Factors Influencing Procurement of Digital Healthcare: A Case Study in Dutch District Nursing

Document Type : Original Article

Authors

1 Health Technology Assessment Unit, Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands

2 Research Group IT Innovations in Healthcare, Windesheim University of Applied Sciences, Zwolle, The Netherlands

3 Department of Operations, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands

Abstract

Background 
Digital health is considered a promising solution in keeping healthcare accessible and affordable. However, implementation is often complex and sustainable funding schemes are lacking. Despite supporting policy, scaling up innovative forms of healthcare progresses much slower than intended in Dutch national framework agreements. The aim of this study is to identify factors that influence the procurement of digital health particular in district nursing.

Methods 
A case study approach was used, in which multiple stakeholder perspectives are compared using thematic framework analysis. The case studied was the procurement of digital health in Dutch district nursing. Literature on implementation of digital health, public procurement and payment models was used to build the analytic framework. We analysed fourteen interviews (secondary data), two focus groups organised by the national task force procurement and eight governmental and third-party reports.

Results 
Five themes emerged from the analysis: (1) rationale, (2) provider-payer relationship, (3) resources, (4) evidence, and (5) the payment model. Per theme a number of factors were identified, mostly related to the design and functioning of the Dutch health system and to the implementation process at providers’ side.

Conclusion 
This study identified factors influencing the procurement of digital health in Dutch district nursing. The findings, however, are not unique for digital health, district nursing or the Dutch health system. The results presented will support policy makers, and decision-makers to improve procurement of digital health. Investing in better relationships between payer and care provider organisations and professionals is an important next step towards scaling digital health.

Keywords


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Articles in Press, Corrected Proof
Available Online from 29 August 2021
  • Receive Date: 23 December 2020
  • Revise Date: 21 June 2021
  • Accept Date: 23 August 2021