The 4P telehealth business framework for Iran.

BACKGROUND: Telehealth services can utilize various information technologies and improve quality and efficiency of healthcare delivery by facilitating education, treatment, follow-up, and decision-making. However, these services are not always commercialized, and in case of commercialization, there is no guarantee for their long-term sustainability in market. Therefore, business models and frameworks are used as part of commercialization processes to identify a set of factors affecting the sustainability, effectiveness, and key business activities. The current study aimed to develop a telehealth business framework for Iran. METHODS: This research was conducted in 2021, and a mixed-methods approach was used for data collection. Initially, a telehealth business framework was developed based on the findings derived from a systematic review and a qualitative research. The proposed framework was then reviewed by an expert panel (n = 9) in which the participants had at least three years of work experience in telehealth. Finally, the framework was validated using the Delphi method (three rounds). RESULTS: The expert panel believed that some components such as partners' expertise, required capital and financial resources, research and analysis, marketing and branding, tax, product registration, and marketing at scientific congresses and science and technology exhibitions needed to be added to the framework. In the Delphi study, 68 out of 74 components proposed in the initial framework were approved across four major dimensions; namely, prerequisites, production, payments and costs, and post-production services. CONCLUSIONS: It seems that the developed framework can facilitate commercializing telehealth technologies and developing business plans. In addition, telehealth start-ups can use this framework and its various components in a competitive market to be more successful in their businesses. However, it is still critical to evaluate the effectiveness of the framework in practice and in relation to the commercialization of telehealth technologies.

Telemedicine acceptance during the COVID-19 pandemic: User satisfaction and strategic healthcare marketing considerations.

A lot remains unexplored regarding the antecedents and outcomes of telemedicine acceptance from health service marketing perspective. This study addresses this gap by integrating the Health Belief Model and the Unified Theory of Acceptance and Use of Technology model in the context of generation Y and Z's response to the COVID-19 pandemic. Data collected from 293 respondents were analyzed using structural equation modeling. The results confirm theoretical rigor of integrating two models examining the antecedents and user satisfaction as an outcome of telemedicine acceptance. The findings also suggest marketing strategies for implementing telemedicine during pandemic. Future research directions are highlighted.

Significados de marketing interno para enfermeiros de um hospital universitário brasileiro / Meanings of internal marketing built by the nurses of a brazilian university hospital / Significados de marketing interno para enfermeros de un hospital universitario brasileño

Objetivo: conhecer os significados de marketing interno para enfermeiras de um hospital universitário brasileiro na perspectiva do interacionismo simbólico. Metodologia: entrevistas qualitativas foram realizadas com dez enfermeiras, nas quais apresentava-se um conceito prévio de marketing interno. Resultados: a análise das falas foi organizada na categoria "construindo significados de marketing interno", com os temas: (1) o agir frente ao símbolo marketing interno e o significado estratégico, (2) o marketing interno e o significado motivacional, e (3) qualidade do cuidado como produto do marketing interno. Foi elaborado também um mapa conceitual com os significados produzidos. Conclusão: o marketing interno mostrou-se aplicável para o contexto de enfermagem, com significados relacionados à qualidade assistencial, por meio da motivação e satisfação dos colaboradores, voltando-os para as metas organizacionais. Enfermeiros líderes podem utilizar o marketing interno para atrair e reter recursos humanos de enfermagem, e melhorar a qualidade e o desempenho da organização

Objective: The study's main purpose has been to understand the meanings of internal marketing built by nurses working in a Brazilian university hospital from the perspective of symbolic interactionism. Methods: This qualitative study was perforemd through interviews with ten registered nurses, in which a previous concept of internal marketing was presented. Results: The speech analysis permitted the participants' statements to be organized in the category "Building the meanings of internal marketing expressed by nurses", which determined the following three subcategories or meaning cores: "The meaning of internal marketing permeated by leadership", "Internal marketing and the motivational meaning", and "Quality of care as a product of internal marketing". A conceptual map showing the meanings was also developed. Conclusion: Internal marketing proved to be applicable to the nursing context, with meanings related to the quality of care by promoting employees' motivation and satisfaction, making them pursue organizational goals. Head nurses can use internal marketing to attract and retain nursing human resources and improve the organization's quality and performance

