identify the key factors influencing investment decisions, evaluates evidence-based frameworks for prioritizing resources, and articulates challenges and future directions for healthcare organizations. Critical drivers of hospital investments include financial health, demographics, ownership structure, and technology adoption. However, program budgeting and marginal analysis, health technology assessment, multi-criteria decision analysis, and evidence-based design frameworks will ensure that decisions are systematic and transparent. These tools help hospitals balance infrastructure investments, technology, specialized clinical programs, and emergency response. The dependence on past allocation practices, funding constraints, and stakeholder misalignment inhibits the best decision-making. For those barriers to be addressed, predictive analytics and artificial intelligence must already be in the evaluation process, as should configuration processes for interrelated tech, and collaboration among stakeholders should be fostered. Furthermore, investments aligned with sustainability principles and equity goals will be more resilient and adaptive to changes in the healthcare landscape. This review highlights the importance of healthcare organizations implementing holistic, evidence-based frameworks to guide investment decisions, including low-hanging fruit from today and industry best practices for tomorrow, shifting a provider's focus to ensure optimal patient outcomes, operational efficiencies, and sustainable growth.

Implementation barriers and facilitators of remote monitoring, remote consultation and digital care platforms through the eyes of healthcare professionals: a review of reviews

OBJECTIVES

Digital transformation in healthcare is a necessity considering the steady increase in healthcare costs, the growing ageing population and rising number of people living with chronic diseases. The implementation of digital health technologies in patient care is a potential solution to these issues, however, some challenges remain. In order to navigate such complexities, the perceptions of healthcare professionals (HCPs) must be considered. The objective of this umbrella review is to identify key barriers and facilitators involved in digital health technology implementation, from the perspective of HCPs.

DESIGN

Systematic umbrella review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

DATA SOURCES

Embase.com, PubMed and Web of Science Core Collection were searched for existing reviews dated up to 17 June 2022. Search terms included digital health technology, combined with terms related to implementation, and variations in terms encompassing HCP, such as physician, doctor and the medical discipline.

ELIGIBILITY CRITERIA

Quantitative and qualitative reviews evaluating digital technologies that included patient interaction were considered eligible. Three reviewers independently synthesised and assessed eligible reviews and conducted a critical appraisal.

DATA EXTRACTION AND SYNTHESIS

Regarding the data collection, two reviewers independently synthesised and interpreted data on barriers and facilitators.

RESULTS

Thirty-three reviews met the inclusion criteria. Barriers and facilitators were categorised into four levels: (1) the organisation, (2) the HCP, (3) the patient and (4) technical aspects. The main barriers and facilitators identified were (lack of) training (n=22/33), (un)familiarity with technology (n=17/33), (loss of) communication (n=13/33) and security and confidentiality issues (n=17/33). Barriers of key importance included increased workload (n=16/33), the technology undermining aspects of professional identity (n=11/33), HCP uncertainty about patients' aptitude with the technology (n=9/33), and technical issues (n=12/33).

CONCLUSIONS

The implementation strategy should address the key barriers highlighted by HCPs, for instance, by providing adequate training to familiarise HCPs with the technology, adapting the technology to the patient preferences and addressing technical issues. Barriers on both HCP and patient levels can be overcome by investigating the needs of the end-users. As we shift from traditional face-to-face care models towards new modes of care delivery, further research is needed to better understand the role of digital technology in the HCP-patient relationship.

