Department of Management of Public Organisations, Cracow University of Economics, ul. Rakowicka 27, 31-510, Cracow, Poland.
Department of Management Studies & Quantitative Methods, University of Naples Parthenope, Via Generale Parisi 13, 80132, Naples, Italy.
BMC Health Serv Res. 2020 Mar 4;20(1):171. doi: 10.1186/s12913-020-5034-9.
The objective of this paper is to identify the key conditions that positively affect the use of e-health services in Central Eastern Europe (CEE) countries. CEE countries after the political and economic transformation in 1989/90 implemented slightly different national health care models. The research question of the study is: how do the various institutional conditions at the national level affect the use of e-health services in CEE countries?
The e-health description was derived from papers indexed in Web of Science and Scopus. The data for computation were collected from the 2015 global survey by the WHO Global Observatory for eHealth. We used a narrative literature review in order to identify key terms associated to e-health and conditions for the implementation of e-health services. The search terms were "e-health" and "*" where * was particular thematic section of e-health according to WHO GOeH. The inclusion criterion was relevance of the paper to e-health and searched phase. Eligibility criteria for countries for being described as CEE countries: Estonia, Lithuania, Latvia, Poland, Hungary, Romania, Bulgaria, Czech Republic, Slovenia, and Croatia (we omitted Slovakia from the analysis because this country was not covered by the WHO Survey). We applied qualitative comparative analysis (QCA) to analyse the necessary order of conditions. The dependent variable of the study is the national rate of use of e-health services.
QCA shows that legal medical jurisdiction, teleprogramme and electronic health records supplemented by adequate training constitute critical conditions to achieve success in e-health implementation.
We conclude that the more formalised a framework for e-health service delivery is, the more likely it will be used. Therefore formalisation fosters the diffusion, dissemination and implementation of e-health solutions in this area. Formalisation must be accompanied by tailored training for health care professionals and patients. Our analyses are related only to the paths of e-health implementation in CEE countries thus consequently the findings and conclusions cannot be directly applied to other countries. The limitations of this study are related the absence of a broader context of e-health development, including the development of ICT infrastructure and ICT literacy.
本文旨在确定积极影响中东欧（CEE）国家使用电子健康服务的关键条件。1989/90 年政治和经济转型后，CEE 国家实施了略有不同的国家医疗保健模式。本研究的研究问题是：国家层面的各种制度条件如何影响 CEE 国家电子健康服务的使用？
电子健康描述源自于索引在 Web of Science 和 Scopus 中的论文。计算数据来自世卫组织全球电子卫生观测站 2015 年的全球调查。我们使用叙述性文献综述来确定与电子健康相关的关键术语和电子健康服务实施的条件。搜索词为“电子健康”和“”，其中是世卫组织全球电子卫生观测站的电子健康特定专题部分。纳入论文的标准是与电子健康和搜索阶段相关的论文。被描述为 CEE 国家的国家入选标准：爱沙尼亚、立陶宛、拉脱维亚、波兰、匈牙利、罗马尼亚、保加利亚、捷克共和国、斯洛文尼亚和克罗地亚（我们将斯洛伐克排除在分析之外，因为该国不在世卫组织调查范围内）。我们应用定性比较分析（QCA）来分析条件的必要顺序。本研究的因变量是国家电子健康服务使用的国家率。
QCA 表明，法律医疗管辖权、电视节目和电子健康记录以及充足的培训构成了电子健康实施成功的关键条件。
我们的结论是，电子健康服务提供框架越正式，就越有可能被使用。因此，正式化促进了该领域电子健康解决方案的传播、传播和实施。正式化必须伴随着医疗保健专业人员和患者的量身定制培训。我们的分析仅与 CEE 国家电子健康实施的路径相关，因此，研究结果和结论不能直接应用于其他国家。本研究的局限性与电子健康发展的更广泛背景有关，包括信息通信技术基础设施和信息通信技术素养的发展。