Objetivo: conocer los significados de marketing interno para enfermeras de un hospital universitario brasileño en la perspectiva del interaccionismo simbólico. Metodología: entrevistas cualitativas fueron realizadas con diez enfermeras, en las cuales se presentaba un concepto previo de marketing interno. Resultados: El análisis de los discursos se organizó en los "significados de marketing interno de construcción" con los siguientes temas: (1) que actúa contra el símbolo de marketing interno y la importancia estratégica, (2) la comercialización interna y el significado de motivación, y (3) calidad del cuidado como producto del marketing interno. Se elaboró también un mapa conceptual con los significados producidos. Conclusión: el marketing interno se mostró aplicable para el contexto de enfermería, con significados relacionados a la calidad asistencial, por medio de la motivación y satisfacción de los colaboradores, volviéndolos a las metas organizacionales. Enfermeros líderes pueden utilizar el marketing interno para atraer y retener recursos humanos de enfermería, y mejorar la calidad y el desempeño de la organización

Segmentación y comportamiento de lealtad de los pacientes: un análisis clúster en los departamentos de salud de la Comunidad Valenciana / Segmentation and Patient Loyalty: A Cluster Analysis of the Health Service Departments in the Valencian Community / Segmentação e comportamento de lealdade dos pacientes: uma análise cluster nos departamentos de saúde da Comunidade Valenciana

Resumen En un marco sanitario de fragmentación territorial y cohabitación de gestión pública con colaboración público-privada, tiene sentido analizar y clasificar los departamentos sanitarios, atendiendo a múltiples objetivos: conocer el comportamiento real de los pacientes cuando pueden elegir dónde ser atendidos, adaptar la cartera de servicios a las preferencias del paciente y organizar la asistencia sanitaria desde una óptica territorial, considerando si afecta el modelo de gestión. Se utilizan datos secundarios (más de dos millones) en la Comunidad Valenciana, con un análisis clúster del comportamiento de lealtad (captación, retención y deserción). Esta metodología permite la reagrupación por similitud de los departamentos, explicando su homogeneidad entre sí y heterogeneidad respecto a otros. Se muestra la bondad de este análisis en el sector sanitario. Asimismo, la clasificación obtenida supone una guía para la gestión estratégica de los servicios sanitarios (a nivel macro y micro) y ahonda en el debate de la colaboración público-privada.

Abstract Under a health service framework marked by the territory segmentation and the coexistence of public administration and public-private ventures, it makes sense to analyze and classify the health service departments by considering the following objectives: to know the way patients actually behave when the choice of the service place is up to themselves; to adapt the service offer to the patient's preferences; and to organize health service based on the territory location, thus considering its influence on the management model. Secondary data from the Valencian Community (over two million data) are used in the cluster analysis of the patient loyal behavior (entering, retention and drop out). This methodology enables the department clustering based on their similarities, thus explaining the homogeneity and heterogeneity with each other. This analysis shows to be useful for the said health service sector. In addition, the resulting classification provides a guide for the strategic management of the health services (at the macro and micro levels) and goes deeper in the debate about public-private ventures.

Resumo Em um marco sanitário de fragmentação territorial e coabitação de gestão pública com parceria público-privada faz sentido analisar e classificar os departamentos sanitários, atendendo objetivos múltiplos: conhecer o comportamento real dos pacientes quando puder eleger onde eles serem atendidos, adaptar o portfolio de serviços às preferencias do paciente e organizar a assistência sanitária desde una ótica territorial, considerando se afeta o modelo de gestão. Utilizam-se dados secundários (mais de dois milhões) na Comunidade Valenciana, com análise cluster do comportamento de lealdade (recrutamento, retenção e deserção). Essa metodologia permite a reagrupação por semelhança dos departamentos, explicando a sua homogeneidade entre se e a heterogeneidade em relação aos demais. Demonstra-se a bondade desta análise no setor sanitário. Da mesma forma, a classificação obtida supõe uma guia para a gestão estratégica dos serviços sanitários (no nível macro e micro) e aprofunda o debate da parceria público-privada.