Factors affecting the adoption of metaverse in healthcare: The moderating role of digital division, and meta-culture

This research aims to find out the factors affecting the adoption of Metaverse in healthcare. This study explores the effect of perceived ease of use, perceived usefulness, and trust on adopting Metaverse in healthcare by keeping digital division and metaculture as moderating variables. The philosophical foundation is rooted in the positivism paradigm, the methodology is quantitative, and the approach used is deductive. Data was collected in Pakistan and China through judgmental sampling from 384 respondents. Partial Least Square Structural Equation Modelling (PLS-SEM) was used to analyze the collected data. The findings validate the relationship between perceived ease of use and the adoption of metaverse with β-value 0.236, t-value 5.207 and p-value 0.000, the relationship between perceived usefulness and the adoption of metaverse with β-value 0.233, t-value 4.017 and p-value 0.000, and the relationship between trust and adoption of a metaverse with β-value 0.192, t-value 3.589 and p-value 0.000. Results also show that the digital divide moderates the relation between perceived ease of use and adopting the metaverse having β-value 0.078, t-value 1.848 and p-value 0.032. Similarly, the findings also show that the digital divide does not moderate the relationships of perceived usefulness and trust with adopting the metaverse. Moreover, the meta culture also does not moderate the relationships of perceived ease of use, usefulness, and trust with adopting the metaverse. The study contributes to theoretical research on adopting a metaverse in healthcare by examining various factors necessary for its development. It also provides guidelines for the developers and adopters of suitable metaverse technology.

Improving the colorectal cancer care pathway via e-health: a qualitative study among Dutch healthcare providers and managers

PURPOSE

This study aims to identify improvement opportunities within the colorectal cancer (CRC) care pathway using e-health and to examine how these opportunities would contribute to the Quadruple Aim.

METHODS

In total, 17 semi-structured interviews were held (i.e., nine healthcare providers and eight managers involved in Dutch CRC care). The Quadruple Aim was used as a conceptual framework to gather and systematically structure the data. A directed content analysis approach was employed to code and analyze the data.

RESULTS

Interviewees believe the available e-health technology could be better exploited in CRC care. Twelve different improvement opportunities were identified to enhance the CRC care pathway. Some opportunities could be applied in one specific phase of the pathway (e.g., digital applications to support patients in the prehabilitation program to enhance the program's effects). Others could be deployed in multiple phases or extended outside the hospital care setting (e.g., digital consultation hours to increase care accessibility). Some opportunities could be easily implemented (e.g., digital communication to facilitate treatment preparation), whereas others require structural, systemic changes (e.g., increasing efficiency in patient data exchanges among healthcare professionals).

CONCLUSION

This study provides insights into how e-health could add value to CRC care and contribute to the Quadruple Aim. It shows that e-health has the potential to contribute to the challenges in cancer care. To take the next step forward, the perspectives of other stakeholders must be examined, the identified opportunities should be prioritized, and the requirements for successful implementation should be mapped out.

Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean–Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.

A comprehensive framework for classification and selection of H4.0 digital technologies affecting healthcare processes in the grey environment

Purpose

This study seeks to provide a conceptual framework for the classification and selection of Healthcare 4.0 (H4.0) digital technologies affecting healthcare processes.

Design/methodology/approach

By examining the literature review, a set of processes of health services based on two axes of interaction and service customization and the axis of labor intensity of the service process matrix was divided into four categories: service factory, mass service, service shop and professional services. Then, using a combination of grey decision-making trial and evaluation laboratory (DEMATEL) and grey weighted aggregates sum product assessment (WASPAS) methods, a framework was presented to compute the impact of each of the H4.0 digital technologies on sub-criteria of the two main axes. Finally, based on the degree of the impact of each technology on the main axes, the technology affecting the four processes was segmented.

Findings

Findings show that the customer participation in the service process (C1), ways to provide customer service (C6) as well as the speed of service delivery (L4) are the most important in the classification of digital technologies affecting healthcare processes.

Research limitations/implications

Various other indicators from the behavioral, cultural, political, social and economic fields can be examined and used as a basis for evaluating H4.0 digital technologies.

Practical implications

The proposed framework can help managers select H4.0 digital technologies to prioritize, review and analyze appropriate technologies to improve and support different processes, prioritize appropriate technologies and review and analyze.

Originality/value

So far, no study has examined the link between digital technologies and various service processes. Therefore, this reinforces the originality and value of the present study.