Approaches to the Development of Effective Strategies for the Adoption of Emerging Technologies in Healthcare Institutions: Overcoming Organizational Barriers
Abstract
La implementación de tecnologías emergentes en el sector de la salud ha transformado significativamente la prestación de servicios, mejorando la eficiencia operativa, la calidad de la atención al paciente y la toma de decisiones clínicas. Este estudio tiene como objetivo explorar las barreras en la adopción de tecnologías emergentes, como aplicaciones de Salud Móvil (mHealth), Big Data Analytics, Cloud Computing, Internet de las Cosas Médicas (IoMT), Realidad Virtual y Realidad Aumentada, telemedicina, inteligencia artificial (IA) y Machine Learning (ML), para proponer estrategias efectivas para superarlas. Las principales barreras se identificaron a través de una revisión de la literatura, incluida la resistencia organizacional, la dinámica de poder y la falta de un enfoque integrado. El estudio se basa en la Teoría de la Difusión de Innovaciones, la Teoría Unificada de Aceptación y Uso de la Tecnología (UTAUT) y la Teoría de la Cognición Distribuida. El análisis indica que la adopción exitosa de estas tecnologías requiere una gestión eficaz del cambio, un liderazgo visible y comprometido, y programas de formación continua. Los hallazgos de este estudio proporcionan un marco integral que orienta la implementación efectiva y sostenible de tecnologías emergentes en las instituciones de salud, sugiriendo futuras líneas de investigación para evaluar el impacto de estas tecnologías y desarrollar modelos teóricos específicos para el contexto de la salud.
Palabras clave: tecnologías emergentes, instituciones de salud, resistencia al cambio.
References
Al-Hazmi, A. M., Sheerah, H. A., & Arafa, A. (2021). Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do? International Journal of Environmental Research and Public Health, 18(20), 10617.
Ash, J. (1997). Organizational Factors that Influence Information Technology Diffusion in Academic Health Sciences Centers. Journal of the American Medical Informatics Association, 4(2), 102–111.
Bajwa, J., Munir, U., Nori, A., & Williams, B. (2021). Artificial intelligence in healthcare: transforming the practice of medicine. Future Healthcare Journal, 8(2), e188–e194.
Batko, K., & Ślęzak, A. (2022). The use of Big Data Analytics in healthcare. Journal of Big Data, 9(1), 1–24.
Bhattacherjee, A., & Hikmet, N. (2007). Physicians’ resistance toward healthcare information technology: a theoretical model and empirical test. European Journal of Information Systems, 16(6), 725–737.
Bhugaonkar, K., Bhugaonkar, R., & Masne, N. (2022). The Trend of Metaverse and Augmented & Virtual Reality Extending to the Healthcare System. Cureus, 14(9).
Block, L., psychology, P. K.-J. of applied social, & 1998, undefined. (1998). Beyond protection motivation: An integrative theory of health appeals. Wiley Online LibraryLG Block, PA KellerJournal of Applied Social Psychology, 1998•Wiley Online Library, 28(17), 1584–1608.
Bovey, W. H., & Hede, A. (2001). Resistance to organizational change: the role of cognitive and affective processes. Leadership & Organization Development Journal, 22(8), 372–382.
Briganti, G., & Le Moine, O. (2020). Artificial Intelligence in Medicine: Today and Tomorrow. Frontiers in Medicine, 7, 509744.
Carayon, P., Schoofs Hundt, A., Karsh, B. T., Gurses, A. P., Alvarado, C. J., Smith, M., & Brennan, P. F. (2006). Work system design for patient safety: the SEIPS model. BMJ Quality & Safety, 15(suppl 1), i50–i58.
Cook, D., Thompson, J. E., Habermann, E. B., Visscher, S. L., Dearani, J. A., Roger, V. L., & Borah, B. J. (2017). From ‘Solution Shop’ Model To ‘Focused Factory’ In Hospital Surgery: Increasing Care Value And Predictability. Https://Doi.Org/10.1377/Hlthaff.2013.1266, 34(5), 746–755.
Cozzoli, N., Salvatore, F. P., Faccilongo, N., & Milone, M. (2022). How can big data analytics be used for healthcare organization management? Literary framework and future research from a systematic review. BMC Health Services Research, 22(1), 1–14.
