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Final Namibian Digital Health Innovation Ecosystem framework
Source publication
Digital Health Innovation Ecosystem is a relatively
new concept, with studies describing it as an ecosystem that
allows patients and other healthcare stakeholders take part in
the healthcare delivery process using digital health technologies
with the inclusion of innovation principles. This paper presents
findings of a study which aimed at developi...
Context in source publication
Citations
... Future work would be to conduct empirical research in the application of advanced technologies such as on-organ sensors in managing bowel conditions. On-organ sensors can further be linked to mobile apps using wireless connectivity such as Bluetooth thereby creating an ecosystem of digital health technologies 37,38 . Researchers working on the development of on-organ sensors can explore the concept of digital twins to support implantation of on-organ sensors in the bowel. ...
The use of digital technologies in managing bowel conditions has been a topic of interest among healthcare practitioners. The objectives of this paper were to provide information about the types of digital technologies that have been used for bowel management and the context of the studies; identify the gaps and challenges in digital technologies for bowel management and propose new methods and techniques for the application of digital technologies in bowel management. A scoping review was conducted following the principles of Preferred Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search was conducted on six academic databases. 1891 papers were retrieved from the initial search; however, 6 papers were included based on the inclusion and exclusion criteria. The findings suggest that published work focused mainly on a research context and with a narrow focus targeting sub-categories of bowel conditions and not implemented in the context of everyday use. The findings also illustrate the variety of early-stage developments focused on increasing support for severe bowel dysfunction, for example, through biofeedback to aid muscle control training, or the placement of artificial anal sphincters to increase rectal perception. However, technology to support bowel management for broader populations with less severe or variable symptoms appears limited. Future work would be to conduct empirical research in the application of advanced technologies such as on-organ sensors in managing bowel conditions. Full paper: https://www.storre.stir.ac.uk/retrieve/fd86cac9-33fe-43da-bd7b-5ef3aca265e3/HCist%20OnOrgan%20Sept%20copy%20%281%29.pdf
... This study follows the DSR guidelines defined by Hevner et al [18], which are grouped into 3 cycles or phases comprising the relevance cycle (identifying problems and the artifact type), design cycle (developing and evaluating the artifact), and rigor cycle (research contribution and communication; Figure 1 [5]). These guidelines have been followed by DSR studies in lowand middle-income countries to develop health information systems such as mobile health (mHealth) [19,[21][22][23][24][25][26][27]. The guidelines by Hevner et al [18], as a necessary element in DSR, are also consistent with the DSR methodology by Peffers et al [20]. ...
BACKGROUND
Personal health records (PHRs) are consumer-centric tools designed to facilitate the tracking, management, and sharing of personal health information. PHR research has mainly been done in developed countries compared to developing countries. Moreover, previous studies that proposed PHR design in developing countries did not describe integration with other systems or there is no stakeholder involvement in exploring PHR requirements.
OBJECTIVE
This research develops an integrated PHR architecture and a PHR prototype in Indonesia using design science research (DSR). We conducted the research in Indonesia, which represents a developing country with the largest population in Southeast Asia and a tiered health system.
METHODS
This study follows the DSR guidelines defined by Hevner et al (2004). The requirements were identified using interviews with 37 respondents from health organizations and a questionnaire with 1,012 patients. Afterward, the proposed architecture and prototype were evaluated by interviews with 6 IT or e-health experts.
RESULTS
The architecture design refers to TOGAF version 9.2 and consists of five components: architecture vision, business architecture, application architecture, data architecture, and technology architecture. The application prototype developed is a high-fidelity prototype for patients and physicians. In the evaluation, improvements were made to add the stakeholders and the required functionality in PHR and add the necessary information to the functions that have been developed in the prototype.
CONCLUSIONS
We use design science to illustrate PHR integration in Indonesia which involve related stakeholders in requirements gathering and evaluation. We develop architecture and application prototypes based on health systems in Indonesia, which consist of routine health services including disease treatment and health examination, as well as promotive and preventive health efforts.
