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Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.

Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians’ experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics.

The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital.

Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies.

This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics.

Digital twin (DT) is an emerging technology that enables sophisticated interaction between physical objects and their virtual replicas. Although DT has recently gained significant attraction in both industry and academia, there is no systematic understanding of DT from its development history to its different concepts and applications in disparate disciplines. The majority of DT literature focuses on the conceptual development of DT frameworks for a specific implementation area. Hence, this paper provides a state-of-the-art review of DT history, different definitions and models, and six types of key enabling technologies. The review also provides a comprehensive survey of DT applications from two perspectives: (1) applications in four product-lifecycle phases, i.e. product design, manufacturing, operation and maintenance, and recycling and (2) applications in four categorized engineering fields, including aerospace engineering, tunneling and underground engineering, wind engineering and Internet of things (IoT) applications. DT frameworks, characteristic components, key technologies and specific applications are extracted for each DT category in this paper. A comprehensive survey of the DT references reveals the following findings: (1) The majority of existing DT models only involve one-way data transfer from physical entities to virtual models and (2) There is a lack of consideration of the environmental coupling, which results in the inaccurate representation of the virtual components in existing DT models. Thus, this paper highlights the role of environmental factor in DT enabling technologies and in categorized engineering applications. In addition, the review discusses the key challenges and provides future work for constructing DTs of complex engineering systems.

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

Total quality management is a valuable approach to continuously improve the quality of organizations; however, scholars debate its applicability to services, which require specific best practices that are different from those related to manufacturing. Moreover, digitization is pervading all kinds of services, but little has been written about total quality service practices in digital-based companies. For this purpose, the authors provide a holistic model of total quality service that reflects the peculiarities of such companies, guided by the question: how do total quality service practices change in digital-based service organizations?

The authors conduct an illustrative case study on Healthware Group, a global integrated digital health organization, to evaluate theoretical assumptions about total quality service practices in the digital environment.

The findings allow to validate the model provided. In addition, the study enables them to observe the changes the authors are witnessing in service provision in the digital era and the consequent transformation of best practices. To be accurate, the authors cannot refer to a full transformation in digital-based companies but rather to the enrichment and extension of TQS practices. The best illustration of these conclusions has been summarized in a set of propositions corresponding to seven of the key levers of a TQS model.

The paper represents the first attempt to discuss the relationship between total quality service and digitalization, offering a set of propositions for academics and insights for practitioners. The model can be used as a tool to visualize the different levers that successful implementation of TQS in digital-based services companies can rely on.

The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.

An output-oriented Data Envelopment Analysis model with a 2-years window analysis extension was used between 2013 and 2018. The analysis was completed with a determination of the sources of productivity changes (between the first and last year of the study period) and factors that influence efficiency.

Efficient regions have been identified and the spatial diversity in their efficiency was confirmed. The study identified individual efficiency trends together with “all-windows” best and worst performers. Using panel modeling, it was confirmed that the efficiency of health protection is influenced by, among others, accreditation certificates, the length of the waiting list or the number of medical personnel.

Although the analysis was conducted at the voivodeship level (NUTS2), which was fully justified, it would be equally important to analyze data with a lower aggregation level. It would be extremely valuable from the perspective of difficulties faced by the healthcare system in Poland.

The identification of areas and problems affecting the efficiency of the healthcare system in Poland may also be a hint for other countries with similar system solutions that also struggle with the same problems.

The paper explains the efficiency of the country's healthcare system while also paying attention to changes in its level, factors influencing it, spatial diversity and impact on the sector functioning.

It is the responsibility of the national governments to deliver healthcare services that are both effective and affordable to everyone. There are still gaps in this supply, which is extremely demanding. In this sense, companies are attempting to reach neglected markets and disrupt the marketplace with novel solutions. Although there are still anecdotal examples, a thorough literature evaluation is lacking. This study aims to provide a synthesis of the future of healthcare start-ups.

Papers that included the term “healthcare start-ups,” “health-tech start-ups,” “start-up,” “Artificial intelligence in healthcare,” and “Health tech start-ups in India” were considered for the analysis. The Biblioshiny package under the R programming tool was considered for a detailed analysis of the papers.

A total of 854 documents were related to healthcare start-ups, from which only 14 papers are related to health-tech start-ups and four papers are related to artificial intelligence in healthcare start-ups. It has been found from the past works of literature that the effectiveness of technology for information and communication in healthcare has significantly increased in recent years. Technology has already begun to permeate the healthcare market from other fields and industries. One way that the internet will help the industry evolve is by integrating digital health into daily life.

The study is not using other databases but is limited to Google Scholar and Scopus. A significant constraint of this study is the paucity of relevant literature in reputable publications on health and information systems. Another restriction was that gray literature, such as any journal or newspaper written by members of the health community about health-tech start-ups, was not taken into account.

Healthcare players should exhibit a fundamental openness to novel solutions to facilitate the digitalization of the healthcare system. Developing technology is widely used, and from an innovation perspective, a start-up should focus on innovation by employing technology and offering revolutionary healthcare solutions.

The novelty of this research is based on its presentation of an organized and thorough literature evaluation, which defines the current state of the art concerning green start-ups. To create a sustainable start-up, a thorough study of the information gained in respect of its healthcare start-up is presented.