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This qualitative case study aims to identify and analyse the factors influencing the implementation and effectiveness of electronic health record systems (EHRS) in primary health-care (PHC) facilities in Tanzania. This study aims to explore ways to optimize the use of EHRS for better health-care service delivery.

The study uses a qualitative case study design. Data were collected through interviews and focus groups conducted with health-care workers and information and communication technology officers at the PHC facilities in Tanzania. Purposive sampling and data source triangulation were used to address potential biases and limitations associated with the study’s small sample size.

This study identifies several key findings related to the implementation and effectiveness of EHRS in Tanzanian PHC facilities. The primary obstacles include inadequate technical infrastructure, poor internet connectivity and insufficient financial resources. The study suggests a comprehensive strategy for improving EHRS, emphasizing patient and health-care professional involvement in system design, investments in technical infrastructure and connectivity, data quality and accuracy and ongoing technical support and training.

This research contributes to the existing body of knowledge by offering a nuanced understanding of the Tanzanian health-care context. It emphasizes the need for tailored solutions and strategies specific to the region’s challenges and opportunities. The study’s originality lies in its focus on EHRS in the Tanzanian context, providing valuable insights for future initiatives. A key policy implication underscores the importance of a supportive regulatory framework, dedicated resources and consistent stakeholder communication for successful EHRS implementation.

This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.

A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.

This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.

We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.

This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.

Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.

This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.

This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.

A structural model was developed based on a literature review. A 29-indicator questionnaire was circulated among service providers in the healthcare system across India, and 253 valid responses were received, corresponding to a response rate of 46%. The research model was assessed using a cross-sectional research design, and the data were analyzed by structural equation modeling using analysis of moment structures (AMOS) software.

Service orientation (SO), technology integration (TI), knowledge sharing (KS) and supply chain integration (SCI) were identified as antecedents of SCF, the consequence of which is responsiveness in service delivery (RSD). Furthermore, patient-centered care moderates the relationship between SCF and RSD.

This paper highlights the impact of SCF on RSD in healthcare organizations. Consideration of the four constructs of SO, TI, KS and SCI as antecedents of SCF and, in turn, RSD may be one of the limitations. Future work may identify other theoretical constructs with potential impacts on SCF and RSD. Furthermore, eight months for data collection could have resulted in early-late response bias. This study was operationalized in India and may reflect political, economic, social, technological, environmental and legal factors unique to India.

The study provides suggestions to practitioners for building RSD by leveraging SO, TI, KS and SCI in flexibility-driven service chain processes. Recognizing the relationships among these constructs can aid in the timely formulation of corrective actions and patient-centric policies.

This paper highlights how focusing on a SCF can promote RSD. This understanding may aid the design of processes that develop patient-centricity and deliver health as a social good in an effective manner.

The empirical evidence from this study can help hospitals integrate and build flexibility in their functions, thus enabling them to deliver responsiveness in care.

This paper aims to explore the value that care from a primary mental health care nurse (PMHCN) can bring to people with mental health (MH) problems in health-care delivery.

This study used a focus group of 20 PMHCNs working in primary care (PC) health settings in Saudi Arabia before using thematic content analysis to describe and explore their views and experiences of the integration of MH care into PC units. The researchers used a semi-structured interview format, which began with open-ended probes and proceeded to use of theoretical sampling based on emerging data related to their experiences and perceptions in the integration process.

Four main themes were derived from the thematic analysis of interviews: collaboration, knowledge and experience, awareness and orientation care and influential role.

This study’s use of qualitative research methods has certain limitations, including the small sample size of 20 participants, which means that it may not be representative of all primary MH nurses in primary health-care centers in Saudi Arabia. To make the results applicable to a broader audience, the researcher sought to moderate this limitation by including participants with extensive experience in multiple settings and nurses of different ages.

The cost implications of the PMHCN service are not yet comprehensively understood, but it is apparent that this model is not only regarded extremely positively by MH practitioners but may also have significant benefits in terms of patient outcomes. The configuration of local services and relevant patient demographics will affect the extent to which this study’s findings are transferable. Meanwhile, further research in this area could seek to provide further evidence about the aspects of the PMHCN service model, such as secondary care referrals and waiting times, accident and emergency attendances and patient recovery rates and the impact of providing such a service on health-care practitioners as well as its cost-effectiveness.

This study’s findings suggest that PMHCNs believe that their care improves the quality of PC for patients in PC settings. Elements of the PC placement that professionals particularly valued include their ability to assist patients in their own community and the inclusion of volunteer stakeholders who act as preceptors. The participants expressed a need for improvement of policy related to referrals within the clinics.

The purpose of this study is to examine the appropriate components and sub-components of Muslim-friendly hospital practices that comply with Islamic medical ethics and Sharia requirements.

A systematic literature review procedure based on the preferred reporting items for systematic reviews and meta-analyses publication standards was used to analyse and identify the precise components and sub-components of Muslim-friendly hospital practices from 239 shortlisted papers.

