08 Oct For the case assignment, you will investigate the firms problem(s) as they relate to Information Systems and prepare a written paper for the case. The individual case must be completed by e
For the case assignment, you will investigate the firm’s problem(s) as they relate to Information Systems and prepare a written paper for the case. The individual case must be completed by each student and submitted for grade by the due date listed in the course schedule. The individual case assignment is noted on Canvas under Upload Assignments.
The case analysis and discussion needs to address the main issues in the case related to information systems. Assume you are a consulting group and are giving advice to the CIO and other senior IS managers and they are the audience for your analysis report. Read the rubric carefully and make sure you understand the requirements for “exemplary performance”.
Sections:
· Executive summary – a couple of short paragraphs which summarize the remainder of the report
· Background – use this section to lead in to your Problem Statement; identify symptoms, critical factors and the current state
· Problem Statement – a succinct statement of the problem/dilemma/issue, in a single declarative sentence; be careful to identify the real problem and not the symptoms of the problem
· Analysis – apply IS models, course content, and outside research to support your position; logically discuss options, implications and tradeoffs
· Recommendations and Conclusions – these should be your recommendations regarding how the organization should deal with the problem; they should be fully supported by the Analysis section
· Appendices – References and Charts – does not count towards the 5 pages
DOI: 10.4018/JCIT.2020100103
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Building a Critical Mass of Users for Digital Healthcare Promotion Programs: A Teaching Case Rennie Naidoo, University of Pretoria, South Africa
https://orcid.org/0000-0001-8392-1136
ABSTRACT
Despiterecenttechnologicaladvancements,theslowadoptionpatternofdigitalhealthcarepromotion programscontinuestobeamajorproblemplaguingmanyhealthcareorganizationstoday.Thehistorical teachingcasestudyisindispensableinimprovingourunderstandingofthecomplexandmultifaceted natureofcontemporarydigitalhealthcarepromotionprograms.Thishistoricalteachingcasepresents informationaboute-health,thee-commerceunitofalargemultinationalhealthcareinsurancecompany. Theteachingcaseshowshowdespitee-health’sabilitytopersuadealargeregisteredbaseofusersto trialitshealthcarepromotionprograms,over90%oftheseregistrantsdiscontinueduseafterashort trialperiodofusingthetechnology.Thishistoricalteachingcasefocusesonthesocialchallenges involved inpersuadingusers to adopt and continueusing e-health’smajor healthcarepromotion innovation:anonlinenutritioncenter.Despiteextensivepromotionsandtheuseofincentives,less than10%oftheuserbaseadoptedandcontinuedtousethishealthcarepromotioninnovation.Thecase reportsonthediscontinuanceamongdigitalhealthcarepromotionusersdespitetheintensiveefforts toretainthem.Studentsandpractitionerswillgaininsightintothekeysocialchallengesinvolved inachievingacriticalmassofusersfordigitalhealthcarepromotioninnovations.Theteachingcase requiresimportantdecisionstobemadebystudentsandpractitionersaboutpresentdigitalhealthcare promotionprogramsbydrawingon inferences frompastdigitalhealthcarepromotionprograms. Finally,thishistoricalteachingcasestudymakesaconvincingcaseforthevalueofhistoricalinsights ininformingpresentdaychallengesfacingcontemporarydigitalhealthcarepromotionprograms.
KeywoRDS Adoption, Electronic Health, Healthcare Informatics, Healthcare Promotion, Preventative Healthcare
INTRoDUCTIoN To DIGITAL HeALTHCARe PRoMoTIoN PRoGRAMS
Astheglobalpopulationrisesandlifeexpectancyratesaroundtheworldcontinuetoincreasedueto advancesinscienceandtechnologyandimprovementstosocio-environmentalconditions,healthcare budgetsarefacingenormouspressure.Onthe21stofNovember1986,theOttawaCharterinitiated theadvocacyofhealthpromotiontoimprovehealthcareglobally(WHO,1986).Healthpromotionis
Thisarticle,originallypublishedunderIGIGlobal’scopyrightonSeptember23,2020willproceedwithpublicationasanOpenAccess articlestartingonJanuary18,2021inthegoldOpenAccessjournal,JournalofCasesonInformationTechnology(convertedtogoldOpen
AccessJanuary1,2021),andwillbedistributedunderthetermsoftheCreativeCommonsAttributionLicense(http://creativecommons.org/ licenses/by/4.0/)whichpermitsunrestricteduse,distribution,andproductioninanymedium,providedtheauthoroftheoriginalworkand
originalpublicationsourceareproperlycredited.
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basedonthepremisethathealthcarecannotbethesoleresponsibilityofthehealthsectorandtherefore seekstoprovidepatientswithbettercontrolovertheirhealththroughinformation,healtheducation, andlifeenhancingskills(Eriksson&Lindström,2008).Thebenefitofempoweringpatientsisnot limitedtothecostreductionofhealthcare,butisalsoariskmitigationfactorfordiseaseaswellas ahealth-enhancingstrategy.