... This study follows the DSR guidelines defined by Hevner et al [18], which are grouped into 3 cycles or phases comprising the relevance cycle (identifying problems and the artifact type), design cycle (developing and evaluating the artifact), and rigor cycle (research contribution and communication; Figure 1 [5]). These guidelines have been followed by DSR studies in lowand middle-income countries to develop health information systems such as mobile health (mHealth) [19,[21][22][23][24][25][26][27]. The guidelines by Hevner et al [18], as a necessary element in DSR, are also consistent with the DSR methodology by Peffers et al [20]. ...
Background
Personal health records (PHRs) are consumer-centric tools designed to facilitate the tracking, management, and sharing of personal health information. PHR research has mainly been conducted in high-income countries rather than in low- and middle-income countries. Moreover, previous studies that proposed PHR design in low- and middle-income countries did not describe integration with other systems, or there was no stakeholder involvement in exploring PHR requirements.
Objective
This study developed an integrated PHR architecture and prototype in Indonesia using design science research. We conducted the research in Indonesia, a low- to middle-income country with the largest population in Southeast Asia and a tiered health system.
Methods
This study followed the design science research guidelines. The requirements were identified through interviews with 37 respondents from health organizations and a questionnaire with 1012 patients. Afterward, the proposed architecture and prototype were evaluated via interviews with 6 IT or eHealth experts.
Results
The architecture design refers to The Open Group Architecture Framework version 9.2 and comprises 5 components: architecture vision, business architecture, application architecture, data architecture, and technology architecture. We developed a high-fidelity prototype for patients and physicians. In the evaluation, improvements were made to add the stakeholders and the required functionality to the PHR and add the necessary information to the functions that were developed in the prototype.
Conclusions
We used design science to illustrate PHR integration in Indonesia, which involves related stakeholders in requirement gathering and evaluation. We developed architecture and application prototypes based on health systems in Indonesia, which comprise routine health services, including disease treatment and health examinations, as well as promotive and preventive health efforts.
... A Digital Health Ecosystem allows the interaction of stakeholders, such as patients, doctors and healthcare providers in a digital platform [13]. Innovation is a principle has been discussed in the context of Digital Health Ecosystems to support healthcare systems [14] [15]. ...
... While Digital Ecosystems have been applied in different domains such as health [14] [15], business [10] and public affairs [20], there is a dearth of studies on Digital Ecosystems for public enterprises. This study contributes to the existing body of knowledge on Digital Ecosystems. ...
A Digital Ecosystem is a digital platform that connects stakeholders and institutions with similar interests. Digital Ecosystems have been applied in different contexts, including health and business. This paper investigated the prospects and challenges of implementing a Digital Ecosystem to support public enterprises. Semi-structured interviews were conducted with 20 participants. The findings suggest that the current infrastructure is suitable for implementing a Digital Ecosystem, however, more resources and tools such as high-speed internet, high-end computers as well as security features are needed to facilitate the efficient functioning of a Digital Ecosystem for public enterprises. The benefits of implementing a Digital Ecosystem to support public enterprises include improved access to information and improved communication between public enterprises. The findings also revealed that a Digital Ecosystem could support team work, monitoring, evaluation and effective decision-making processes as the information required for decision making would be readily available. The potential challenges of implementing a Digital Ecosystem for public enterprises include lack of skills, lack of funds, organisational resistance to change and lack of awareness of the benefits of a Digital Ecosystem for public enterprises. In order to overcome these challenges, it is recommended that institutions of higher learning incorporate Digital Ecosystems into their curriculum, create awareness of the benefits of Digital Ecosystems to support public enterprises through social media platforms and government websites as well as provide specialised training to current employees in public enterprises. The findings of this study will inform key stakeholders in public enterprises on the prospects of implementing a Digital Ecosystem.
Background:
Information exchange is essential for transitioning high-quality care between care settings. Inadequate or delayed information exchange can result in medication errors, missed test results, considerable delays in care, and even readmissions. Unfortunately, long-term and postacute care facilities often lag behind other health care facilities in adopting health information technologies, increasing difficulty in facilitating care transitions through electronic information exchange. The research gap is most evident when considering the implications of the inability to electronically transfer patients' health records between these facilities.
Objective:
This study aimed to design and evaluate an open standards-based interoperability solution that facilitates seamless bidirectional information exchange between acute care and long-term and postacute care facilities using 2 vendor electronic health record (EHR) systems.