The study revealed that Sharia compliance prescription, Islamic infrastructure, Islamic medical practices, compassion and support, competencies of Islamic medical services, conducive Islamic surroundings, reasonable and convenience services and Islamic work culture are important elements that need to be in practice by Muslim-friendly hospital providers.

This study focuses on studies conducted between January 2010 to August 2022 from the Web of Science, Scopus and Google Scholar databases. This study contributes to the literature through the identification of eight main components and 53 sub-components that were found to be the core and essential determinants in the establishment of the Muslim-friendly hospital practices framework.

The proposed Muslim-friendly hospital practices framework are envisaged to motivate policymakers in Malaysia and Indonesia as well as other Muslim countries to implement the proposed framework through a greater number of supportive legislative measures as well as practical promotion and education policies to further enhance the market.

The number of health-care providers contemplating the integration of Islamic or Muslim-friendly practices into their strategic plans and daily operations is continuously increasing. However, the dearth of studies that provide conclusive evidence of the correct determinants of Muslim-friendly hospital practices that ensure strict Islamic medical ethics and Sharia-compliant service delivery standards had created an impediment that needs to be addressed urgently.

This study aims to examine the perceptions and evaluations of Muslim COVID-19 survivors and health workers regarding the halal, business and ethical attributes of hospitals during their interactions related to COVID-19 treatment.

Descriptive qualitative research with semi-structured online interviews was used to gather insights from COVID-19 survivors and health workers who treated COVID-19 patients. The findings were then compared with existing literature on hospital services and Sharia attributes.

The study found that patients and health-care workers in hospitals are concerned about whether the hospital follows Sharia law, the quality of health-care and hospital services and the ethical conduct of hospital staff. This is especially true during the COVID-19 pandemic, when patients are more anxious about religious conduct and the afterlife.

Hospitals need to address halal attributes in all aspects of their services for Muslim patients and business attributes such as standard health-care quality, service quality and ethical attributes. Participants indicated that when these needs are met, they are more likely to revisit the hospital and recommend it to others.

This study contributes to understanding the expectations of Muslim patients regarding hospital services that meet Islamic ethical and business requirements. Using the COVID-19 pandemic as a case study broadens the understanding of how to better serve Muslim customers.

The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.

The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.

The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.

The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.

This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.

Disasters and pandemics pose challenges to health-care provision. Accordingly, the need for adopting innovative approach is required in providing care to patient. Therefore, the purpose of this study is to present telehealth as an innovative approach for providing care to patients and reducing spread of the infection and advocates for the adoption of telehealth for digitalized treatment of patients.

An integrative review methodology of existing evidence was conducted to provide implications for integration of telehealth for digitalized treatment of patients. This paper draws on Technology Organization Environment (TOE) framework to develop a model and propositions to investigate the factors that influence telehealth adoption from the perspective of the supply side and the demand side of medical services.

Findings from this study discuss applications adopted for telehealth and recommendations on how telehealth can be adopted for medical-care delivery. More importantly, the findings and propositions of this study can act as a roadmap to potential research opportunities within and beyond the pandemic. In addition, findings from this study help provide guidelines on how health practitioners can rapidly integrate telehealth into practice for public health emergencies.

This study identifies the social, technological and organizational factors that influence telehealth adoption, and opportunities of adopting telehealth during the public health emergencies. This study concludes that specific policy changes to improve integration of interoperable solutions; data security; better physical infrastructures; broadband access; better transition and workflow balance; availability of funding and remuneration; regulations and reimbursement; awareness; and training will improve telehealth adoption during public health emergencies.

Additive manufacturing (AM), also known as three-dimensional (3D) printing technology, has been used in the health-care industry for over two decades. It is in high demand in the health-care industry due to its strength to manufacture custom-designed and personalized 3D constructs. Recently, AM technologies are being explored to develop personalized drug delivery systems, such as personalized oral dosages, implants and others due to their potential to design and develop systems with complex geometry and programmed controlled release profile. Furthermore, in 2015, the US Food and Drug Administration approved the first AM medication, Spritam® (Apprecia Pharmaceuticals) which has led to tremendous interest in exploring this technology as a bespoke solution for patient-specific drug delivery systems. The purpose of this study is to provide a comprehensive overview of AM technologies applied to the development of personalized drug delivery systems, including an analysis of the commercial status of AM based drugs and delivery devices.

This review paper provides a detailed understanding of how AM technologies are used to develop personalized drug delivery systems. Different AM technologies and how these technologies can be chosen for a specific drug delivery system are discussed. Different types of materials used to manufacture personalized drug delivery systems are also discussed here. Furthermore, recent preclinical and clinical trials are discussed. The challenges and future perceptions of personalized medicine and the clinical use of these systems are also discussed.

Substantial works are ongoing to develop personalized medicine using AM technologies. Understanding the regulatory requirements is needed to establish this area as a point-of-care solution for patients. Furthermore, scientists, engineers and regulatory agencies need to work closely to successfully translate the research efforts to clinics.

This review paper highlights the recent efforts of AM-based technologies in the field of personalized drug delivery systems with an insight into the possible future direction.

Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.