Unleashing innovation in first-line healthcare: The barriers to realizing platform openness.

PURPOSE: Digital platforms are essential for fostering innovation in first-line healthcare. These platforms require openness, allowing external parties to utilize, enhance, or profit from them. Yet, knowledge about barriers to realizing platform openness is lacking. This research investigates the barriers to realizing platform openness in first-line healthcare. METHOD: This research employed a qualitative exploratory approach. We collected data through thirteen semi-structured interviews with platform experts, application developers, and healthcare practitioners. As a study setting, we focused on Dutch first-line healthcare. We then analyzed the data using thematic analysis. RESULT: We identify barriers in three main categories that hinder platform openness: technology-related (e.g., redundancy in development work), business-related (e.g., profit-maximizing strategy), and healthcare-related (e.g., reluctance to change). SCIENTIFIC CONTRIBUTION: We contribute to the platform literature in medical informatics by being among the first to examine openness barriers that hinder platform-based innovation. We thus explain why platform implementations often do not result in substantial improvements in healthcare delivery despite their transformative impact in other industries.

Just-in-time adaptive interventions for adolescent and young adult health and well-being: protocol for a systematic review.

INTRODUCTION: Health behaviours such as exercise and diet strongly influence well-being and disease risk, providing the opportunity for interventions tailored to diverse individual contexts. Precise behaviour interventions are critical during adolescence and young adulthood (ages 10-25), a formative period shaping lifelong well-being. We will conduct a systematic review of just-in-time adaptive interventions (JITAIs) for health behaviour and well-being in adolescents and young adults (AYAs). A JITAI is an emerging digital health design that provides precise health support by monitoring and adjusting to individual, specific and evolving contexts in real time. Despite demonstrated potential, no published reviews have explored how JITAIs can dynamically adapt to intersectional health factors of diverse AYAs. We will identify the JITAIs' distal and proximal outcomes and their tailoring mechanisms, and report their effectiveness. We will also explore studies' considerations of health equity. This will form a comprehensive assessment of JITAIs and their role in promoting health behaviours of AYAs. We will integrate evidence to guide the development and implementation of precise, effective and equitable digital health interventions for AYAs. METHODS AND ANALYSIS: In adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we will conduct a systematic search across multiple databases, including CENTRAL, MEDLINE and WHO Global Index Medicus. We will include peer-reviewed studies on JITAIs targeting health of AYAs in multiple languages. Two independent reviewers will conduct screening and data extraction of study and participant characteristics, JITAI designs, health outcome measures and equity considerations. We will provide a narrative synthesis of findings and, if data allows, conduct a meta-analysis. ETHICS AND DISSEMINATION: As we will not collect primary data, we do not require ethical approval. We will disseminate the review findings through peer-reviewed journal publication, conferences and stakeholder meetings to inform participatory research. PROSPERO REGISTRATION NUMBER: CRD42023473117.

eHealth adoption factors in medical hospitals: A focus on the Netherlands.

BACKGROUND: Despite strong policy interest in eHealth, actual adoption in many European hospitals is low. PURPOSE: This study develops and tests in a preliminary way an organisational eHealth adoption model rooted in several adoption frameworks to improve understanding of this phenomenon. METHODS: The model is explored through a survey among hospitals in the Netherlands using a Structural Equation Modelling (SEM) approach. Specific attention is paid to measurement of organisational readiness and to adoption as a process including different stages. RESULTS: Our results suggest a sharp decrease in the adoption process by hospitals after the stage of interest/commitment. Adoption tends to be significantly affected by size of the hospital, organisational readiness including technical aspects, and top management support. CONCLUSIONS: eHealth adoption tends to be not a linear process nor a linear function of contextual antecedents. Organisational readiness is an important antecedent for eHealth adoption. The paper concludes with organisational strategies and policies to foster eHealth adoption in hospitals and suggestions for future study.

Collective action for a common service platform for independent living services.

OBJECTIVE: The paper aims to explain how and why organizations, providing assistive devices and related web services for elderly independent living services, might be willing to collaborate and to share their resources and data on a common service platform. METHOD: A theoretical framework from literature on collective action theory, platform and business ecosystem concepts was developed to explain what factors influence inter-organizational collective action for a common service platform. The framework was tested in a case study of collaborative platform project for independent living services in Finland. Semi-structured interviews with the project managers and the decision makers of involved organizations were the primary source of data collection. RESULT: Strikingly, interdependency among the organizations was not found to be important for collaboration in this case. Instead, we found that a central organization can play an important role in initiating, facilitating and encouraging collaboration among different parties. Moreover, we found more willingness for collaboration when the platform is aimed to be open to third-parties to complement the platform with additional services. CONCLUSIONS: Strategies of the platform leader and openness of the platform towards third parties are the most important drivers for collective action between organizations offering independent living services. Establishing common service platforms for independent living services requires explicit attention to these inter-organizational issues.