Cresswell, K., Hernández, A. D., Williams, R., & Sheikh, A. (2022). Key Challenges and Opportunities for Cloud Technology in Health Care: Semistructured Interview Study. JMIR Human Factors, 9(1).
Cresswell, K. M., Bates, D. W., & Sheikh, A. (2013). Ten key considerations for the successful implementation and adoption of large-scale health information technology. Journal of the American Medical Informatics Association, 20(e1), e9–e13.
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly: Management Information Systems, 13(3).
Di Fabio, A., & Gori, A. (2016). Developing a new instrument for assessing acceptance of change. Frontiers in Psychology, 7(MAY).
Dimaggio, P. J., & Powell, W. W. (1983). The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields. In Source (Vol. 48, Issue 2). American Sociological Review.
Do Nascimento, I. J. B., Marcolino, M. S., Abdulazeem, H. M., Weerasekara, I., Azzopardi-Muscat, N., Goncalves, M. A., & Novillo-Ortiz, D. (2021). Impact of big data analytics on people’s health: Overview of systematic reviews and recommendations for future studies. Journal of Medical Internet Research, 23(4), e27275.
Dwivedi, R., Mehrotra, D., & Chandra, S. (2022). Potential of Internet of Medical Things (IoMT) applications in building a smart healthcare system: A systematic review. Journal of Oral Biology and Craniofacial Research, 12(2), 302–318.
Erwin, D. G., & Garman, A. N. (2010). Resistance to organizational change: Linking research and practice. In Leadership and Organization Development Journal (Vol. 31, Issue 1, pp. 39–56).
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. Journal for Nurse Practitioners, 17(2), 218–221.
Gao, F., Thiebes, S., & Sunyaev, A. (2018). Rethinking the meaning of cloud computing for health care: A taxonomic perspective and future research directions. Journal of Medical Internet Research, 20(7), e10041.
Garg, A. X., Adhikari, N. K. J., McDonald, H., Rosas-Arellano, M. P., Devereaux, P. J., Beyene, J., Sam, J., & Haynes, R. B. (2005). Effects of Computerized Clinical Decision Support Systems on Practitioner Performance and Patient Outcomes: A Systematic Review. JAMA, 293(10), 1223–1238.
Ginter, P. M. and D. W. J. and S. L. E. (2018). The strategic management of health care organizations. john wiley & sons.
Gochhait, S., Singh, T., Bende, A., Thapliyal, M., Vemulapalli, H., Shukla, G., Ghosh, D., & Chinta, D. (2020). Implementation of EHR using digital transformation: A study on telemedicine. 2020 International Conference for Emerging Technology, INCET 2020.
Gosling, A. S., Westbrook, J. I., & Braithwaite, J. (2003). Clinical Team Functioning and IT Innovation: A Study of the Diffusion of a Point-of-care Online Evidence System. Journal of the American Medical Informatics Association, 10(3), 244–251.
Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ care. The Lancet, 362(9391), 1225–1230.
Gu, D., Yang, X., Deng, S., Liang, C., Wang, X., Wu, J., & Guo, J. (2020). Tracking knowledge evolution in cloud health care research: Knowledge map and common word analysis. Journal of Medical Internet Research, 22(2), e15142.
Habehh, H., & Gohel, S. (2021). Machine Learning in Healthcare. Current Genomics, 22(4), 291–300.
Harrison, M. I., Koppel, R., & Bar-Lev, S. (2007). Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis. Journal of the American Medical Informatics Association, 14(5), 542–549.
Hartnick, C., Shah, M., Coppess, S. M., Yamasaki, A., Johnson, K. E., Prager, J., Wootten, C. T., Gallagher, T., Propst, E., & Kaplan, R. S. (2020). Assessing the Value of Pediatric Aerodigestive Care. NEJM Catalyst Innovations in Care Delivery, 1(4).
Henriksen, K. ; K. R. ; M. D. (1993). Industrial ergonomic factors in the radiation oncology therapy environment (Advances in industrial ergonomics and safety V, Ed.). Taylor and Francis.
Holden, R. J., & Karsh, B. T. (2010). The Technology Acceptance Model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159–172.
Hutchins, E. (1995). Cognition in the Wild.
Ibrahim, A. E., Magdy, M., Khalaf, E. M., Mostafa, A., & Arafa, A. (2021). Teledermatology in the time of COVID-19. International Journal of Clinical Practice, 75(12), e15000.
