Stakeholders different approach to e-health

The basic condition to ensure successful functioning of the system is its acceptability to the stakeholders (Brugha, Varvasovszky, 2000) in the course of the project implementation and compliance with the stakeholder approach... [ view full abstract ]

The basic condition to ensure successful functioning of the system is its acceptability to the stakeholders (Brugha, Varvasovszky, 2000) in the course of the project implementation and compliance with the stakeholder approach to public health technologies. System's acceptability is only possible when stakeholders are involved into the process of development and measurement. Diversity of approaches allows modelling a variant acceptable to all parties, though the modelling must be a continuous and evolutionary process, i.e. the measurement system must be dynamic.
The majority of analysts emphasize that stakeholder inclusion into eHealth processes is out of question. Stakeholder approach to eHealth must be constantly monitored and the acceptable evaluation criteria must be regularly updated. The conducted research is the first attempt to identify stakeholder indicators to be regularly monitored and updated in the future. Similar research is planned to be conducted each 3 years with the aim to identify dynamics of the applicable criteria and indicators.
Respondents were selected in accordance to the geographical distribution and diversity of the levels and types of the represented jobs and institutions. All interviews have been transcribed. The responses were grouped into categories and subcategories by means of quality data analysis software NVivo. Frequency of used concepts has been identified with the distinction of major problems. Interview questions for the secondary data analysis were selected from responses on major eHealth problems: positive experience in eHealth, expectations, descriptions of eHealth objectives. Open questions allowed respondents to express their views on the quality of eHealth information systems and successful projects.
Stakeholder criteria may be evaluated independently from the actual moment of eHealth implementation, i.e. in any stage of eHealth development. Such preliminary assessment may provide data about readiness to start implementation and the needs and expectations of the user. The constituent elements and indicators must be adapted to cultural, economic and social environment and the national health care system of the individual country.
It has to be noted that each respondent group pointed out different eHealth key elements. For example, IT companies distinguished shortage of time allocated for eHealth implementation in the first place. Doctors specified quality of information (count = 45) and compatibility of technologies (count = 37) as the most important criteria whereas administrative workers emphasized shortcomings in legal regulation (count = 46). Also, each category tends to identify problems within the scope of other categories. IT specialists in health care institutions noted poor computer literacy and motivation among doctors whereas doctors mostly appeal to irrelevant software design (the quality of information, appearance, data input, data representation, data control, menu, commands, dialogue boxes, navigation).
Such discrepancies in the emphasis of important factors shows limitations in stakeholder approaches, complementary to each other. They clearly demonstrate that no individual stakeholder group is able to spotlight all possible problems in eHealth development. Thus, the more diverse approaches and stakeholders are timely involved into IT development the more effectively the development success may be controlled.