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Online health question-and-answer (Q&A) forums have developed a new business model whereby listeners (peer patients) can pay to read health information derived from consultations between askers (focal patients) and answerers (physicians). However, research exploring the mechanism behind peer patients' purchase decisions and the specific nature of the information driving these decisions has remained limited. This study aims to develop a theoretical model for understanding how peer patients make such decisions based on limited information, i.e. the first question displayed in each focal patient-physician interaction record, considering argument quality (interrogative form and information details) and source credibility (patient experience of focal patients), including the contingent role of urgency.

The model was tested by text mining 1,960 consultation records from a popular Chinese online health Q&A forum on the Yilu App. These records involved interactions between focal patients and physicians and were purchased by 447,718 peer patients seeking health-related information until this research.

Patient experience embedded in focal patients' questions plays a significant role in inducing peer patients to purchase previous consultation records featuring exchanges between focal patients and physicians; in particular, increasingly detailed information is associated with a reduced probability of making a purchase. When focal patients demonstrate a high level of urgency, the effect of information details is weakened, while the interrogative form is strengthened.

The originality of this study lies in its exploration of the monetization mechanism forming the trilateral relationship between askers (focal patients), answerers (physicians) and listeners (peer patients) in the business model “paying to view others' answers” in the online health Q&A forum and the moderating role of urgency in explaining the mechanism of how first questions influence peer patients' purchasing behavior.

The purpose of this research paper is to explore the determinants of patients' service choices between telephone consultation and text consultation in online health communities (OHCs).

This study utilized an empirical model based on the elaboration likelihood model and examined the effect of information, regarding service quality (the central route) and service price (the peripheral route), using online health consultation data from one of the largest OHCs in China.

The logistic regression results indicated that both physician- and patient-generated information can influence the patients' service choices; service price signals will lead patients to cheaper options. However, individual motivations, disease risk and consulting experience change a patients' information processing regarding central and peripheral cues.

Previous researchers have investigated the mechanism of patient behavior in OHCs; however, the researchers have not focused on the patients' choices regarding the multiple health services provided in OHCs. The findings of this study have theoretical and practical implications for future researchers, OHC designers and physicians.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.

Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.

The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.

This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.

Telemedicine, similarly to social media, accelerates information exchange, enriches information, provides better access to information and, furthermore, has an impact on mobilizing resources in business-to-business relationships. This paper aims to contribute to the understanding of the changes brought about by telemedicine, as a new technology, in patient routes.

This case study method was applied to examine five health-care protocols through their patient routes (series of activities) with and without telemedicine technology. The ARA model was applied to examine the changes telemedicine engendered in relation to activities, resources and actors. The strategy of visual mapping was applied for the comparative analysis.

The analyzed cases show that the new resources applied through telemedicine technology modified the number and substance of relevant activities and the set and role of actors who were involved. The quantity or the availability of output information increased in patient routes when new resources were added by telemedicine technology. When technology change occurred, any change in data or information systems – the two building blocks of information – could result in new or modified activities. If data that is used or produced while undertaking an activity change simultaneously along with the information system used for encrypting this data, then this “joint change” will certainly entail some kind of change in the set of activities, resources or actors that are involved. If not, then the activities continued the same as with the face-to-face protocol (without the new technology).

The novelty of the paper is that the results highlight the role of information in the extent of change in interactions induced by new technology. Findings about such changes show how information influenced by activities, resources and actors can help decision-makers in relation to the use of telemedicine.

Taking a business lens of telehealth, this article aims to review and provide a state-of-the-art overview of telehealth research.

This research conducts a systematic literature review using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) protocol and a collection of bibliometric analytical techniques (i.e. performance analysis, keyword co-occurrence, keyword clustering and content analysis).

Using performance analysis, this article unpacks the publication trend and the top contributing journals, authors, institutions and regions of telehealth research. Using keyword co-occurrence and keyword clustering, this article reveals 10 major themes underpinning the intellectual structure of telehealth research: design and development of personal health record systems, health information technology (HIT) for public health management, perceived service quality among mobile health (m-health) users, paradoxes of virtual care versus in-person visits, Internet of things (IoT) in healthcare, guidelines for e-health practices and services, telemonitoring of life-threatening diseases, change management strategy for telehealth adoption, knowledge management of innovations in telehealth and technology management of telemedicine services. The article proposes directions for future research that can enrich our understanding of telehealth services.

This article offers a seminal state-of-the-art overview of the performance and intellectual structure of telehealth research from a business perspective.

Consumer confusion is an emerging phenomenon of interest that significantly drives choice behaviour. Considering the dearth of scholarly focus on confusion faced by consumers in a healthcare setting, this paper aims to conceptualize and validate a patient confusion model consisting of its drivers and outcomes.

Drawing upon adaptive decision-making framework and consumer confusion literature, patient confusion model has been developed. Empirical data of 310 patients from three private sector hospitals in India was collected through pen and paper survey administration. The hypothesized patient confusion model was tested using partial least squares structural equation modelling (PLS-SEM) to derive confirmatory results.

The results confirm the role of decision-making variables such as information overload, information similarity, information ambiguity, information asymmetry, patient involvement and physician-patient communication in the occurrence of patient confusion. A significant impact of confusion on switching intention was also confirmed, providing insights for healthcare managers.

The effect of confusion on switching intention of consumers found through the present study holds significant implications from a healthcare management standpoint. Dissemination of credible information, improved communication between doctors and patients and creation of organized channels of health information provision also represent some of the notable implications for healthcare managers to mitigate patient confusion.

This study presents an empirically validated model of patient confusion creating a research agenda for theory development in this emerging area. Consumer confusion represents a core consumer behaviour problem that is of utmost significance in the healthcare sector. This paper is one of the first and early attempts to address this research problem.

Free knowledge sharing in the online health community has been widely documented. However, whether free knowledge sharing can help physicians accumulate popularity and further the accumulated popularity can help physicians attract patients remain unclear. To unveil these gaps, this study aims to examine how physicians' popularity are affected by their free knowledge sharing, how the relationship between free knowledge sharing and popularity is moderated by professional capital, and how the popularity finally impacts patients' attraction.

The authors collect a panel dataset from Hepatitis B within an online health community platform with 10,888 observations from April 2020 to August 2020. The authors develop a model that integrates free knowledge sharing, popularity, professional capital, and patients' attraction. The hierarchical regression model is used to for examining the impact of free knowledge sharing on physicians' popularity and further investigating the impact of popularity on patients' attraction.

The authors find that the quantity of articles acted as the heuristic cue and the quality of articles acted as the systematic cue have positive effect on physicians' popularity, and this effect is strengthened by physicians' professional capital. Furthermore, physicians' popularity positively influences their patients' attraction.

This study reveals the aggregation of physicians' popularity and patients' attraction within online health communities and provides practical implications for managers in online health communities.

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.