Understanding e-health adoption costs in a Dutch nursing and homecare organization: a case study investigating adoption of a Smart Glass in wound care

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Different forms of e-health are currently in development that could be a solution for keeping the Dutch healthcare system sustainable. Main problem is that many healthcare organizations fail in successful e-health adoption. This study aims to understand factors influencing successful adoption of a Smart Glass in a Dutch nursing and homecare organization together with identifying and estimating (hidden) cost drivers involved in this adoption process. A conceptual model is proposed combining the extended Unified Theory of Acceptance and Use of Technology (UTAUT2), Technological-Organizational-Environmental (TOE) and Knowledge Management (KM) framework. Cost drivers were identified by using Time Driven Activity Based Costing (TDABC). Data was collected using semi-structured interviews (n=10) and analysed using a thematic content analysis showing that there is a complex interplay between individual- and organizational factors that influences successful e-health adoption. Main cost drivers in this project were personnel costs (43%) of which 19% were hidden costs: unidentified project costs. Of the time that should have been spent on care, 3,4% was spent on adoption of the Smart Glass resulting in reduced productivity and increased workloads of healthcare workers. Overall, successful adoption of e-health is a complex and dynamic process between individual and organizational factors that involves mainly time investments of personnel. Mapping how e-health adoption affects productivity and workloads is required for e-health adoption to succeed. Furthermore, this study suggests the implementation of new technologies one by one or when e-health is implemented in parallel to schedule dedicated time per employee for the adoption process.
Faculteit der Natuurwetenschappen, Wiskunde & Informatica