Id, S. C., Schiaffonati, V., & Aliverti, A. (2022). Challenges and recommendations for wearable devices in digital health: Data quality, interoperability, health equity, fairness. PLOS Digital Health, 1(10), e0000104.
Kan Yeung, A. W., Tosevska, A., Klager, E., Eibensteiner, F., Laxar, D., Stoyanov, J., Glisic, M., Zeiner, S., Kulnik, S. T., Crutzen, R., Kimberger, O., Kletecka-Pulker, M., Atanasov, A. G., & Willschke, H. (2021). Virtual and augmented reality applications in medicine: Analysis of the scientific literature. Journal of Medical Internet Research, 23(2), e25499.
Kassutto, S. M., Baston, C., & Clancy, C. (2021). Virtual, Augmented, and Alternate Reality in Medical Education: Socially Distanced but Fully Immersed. ATS Scholar, 2(4), 651–664.
Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family Medicine and Community Health, 8(3), e000530.
Lapointe, L., & Rivard, S. (2005). A multilevel model of resistance to information technology implementation. MIS Quarterly: Management Information Systems, 29(3), 461–491.
Lawrence, P., Title), J. L.-(No, & 1967, undefined. (n.d.). Organization and environment: Managing differentiation and integration. Cir.Nii.Ac.Jp. Retrieved July 24, 2024, from
Lega, F., policy, C. D. P.-H., & 2005, undefined. (n.d.). Converging patterns in hospital organization: beyond the professional bureaucracy. Elsevier. Retrieved July 24, 2024, from
Lu, L., Zhang, J., Xie, Y., Gao, F., Xu, S., Wu, X., & Ye, Z. (2020). Wearable Health Devices in Health Care: Narrative Systematic Review. JMIR Mhealth Uhealth 2020;8(11):E18907
Ludwig, M., Merode, F. Van, Health, W. G.-T. E. J. of, & 2010, undefined. (2010). Principal agent relationships and the efficiency of hospitals. SpringerM Ludwig, F Van Merode, W GrootThe European Journal of Health Economics, 2010•Springer, 11(3), 291–304.
Malhotra, S., Jordan, D., Shortliffe, E., & Patel, V. L. (2007). Workflow modeling in critical care: Piecing together your own puzzle. Journal of Biomedical Informatics, 40(2), 81–92.
Mares, J. (2018). Resistance of health personnel to changes in healthcare.
Mariano, B. (2020). Towards a global strategy on digital health. Bulletin of the World Health Organization, 98(4), 231.
McLean, R., Hooks, J., & Guttman, C. (2020). Organization design and management. Medical Quality Management: Theory and Practice: Third Edition, 177–196.
Mehrtak, M., SeyedAlinaghi, S., MohsseniPour, M., Noori, T., Karimi, A., Shamsabadi, A., Heydari, M., Barzegary, A., Mirzapour, P., Soleymanzadeh, M., Vahedi, F., Mehraeen, E., & Dadras, O. (2021). Security challenges and solutions using healthcare cloud computing. Journal of Medicine and Life, 14(4), 448–461.
Meyer, J. W., & Rowan, B. (1977). Institutionalized Organizations: Formal Structure as Myth and Ceremony. American Journal of Sociology, 83(2), 340–363.
Mintzberg, H. (1989). The Structuring of Organizations. Readings in Strategic Management, 322–352.
Moran, J. W., & Brightman, B. K. (2000). Leading organizational change. Journal of Workplace Learning: Employee Counselling Today, 12(2), 66–74.
Norman, D. A. (1988). The psychology of everyday things. Basic books.
Nouri, R., Kalhori, S. R. N., Ghazisaeedi, M., Marchand, G., & Yasini, M. (2018). Criteria for assessing the quality of mHealth apps: a systematic review. Journal of the American Medical Informatics Association, 25(8), 1089–1098.
Palepu, S., Nitsch, A., Narayan, M., Kim, S., & Osier, N. (2020). A Flat Organizational Structure for an Inclusive, Interdisciplinary, International, and Undergraduate-Led Team. Frontiers in Education, 5, 493540.
Pasmore, W., Winby, S., Mohrman, S. A., & Vanasse, R. (2019). Reflections: Sociotechnical Systems Design and Organization Change. Journal of Change Management, 19(2), 67–85.
