ABSTRACT
Objective and Background: This research aims to develop a theoretical service quality (SQ) model for direct-to-consumer (DTC) telemedicine consultations. Although it can change care delivery for the better, it is crucial to create the appropriate measurement tool to collect and analyze patient's perceptions of SQ to identify any service pitfall and encourage a faster adoption. To the best of the authors' knowledge, this article is one of the first to investigate and propose a SQ model for DTC telemedicine consultations. This study is therefore motivated by a clear need for such a model as it is currently inexistent. Methods: A literature review of health and e-service quality (e-SQ) models was conducted to identify a suitable instrument for the research. A total of 60 studies were included. Results: The main findings are threefold: (1) DTC telemedicine SQ is interdisciplinary: it encompasses generic and context-specific dimensions from the health, e-SQ, and information system literature; (2) the existing SQ models are not adequate, they do not cover all dimensions of DTC telemedicine services; (3) although LeRouge et al.'s Telemedicine service encounter quality model was identified as a reference model, it is inadequate to simply transpose it to the context of the study. Thus, the elaboration of a more suitable instrument and creation of a new updated model by the authors. Conclusion: The conceptual model captures three primary dimensions (system quality, interaction quality and use quality) that represent SQ of DTC telemedicine consultations from a patient perspective.
Subject(s)
Telemedicine , Humans , Delivery of Health Care , Referral and ConsultationABSTRACT
OBJECTIVE: To analyze the strategic alliances that Catalan hospitals form with other health care entities and other types of institutions to foster technological and organizational innovation. METHODS: Qualitative case studies were conducted at a sample of 16 public hospitals in Catalonia, Spain. The sample was limited to three (Level 1-3) of Catalonia's four levels of hospitals (classified according to the complexity of the diagnoses and treatments they provide), but Level 4 hospitals were considered as part of the network in the analysis of the alliances. At each hospital, interviews were conducted with the manager, the medical director, and the service director, using a questionnaire that gathered information on strategic alliances with a focus on telemedicine. Qualitative data processing was applied to identify patterns of alliances between hospitals and other institutions. RESULTS: Catalan hospitals interact with other health care agents through three main types of associations: alliances with other hospitals (the most frequent type); alliances with primary care centers (reported mostly by Level 2 hospitals); and alliances with other institutions (e.g., local government, medical companies, and universities). Human resource-sharing (staff mobility) and training were reported most frequently as reasons for creating the alliances. CONCLUSIONS: Strategic alliances are formed between hospitals and other health care agents to help improve performance, competitiveness, and services provided to users. These results may help health care system managers promote strategic alliances as a means of optimizing system efficiency without reducing user satisfaction-a key challenge within the context of the current economic situation.
Subject(s)
Community-Institutional Relations , Cooperative Behavior , Hospitals, Public/statistics & numerical data , Interinstitutional Relations , Diffusion of Innovation , Government Agencies , Hospital Administrators , Hospital Shared Services/organization & administration , Hospital Shared Services/statistics & numerical data , Hospitals, Public/classification , Humans , Information Services/organization & administration , Interviews as Topic , Physician Executives , Practice Guidelines as Topic , Primary Health Care/organization & administration , Public-Private Sector Partnerships , Spain , Surveys and Questionnaires , Telemedicine/organization & administration , UniversitiesABSTRACT
OBJECTIVE: To analyze the strategic alliances that Catalan hospitals form with other health care entities and other types of institutions to foster technological and organizational innovation. METHODS: Qualitative case studies were conducted at a sample of 16 public hospitals in Catalonia, Spain. The sample was limited to three (Level 1-3) of Catalonia's four levels of hospitals (classified according to the complexity of the diagnoses and treatments they provide), but Level 4 hospitals were considered as part of the network in the analysis of the alliances. At each hospital, interviews were conducted with the manager, the medical director, and the service director, using a questionnaire that gathered information on strategic alliances with a focus on telemedicine. Qualitative data processing was applied to identify patterns of alliances between hospitals and other institutions. RESULTS: Catalan hospitals interact with other health care agents through three main types of associations: alliances with other hospitals (the most frequent type); alliances with primary care centers (reported mostly by Level 2 hospitals); and alliances with other institutions (e.g., local government, medical companies, and universities). Human resource-sharing (staff mobility) and training were reported most frequently as reasons for creating the alliances. CONCLUSIONS: Strategic alliances are formed between hospitals and other health care agents to help improve performance, competitiveness, and services provided to users. These results may help health care system managers promote strategic alliances as a means of optimizing system efficiency without reducing user satisfaction-a key challenge within the context of the current economic situation.
OBJETIVO: Analizar las alianzas estratégicas que los hospitales catalanes forjan con otras entidades de atención de la salud y otros tipos de instituciones para fomentar la innovación tecnológica y de las organizaciones. MÉTODOS: Se condujeron estudios cualitativos de casos en una muestra de 16 hospitales públicos de Cataluña, España. La muestra se limitó a tres (Niveles 1 a 3) de los cuatro niveles de los hospitales catalanes (clasificados según la complejidad de los diagnósticos y los tratamientos que proporcionan), pero los hospitales de Nivel 4 se consideraron parte de la red en el análisis de las alianzas. En cada hospital se efectuaron entrevistas con el gerente, el director médico y el director de servicio, mediante un cuestionario que recopilaba información sobre las alianzas estratégicas con hincapié en la telemedicina. Se aplicó el procesamiento cualitativo de datos para identificar los modelos de alianzas entre los hospitales y otras instituciones. RESULTADOS: Los hospitales catalanes interactúan con otros agentes de atención de la salud a través de tres tipos principales de asociaciones: alianzas con otros hospitales (el tipo más frecuente); alianzas con centros de atención primaria (según lo informado principalmente por los hospitales de Nivel 2); y alianzas con otras instituciones (por ejemplo, el gobierno local, las empresas médicas y las universidades). El intercambio de recursos humanos (movilidad del personal) y la capacitación fueron mencionados como los motivos más frecuentes para crear las alianzas. CONCLUSIONES: Se forman alianzas estratégicas entre los hospitales y otros agentes de atención de la salud con el objeto de mejorar el desempeño, la competitividad y los servicios prestados a los usuarios. Estos resultados pueden ayudar a los gerentes de los sistemas de atención de la salud a promover alianzas estratégicas como medio para optimizar la eficiencia del sistema sin reducir la satisfacción de los usuarios -un reto clave en el contexto de la situación económica actual.