Methods:
Using the design science research methodology, we designed an interoperability solution that improves the bidirectional information exchange between acute care and long-term care (LTC) facilities using different EHR systems. Different approaches were applied in the study with a focus on the relevance cycle, including eliciting detailed requirements from stakeholders in the health system who understand the complex data formats, constraints, and workflows associated with transferring patient records between 2 different EHR systems. We performed literature reviews and sought experts in the health care industry from different organizations with a focus on the rigor cycle to identify the components relevant to the interoperability solution. The design cycle focused on iterating between the core activities of implementing and evaluating the proposed artifact. The artifact was evaluated at a health care organization with a combined footprint of acute and postacute care operations using 2 different EHR systems.
Results:
The resulting interoperability solution offered integrations with source systems and was proven to facilitate bidirectional information exchange for patients transferring between an acute care facility using an Epic EHR system and an LTC facility using a PointClickCare EHR system. This solution serves as a proof of concept for bidirectional data exchange between Epic and PointClickCare for medications, yet the solution is designed to expand to additional data elements such as allergies, problem lists, and diagnoses.
Conclusions:
Historically, the interoperability topic has centered on hospital-to-hospital data exchange, making it more challenging to evaluate the efficacy of data exchange between other care settings. In acute and LTC settings, there are differences in patients' needs and delivery of care workflows that are distinctly unique. In addition, the health care system's components that offer long-term and acute care in the United States have evolved independently and separately. This study demonstrates that the interoperability solution improves the information exchange between acute and LTC facilities by simplifying data transfer, eliminating manual processes, and reducing data discrepancies using a design science research methodology.
This article sought to analyze the innovation ecosystems in health, countries that develop them and the theoretical models they resort to. To this end, three databases carried out a systematic review through a bibliographic search in English, Spanish and Portuguese. 40% of health innovation ecosystems are in the USA, 13% in South Africa, 10% in the UK, 6.67% in Namibia, and 30% in various countries. Of the theoretical models used, 13% resort to the quadruple helix, open innovation 13%, the triple helix 10%, and ehealth 7%. The USA concentrated the development of innovation ecosystems. Quadruple helix and open innovation, were the theorical models frequently used, both includes society as part of its implementation.
Globally, the healthcare industry is plagued by fragmentation, and this fragmentation of the health system has become one of the major problems facing especially low- and middle-income countries. Likewise, the current health system in South Africa is highly fragmented and segmented, with two-tiered systems characterised by a multiplicity of health information systems. This fragmentation has inhibited the efficient delivery of healthcare services and resulted in limited access to integrated health data across healthcare providers. This paper proposes a Digital Health Ecosystem framework to address fragmentation of the health system in South Africa. A qualitative approach was employed, using desktop-based research. A literature review was conducted to elucidate the need for a framework to address fragmentation of the health system in South Africa. It emerged from the literature that the coexistence of subsystems operating independently contributes to health system fragmentation in South Africa. The proposed framework aims to address the ubiquitous problem of health system fragmentation and to enhance data-sharing capabilities across healthcare facilities. A Digital Health Ecosystem offers capabilities to create a digital environment for cooperation, data sharing and information exchange between a network of healthcare organisations. The technology offers South African healthcare facilities a new way to work seamlessly together to provide multidisciplinary and collaborative healthcare services to patients. Healthcare facilities in South Africa are urged to embrace a Digital Health Ecosystem to improve the safety and quality of healthcare and increase access to and availability of clinical, patient and administrative data.
This paper proposes an integrated research framework that takes advantage of the similarities of design science research (DSR) and Design-based research (DBR) for developing a new decision support system (DSS) artefact. Firstly, the paper discusses the progression of DSR in the Information Systems and evolution of DBR in educational technology notifying the similarities and limitations. Next, we apply our proposed framework combining DSR and DBR to develop and effectively evaluate the artefact of the Educational DSS that can be used to identify students at risk and improve student retention and completion rate. Further, our paper creates a basis of methodological guide to construct and evaluate a machine learning (ML) based DSS artefact by conformity to the features and tenets of commonalities between DSR and DBR and correlating them to Peffer’s design science research approach. In line with the characteristic of DSR and DBR, the development framework that we proposed will be used as a new source of knowledge to design any IT artefact in the education domain.