Overtheyears,ICTbegantobeintegratedintohealthsystemsandservicesworldwide.During the1990s,e-commerceemergedandenablednewways toconduct transactionsvia the Internet. eHealthwasalsoenabledby theInternet.The termeHealthrefers to theuseof informationand communication technologies to improve health and the health care system (Oh, Rizo, Enkin & Jadad,2005).TheInternetreferstothegloballyconnectednetworkofcomputers.Althoughtheterm InternetisusedinterchangeablywithWorldWideWebor‘theWeb’,theWorldWideWebrefers tomultimedia-baseddocumentsthatcanbeaccessedonline,overtheInternet(Lupton,2014).This becameknownastheWeb1.0eraortheso-calledbrochurewebera.TheWeb1.0erabeganrapidly in1990sbecauseoftheavailabilityofbrowserswithuser-friendlygraphicalinterfaces.TheWorld Wide Web had become avaluable channel for accessing and seeking health information. Rapid improvementincommunication,hardwareandsoftwaretechnologiesalsoledtonewandbetterhealth serviceofferingsviatheInternet.Bytheearly2000s,therewasanoticeableshiftintheuseofthe webandthedevelopmentofweb-basedapplications.ThiswastermedWeb2.0andinvolvesusers creating,organizing,sharing,critiquingandupdatingcontent.Web2.0connectspeopleandcontent inuniqueways.Web2.0facilitatesan‘architectureofparticipation’–adesignthatencouragesuser interaction,empowermentandcommunitycontributions.PopularWeb2.0applicationsincludeFlickr, Wikipedia,Facebook,MySpace,TwitterandYouTube.Bythemid-2000s,Healthcare2.0emerged totakeadvantageofthenetworkofWeb2.0applicationsandservicesdeliveredthroughtheWeb platform.Health2.0usessocialnetworkingsites,blogs,email listservices,onlinecommunities, podcasts,search,tagging,videos,andwikistopersonalizehealthcareandtocollaborateandpromote healtheducation(Lupton,2014).
Recentadvances inprocessor,memory,anddiskstoragecapacityhavemadedigitaldevices relativelyinexpensiveandaccesstoonlineplatformshavebecomemoreubiquitous.Consequently, increasinglysmallerdigitaldevicesfromthepersonalcomputertothetablettosmartphonestowearable computersarebeingbeenusedinhealthcare(Lupton,2015).m-Healthormobilehealthisdefined astheuseofmobiledevices,suchasmobilephones,patientmonitoringdevices,personaldigital assistants(PDAs),andotherwirelessdevicestosupporthealthpractices(Bert,Giacometti,Gualano& Siliquini,2014).Forexample,trackingdevicescanbeusedtomonitorapatient’scalorieconsumption, exerciseandmetabolicrate.Thesedevicesarebeingintegratedwithsocialmediatoprovidesupport andmotivation.ExpertspredictthattheWebwillevolveintoWeb3.0orthe‘SemanticWeb’(Giustini, 2007).TheSemanticWebaimstoimproveuponthemeaningfulnessofinformationontheWebthereby improvingcooperationbetweendigitaldevices,healthcarepractitionersandpatients.
Apartfromthecreationofdigitalcontentbyhealthcareuserswhentheyuploadinformationto theInternet,sensorsembeddedinhealthcaredigitaldevicesandphysicalhealthcareenvironmentsare alsogeneratingmassivedatasets(NevesStachyra,Rodrigues2008;Panesar,2019).Thesemassive datasetsarereferredtoas‘bigdata’.Cloudcomputingtechnologiesarebeingusedtofacilitatethe production,storageandsharingofthesebigdatasetstoprovidedigitalhealthcaresolutions(Darwish, Hassanien,Elhoseny,Sangaiah&Muhammad,2019).Artificialintelligenceandmachinelearning arebeingused touncoverhiddenconnectionsandpatterns in thesemassivedatasets toprovide evidence-baseddigitalhealthcaresolutions(Panesar,2019).Today’shealthcareICTecosystemis muchmorecomplexandinvolvesnetworkproviders,networkoperators,digitaldevicesuppliers, platform,contentandapplicationsproviders,healthcarecompanies,healthagencies,governments andpatients(Fransman,2007).Theterm‘digital’isnowbeingemployedtodescribepaper-based elementsthathavebeentransformedintodigitalformats,andthedevices,communicationnetworks andsoftwareapplicationsthatusetheseformats.