Piovani, D., & Bonovas, S. (2022). Real World—Big Data Analytics in Healthcare. International Journal of Environmental Research and Public Health 2022, Vol. 19, Page 11677, 19(18), 11677.
Plsek, P. E., & Greenhalgh, T. (2001). Complexity science: The challenge of complexity in health care. BMJ, 323(7313), 625–628.
Porter, M. E., & Lee, T. H. (2021). Integrated Practice Units: A Playbook for Health Care Leaders. NEJM Catalyst Innovations in Care Delivery, 2(1).
Rindfleisch, T. C. (1997). Privacy, Information Technology, and Health Care. Communications of the ACM, 40(8), 92–100.
Rogers, E. M., Singhal, A., & Quinlan, M. M. (2014). Diffusion of Innovations. An Integrated Approach to Communication Theory and Research, 432–448.
Rogers, L., De Brún, A., & McAuliffe, E. (2023). Exploring healthcare staff narratives to gain an in-depth understanding of changing multidisciplinary team power dynamics during the COVID-19 pandemic. BMC Health Services Research, 23(1), 419.
Rotolo, D., Hicks, D., & Martin, B. R. (2015). What is an emerging technology? Research Policy, 44(10), 1827–1843.
Sadhu, P. K., Yanambaka, V. P., Abdelgawad, A., & Yelamarthi, K. (2022). Prospect of Internet of Medical Things: A Review on Security Requirements and Solutions. Sensors 2022, Vol. 22, Page 5517, 22(15), 5517.
Selznick, P. (1996). Institutionalism “Old” and “New.” Administrative Science Quarterly, 41(2), 270.
Sheehan, B., Kaufman, D., Stetson, P., & Currie, L. M. (2009). Cognitive Analysis of Decision Support for Antibiotic Prescribing at the Point of Ordering in a Neonatal Intensive Care Unit. AMIA Annual Symposium Proceedings, 2009, 584.
Sittig, D. F., Singh, H., Sittig, D. F., & Singh, H. (2015). A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems. 3, 59–80.
Smuck, M., Odonkor, C. A., Wilt, J. K., Schmidt, N., & Swiernik, M. A. (2021). The emerging clinical role of wearables: factors for successful implementation in healthcare. Npj Digital Medicine 2021 4:1, 4(1), 1–8.
Steinmann, G., Daniels, K., Mieris, F., Delnoij, D., Van De Bovenkamp, H., & Van Der Nat, P. (2021). Redesigning value-based hospital structures: a qualitative study on value-based health care in the Netherlands. Springer, 22(1), 1193.
Stoelwinder, J. U. (1990). The Relationship Between Organisation Structure And Management Control In Hospitals: An Elaboration and Bureaucracy Model. Accounting, Auditing & Accountability Journal, 3(3), 18–33.
Stoumpos, A. I., Kitsios, F., & Talias, M. A. (2023). Digital Transformation in Healthcare: Technology Acceptance and Its Applications. International Journal of Environmental Research and Public Health, 20(4).
Venkatesh, V., Smith, R. H., Morris, M. G., Davis, G. B., Davis, F. D., & Walton, S. M. (2003). USER ACCEPTANCE OF INFORMATION TECHNOLOGY: TOWARD A UNIFIED VIEW 1. In User Acceptance of IT MIS Quarterly (Vol. 27, Issue 3).
Vera, A., & Kuntz, L. (2007). Process-based organization design and hospital efficiency. http://journals.lww.com/hcmrjournal
Vial, G. (2019). Understanding digital transformation: A review and a research agenda. The Journal of Strategic Information Systems, 28(2), 118–144.
Vincent, C., Taylor-Adams, S., & Stanhope, N. (1998). Framework for analysing risk and safety in clinical medicine. BMJ, 316(7138), 1154–1157.
Weiner, B. J. (2020). A theory of organizational readiness for change. Handbook on Implementation Science, 215–232.
Westbrook, J. I., Braithwaite, J., Gibson, K., Paoloni, R., Callen, J., Georgiou, A., Creswick, N., & Robertson, L. (2009). Use of information and communication technologies to support effective work practice innovation in the health sector: A multi-site study. BMC Health Services Research, 9(1), 1–9.
