ABSTRACT
OBJECTIVES: The role of startups has been growing in healthcare delivery, particularly in telehealth and telemedicine. Yet, little has been published about their role in evolving digital healthcare ecosystem. This study aimed to review the literature on telehealth startups to understand their roles, challenges, business models, and directions for sustainable innovation and commercialization. METHODS: Ten databases were screened: PubMed, Scopus, Web of Science, IEEE Xplore, ACM digital library, EBSCOhost, Embase, Medline, Cochrane review, and PsycINFO. The articles were shortlisted based on pre-determined screening criteria, and qualitative synthesis was performed. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Cohen's K was calculated to ensure the reliability of the authors scoring on the quality appraisal test and qualitative synthesis. RESULTS: 26 articles were included in the review. Findings are clubbed under five themes: remote and on-demand healthcare; healthcare data management; digital therapeutics; high-tech driven personalized care; and information integration and exchange. Technical infrastructure, regulation, and revenue generation were identified as major challenges for telehealth start-ups. Osterwalder business canvas was the predominantly used model. Value perspectives were recognized for a sustainable telehealth innovation and its commercialization. CONCLUSION: Telehealth startups are evolving to meet digital healthcare needs and playing a significant role in teleconsultations, telemonitoring, and electronic health record solutions. Recently, their focus has shifted towards smartphone-enabled AI-driven personalized care, including digital therapeutics and wearable device innovation. They have significant technical and operational challenges in innovation and commercialization to optimize their role. The review also provides researchers with a new understanding of telehealth startups' sustainable innovation and commercialization through the systematic direction of value proposition, creation, and capture.
Subject(s)
Remote Consultation , Telemedicine , Humans , Reproducibility of Results , Ecosystem , Delivery of Health CareABSTRACT
As the world continues to deal with climate-induced heat events, sustainable energy behaviours, or lifestyles combined with non-behavioural interventions have been identified as crucial pathways to curb the demand for air conditioners. Typically, ecological communities serve as a reference point for sustainable lifestyles as they have strong environmental self-identity and values and are more likely to further engage in pro-environmental and energy-saving actions. Yet, it is unknown if individuals within these communities will act as expected, especially when confronted with extreme climatic challenges like heatwaves. It is also unclear which factors will define individual responses to these challenges. Utilising environmental self-identity and Value-Belief-Norm theories, this paper examines factors underlying cooling consumption behaviours of households living in a Universal Community with strong environmental world views in India. Twenty in-depth qualitative interviews with residents, thematically analysed, found that while people expressed strong environmental self-identity, preferences for air conditioner use was often mediated by hedonic factors such as comfort and sleep. Moral norms played a positive role in how people operated their air conditioners. Yet, when faced with the choice of using energy-efficient air conditioners, biospheric concern was of limited importance while situational factors like cost and functionality were more pivotal. The above results raise interesting questions around the difficulties that might emerge in changing preferences around air conditioning behaviours in non-environmental communities, especially, if environmentally conscious communities which are expected to be "the locus of change for energy efficiency actions" are significantly influenced by hedonic values.
