JMIR Publications

ABSTRACT

Background:

Globally, public healthcare is under increasing pressure, an economic burden currently amplified by the Covid-19 outbreak. With the recognition that Universal Health Coverage (UHC) improves the health of a population and reduces health inequalities, UHC has been acknowledged as a priority goal. To meet the global needs in a population with increased chronic illness and longer life expectancy, the healthcare system is in dire need of new, emerging technologies. E-health solutions as a method of delivery may have an impact on quality of care and health care costs. As such, it is important to study different methods previously used in order to avoid sub-optimal implementation and promote general guidelines to further develop e-health solutions.

Objective:

This study aims to explore and thematically categorize early phase studies on e-health technologies that are under development or undergoing testing. Further, to assess enablers and barriers in terms of usability, scaling and data management of e-health implementation.

Methods:

A structured search was performed in PubMed, Medline and Cochrane to identify and provide insight of current e-health technology and methodology under development and to gain insight in the future potential of e-health technologies.

Results:

In total, 27 articles were included in this review. The clinical studies were categorized thematically by illness compared to four technology types deemed relevant; apps/web-based technology, sensor technology, virtual reality and television. All e-health assessment and implementation studies were categorized by their focus point; usability, scaling and data management. Studies assessing the effect of e-health were divided into feasibility studies, qualitative studies and heuristic assessments. Studies focusing on usability (16/27) mainly addressed user involvement and learning curve in the adoption of e-health, while the majority of scaling studies (6/27) focused on strategic and organizational aspects of upscaling e-health solutions. Studies focusing on data management (5/27) addressed data processing and data sensitivity in adoption and diffusion of e-health. Efficient processing of data in a secure manner, as well as user involvement and feedback, both throughout small studies and during upscaling were the important enablers considered for successful implementation of e-health.

Conclusions:

E-health interventions have considerable potential to improve lifestyle changes and adherence to treatment recommendations. To promote efficient implementation and scaling, user involvement to promote user-friendliness, secure and adaptable data management, and strategical considerations need to be addressed early in the development process. E-health should be assessed during its development into health services. The wide variation in interventions and methodology makes comparison of the results challenging and calls for standardization of methods.