J Korean Acad Community Health Nurs.  2017 Jun;28(2):129-143. 10.12799/jkachn.2017.28.2.129.

Qualitative Analysis of Tele-healthcare Systems based on the Diffusion of Innovation Model

• Kwon MS
• Jang JH

• KMID: 2392854
• DOI: http://doi.org/10.12799/jkachn.2017.28.2.129

Abstract

PURPOSE
The purpose of this study is to explore factors which influence adoption, implementation and continued use of tele-healthcare systems.
METHODS
Qualitative research was conducted by in-depth interviews with 17 professionals from various fields of organizations involved in developing and implementing tele-healthcare systems. Data were analysed thematically, using a conceptual model of diffusion of innovations.
RESULTS
The system users were reacted positively to the 3 attributes out of 9 which decided the adoption of innovation. In addition, it is required to redesign the tele-health care system simpler and easier so that the system users can access to the system much more easily regardless of space and time limitations. From the design stage on an individual level, it is necessary to conduct detailed needs analysis and listen to users who are at the center of innovation diffusion. On an organizational level, it is necessary to actively prepare for possible problems during system implementation, educate the users and build communication channels continuously.
CONCLUSION
This study has identified the factors affecting the innovation of tele-health care systems and contributed to the understanding of the operation of tele-health care systems by the diffusion of innovation theory in community health posts.

Keyword

Telemedicine; Diffusion of innovation; Delivery of health care; Qualitative research

MeSH Terms

Delivery of Health Care
Diffusion of Innovation*
Diffusion*
Qualitative Research
Telemedicine

Figure

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  Figure 1. Conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization, based on a systematic review of empirical research studies. [15]

Reference

References

1. Statics Korea. 2014 Korean social indicators [Internet]. Daejeon: Statics Korea;2015. [cited 2016 November 10]. Available from:. http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=1438.

2. Centers for Disease Control and Prevention. 2015 status and issue of chronic disease [Internet]. Cheongju: Centers for Disease Control and Prevention;2016. [cited 2016 November 12]. Available from:. http://www.cdc.go.kr/CDC/notice/CdcKrIntro0504.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0110&cid=70948.

3. Centers for Disease Control and Prevention. Korean ‘e-health roadmap’ [Internet]. Cheongju: Centers for Disease Control and Prevention;2016. [cited 2016 November 18]. Available from:. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=335212.

4. Statistics Korea. 2015 Gangwondo the aged statistics [Internet]. Daejeon: Statics Korea;2015. [cited 2016 October 12]. Available from:. http://kostat.go.kr/office/dbro/rodb_nw/2/1/index.board?bmode=read&aSeq=348824.

5. Park SY, Park BW, Kim JK. Gangwondo direction for improvement of local medical service [Internet]. Chuncheon: Research Institute for Gangwon;2015. [cited 2016 November 12]. Available from:. http://www.rig.re.kr/hb/main/sub01_03?articleSeq=13167&mode=readForm&curPage=23&boardCode=BDAAAA03.

6. Noh GY, Kwon MS, Jang HJ. The acceptance model of tele-medicine for chronic disease in rural community. The Journal of the Korea Contents Association. 2014; 14(8):287–296. https://doi.org/10.5392/JKCA.2014.14.08.287.

7. Noh GY, Kwon MS, Park DJ. Telemedicine and community. Chuncheon: Hallym University Press;2015. p. 252.

8. Ryu SW, Lee HS, Lee KH, Yoon JY. The operational reality and performance evaluation of Kangwon chronic disease teleme-dicine service system. Policy Report. Chuncheon: Korea Institute for Health and Social Affairs;2006. November. Report No.: Policy 2006-40.

9. Gangwon Integrated Telemedicine Center. Gangwon-do public u-health service operating performance -Telemedicine centered on chronic disease-. Policy Report. Chuncheon: Gang-won Provincial Office;2013. January.

