Coopmans Aafke G, Mannak Remco S, Braspenning Anna M, Wouters Eveline J M, Bongers Inge M B
Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Department of Organization Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
J Med Internet Res. 2025 Jun 10;27:e67839. doi: 10.2196/67839.
The success of eHealth relies on interorganizational collaboration (IOC) throughout the development, evaluation, and implementation phases of eHealth deployment. This IOC is complex, as it involves a diversity of organizations from different sectors, such as technological, academic, health care, and governmental organizations, collaborating to deploy eHealth. Between these organizations, organizational boundaries, defined as the demarcation of an organization from its environment, arise. When these boundaries are perceived as aligned and enable complementarity, IOC is facilitated. By contrast, misalignment of organizational boundaries can hinder IOC. A dialogical learning mechanism, defined as a learning process that occurs when boundaries hinder IOC, can support learning how to navigate such boundaries. However, it is difficult to determine whether and when organizational boundaries facilitate or hinder IOC, and which dialogical learning mechanisms can be used to address these challenges during eHealth deployment. Previous literature presents the barriers and facilitators of IOC during eHealth deployment only for subsets of organizations or specific phases, leaving their generic versus phase specific applicability uncharted.
This scoping review aims to identify whether, and under what circumstances, organizational boundaries facilitate or hinder IOC during the development, evaluation, and implementation of eHealth.
A scoping review was conducted using searches in the PubMed, PsycINFO, CINAHL, and Web of Science databases. Articles were eligible for inclusion if they were empirical studies written in English or Dutch and contained findings on factors influencing IOC during the development, evaluation, or implementation phases of eHealth deployment. The search yielded 11,867 articles, of which 16 met the inclusion criteria. Open and axial coding of the extracted findings was performed to identify organizational boundaries and dialogical learning mechanisms that hindered or facilitated IOC during eHealth deployment.
In each phase, different organizational boundaries either hindered or facilitated IOC. The dialogical learning mechanism identification was crucial for enhancing IOC and was supported by training or by establishing IOC from previous relationships. Additionally, the learning mechanism coordination improved IOC and depended on the involvement of boundary spanners (ie, individuals who span organizational boundaries) and the use of boundary objects (ie, objects which help bridge different social worlds). Furthermore, the mechanism reflection, fostered through open and frequent communication, facilitated IOC. The dialogical learning mechanism transformation did not influence IOC during any phase of eHealth deployment.
IOC in eHealth deployment is a dynamic process that depends on the dialogical learning mechanisms identification, coordination, and reflection to navigate organizational boundaries. This review is the first to present organizational boundaries and dialogical learning mechanisms that influence IOC across the different phases of eHealth deployment. However, further research that explicitly considers these phases is needed to deepen the understanding of IOC in eHealth deployment.
电子健康的成功依赖于在电子健康部署的整个开发、评估和实施阶段的组织间协作（IOC）。这种组织间协作很复杂，因为它涉及来自不同部门的各种组织，如技术、学术、医疗保健和政府组织，它们共同协作来部署电子健康。在这些组织之间，出现了组织边界，即一个组织与其环境的划分。当这些边界被认为是一致的并能实现互补性时，组织间协作就会得到促进。相比之下，组织边界的不一致会阻碍组织间协作。一种对话式学习机制，被定义为当边界阻碍组织间协作时发生的学习过程，可以支持学习如何跨越这些边界。然而，很难确定组织边界何时以及是否促进或阻碍组织间协作，以及在电子健康部署期间可以使用哪些对话式学习机制来应对这些挑战。先前的文献仅针对部分组织子集或特定阶段介绍了电子健康部署期间组织间协作的障碍和促进因素，其一般适用性与阶段特定适用性尚不明确。
本综述旨在确定在电子健康的开发、评估和实施过程中，组织边界在何种情况下促进或阻碍组织间协作。
通过在PubMed、PsycINFO、CINAHL和Web of Science数据库中进行检索，开展了一项范围综述。如果文章是用英语或荷兰语撰写的实证研究，并且包含有关电子健康部署的开发、评估或实施阶段影响组织间协作的因素的研究结果，则有资格纳入。检索共得到11867篇文章，其中16篇符合纳入标准。对提取的研究结果进行开放式编码和轴心式编码，以确定在电子健康部署期间阻碍或促进组织间协作的组织边界和对话式学习机制。
在每个阶段，不同的组织边界要么阻碍要么促进组织间协作。对话式学习机制的识别对于加强组织间协作至关重要，并且通过培训或基于先前关系建立组织间协作得到支持。此外，学习机制的协调改善了组织间协作，并且取决于边界跨越者（即跨越组织边界的个人）的参与以及边界对象（即有助于连接不同社会世界的对象）的使用。此外，通过开放和频繁的沟通促进的机制反思也促进了组织间协作。在电子健康部署的任何阶段，对话式学习机制的转变都不会影响组织间协作。
电子健康部署中的组织间协作是一个动态过程，依赖于对话式学习机制的识别、协调和反思来跨越组织边界。本综述首次提出了影响电子健康部署不同阶段组织间协作的组织边界和对话式学习机制。然而，需要进一步明确考虑这些阶段的研究，以加深对电子健康部署中组织间协作的理解。