10. Lee JK. The effects of quality and accessibility of telehealth service for patients with chronic disease on patient satisfaction, compliance, and intention to reuse. Journal of the Korean Society of Health Information and Health Statistics. 2010; 35(2):149–176. https://doi.org/10.14367/kjhep.2014.31.2.55.

11. Kwon MS, Noh GY, Choi JH. The effect of the telemedicine service system application for the patients with hypertension at community health practitioner posts in Gangwon province. Korean Journal of Health Education and Promotion. 2014; 31(2):55–64. https://doi.org/10.14367/kjhep.2014.31.2.55.

12. Kwon MS, Yang SO, Jang JH. Health related lifestyles, self-efficacy and health related quality of life by the types of hypertension management in community health posts. Journal of Korean Public Health Nursing. 2015; 29(3):565–581. https://doi.org/10.5932/JKPHN.2015.29.3.565.

13. National Evidence-based Healthcare Collaborating Agency. Effects of telemedicine service [Internet]. Seoul: National Evidence-based Healthcare Collaborating Agency;2016. [cited 2016 November 12]. Available from:. http://www.neca.re.kr/news/report_view.jsp?boardNo=AE&seq=10623&q=626f6172644e6f3d4145.

14. Kwon MS, Park DJ, Choi JH. Experience on telemedicine use of community health practitioners. Korean Journal Of Health Education And Promotion. 2013; 30(2):23–39. https://doi.org/10.14367/kjhep.2013.30.2.023.

15. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: A systematic review and recommendations. Milbank Quarterly. 2004; 82(4):581–629. https://doi.org/10.1111/j.0887-378X.2004.00325.x.

16. Rogers EM. Diffusion of innovations. 4th ed. New York: Free Press;2010. p. 518.

17. Greenhalgh T, Wherton J, Sugrahood P, Hinder S, Procter R. What matters to older people with assisted living needs? A Phenomenological analysis of the use and non-use of telehealth and telecare. Social Science & Medicine. 2013; 93:86–94. https://doi.org/10.1016/j.socscimed.2013.05.036.

18. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15(9):1277–1288. https://doi.org/10.1177/1049732305276687.

19. Lincoln YS, Guba EG. Naturalistic Inquiry. Newbury Park: Sage Publications Inc;1985. p. 416.

20. Glanz K, Rimer BK, Viswanath K. Health behavior: Theory, research, and practice. 5th ed. Sanfrancisco: John Wiley & Sons;2015. p. 512.

21. Korea Institute for Health and Social Affairs. Analysis of policy on the adoption and diffusion of new healthcare technology. Research Report. Sejong: Korea Institute for Health and Social Affairs;2014. July. Report No.: 2014-07.

22. Kim PS. The preferred direction of promoting telemedicine system. Paper presented at: Policy debate_The preferred direction of promoting telemedicine system. 2016 June 22: Citizens United for Better Society (CUBS). Seoul.

23. Jeun YJ. Prerequisites for activation of telemedicine. Journal of the Korea Society of Computer and Information. 2014; 19(8):169–176. https://doi.org/10.9708/jksci.2014.19.8.169.

24. Sugarhood P, Wherton J, Procter R, Hinder S, Greenhalgh T. Technology as system innovation: A key informant interview study of the application of the difffusion of innovation model to telecare. Disability and Rehabilitation. 2014; 9(1):79–87. https://doi.org/10.3109/17483107.2013.823573.

25. Lee PS, Shim JT. A study on impact of introduction characteristics of ERP systems on innovation diffusion and business performance in public enterprise. Journal of the Korea Industrial Information System Society. 2007; 12(5):133–145.

26. Ministry of Health and Welfare. The ministry of health and welfare is planning to dissolve areas of vulnerable health care system cooperating with local governments [Internet]. Sejong: Ministry of Health and Welfare;2016. [cited 2016 October 29]. Available from:. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=334146&page=1.