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ICTshaveplayedacrucialroleinprovidingadigitalplatformforpublishinganddisseminating healthalertsandinformationtothegeneralpublic,scientistsandhealthcareprofessionals.eHealth innovations like electronic health records, computer assisted prescription systems, and clinical databases have already directly benefited many patients and holds great promise for the future. Digitalplatformsareplayingandwillcontinuetoplayacrucialroleinhealthpromotion.eHealth innovationsareexpectedtoempowerandprovidecost-effectiveapproachesforpatientcareandtohelp governmentagenciesandhealthcareorganizationstocopewiththechallengesofincreasinghealthcare costs.However,theevidenceshowsthatthelevelsofuseruptakeformanyoftheseinnovationsare currentlyverylowandthatthediffusionofmanyoftheseeHealthinnovationsisbeingimpededby anumberofsignificantbarriers(Oderanti&Li,2018;Gugglberger,2018;Parasuraman&Colby, 2007).Despitethetechnologicaladvancementsandthepotentialofdigitalhealthpromotiontotackle theglobalhealthcrisis,someresearchersarguethatthattherecontinuestobeacrisisindigitalhealth promotiondelivery(vanGemert-Pijnen,Nijland,vanLimburg,Ossebaard,Kelders,Eysenbach& Seydel,2011;KeshavarzMohammad,2019).Thekeychallengesarenottechnologicalbutsocial.
Healthcare promotion innovations have earned a reputation for diffusing relatively slowly comparedtootherhealthcareinnovations(Rogers,2002;Rogers,2010;Greenhalgh,Robert,Bate, Macfarlane&Kyriakidou,2008).Itmaybesimplistictoassumethatstrongmonetary,andother formsofincentivesforprevention,willresolvethecomplexproblemofconsumerhealth(Reichheld &Schefter,2000;Jost,2007).Despitethemixedviewsabouttheefficacyofhealthcarepromotion programsintheliterature(Adam&DeBont,2003;Bandura,2004;Lister,West,Cannon,Sax& Brodegard,2014),informationandcommunicationtechnologiesaredeemedtobeimportantenablers inhealthcareservices(Larkin,2001;Schraefel&Churchill,2014;Sulaiman&Wickramasinghe, 2014;Orji&Moffatt,2018).However,healthcarepromotionprogramsarequitecomplex(Solberg, Kottke,Conn,Brekke,Calomeni&Conboy,1997),yettheycontinuetobehandledpoorlyandfail todeliveronanticipatedbenefits(Ward,2013;Ginter,Duncan,&Swayne,2018;Greenhalgh,2018). Tomanagethiscomplexity,somescholarshavesuggestedthattheseinterventionsneedtoaddress thesocialchallenges(McLeroy,Bibeau,Steckler,&Glanz,1988;Green,Richard,&Potvin,1996; Iyengar&Nair,2000;Schlosser,2002;PorterandTeisberg,2006).
Thiscaseisaboutthedifficultiesinvolvedindigitalhealthcarepromotionprogramsattaininga criticalmassofusers.Asstudentsexplorethecasetheywillberequiredtoaddressthemanysocial challenges raised by digital healthcare promotion programs. This case highlights the challenges experiencedbye-Health,thee-commercechannelforHealthInsuranceCompany(HIC),anditsOnline NutritionCenter.AfterabandoningtheOnlineNutritionCenter,some15yearsago,HICisrevisiting whetherornottopursueadigitalstrategyforthepromotionofnutritionamongitscustomers,given thelatestadvancesintechnology.Beforeproceeding,theExecutivehasconcludedthatareviewof thepastOnlineNutritionCenterinitiativeisneeded.Theybelievethatsuchanassessmentofthe pastcouldprovidevaluableinsightsandlessonslearnedtoinformtheirdecisionaboutthefuture.
SeTTING THe STAGe
Introducing the e-Health Case Study TerryRossiburst intohisoffice,walkeddirectly tohisdeskandslumpedintohischair.Hehad justarrivedfromanother toughExcomeeting.Thecommitteewasconcerned that the“wellness innovations”deliveredontheWebhadsofarappealedtoonlyaminorityofcustomersandnotthe highnumbersthathadbeenpromisedbye-Health.Atbest,thehealthcarepromotionprogram,the onlinenutritioncenter,wasservingasacomplementarychannelforasmallcaptiveaudience.Terry wonderedhowhewasgoingtoimprovetheperformanceoftheonlinenutritioncenter.Terryknew that ifhewere toconvince theExco that thishealthcarepromotionprogramwasa success, this programwouldhavetoattainacriticalmassofusers.Hewasconsideringthestepshecouldtaketo ensurethate-Healthbuiltacriticalmassofusers.
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CASe DeSCRIPTIoN
e-Health’s Nutrition Centre E-HealthistheindividualbrandnameofthewebsiteforHealthcareInsuranceCompany(HIC)(Figure 1).HICiscomposedoftwootherbusinessunits:WellnessScienceCompany(WSC),acompanythat providedwellnessandloyaltyprogramsforcustomers,andBritishHealthcareInsuranceCompany (BHC)whichfocusesonoffering“consumer-engagedhealthcareproducts”forUK’sprivatemedical insurancemarket.TheaimofWSCistoprovidememberswithtoolsto“preventdiseaseandimprove theirwell-being”.WSCwaslaunchedin1997inresponsetothegrowingtrendtowardsahealthier, moreactivelifestyle,basedonthepremisethathealthierlifestylescouldtranslateintolong-termsavings onhealthcarecosts.WSCprovidesmemberswithaccesstoselectedhealthandfitnessfacilities,and createsstrongincentivesfortheircustomerstousethem.Membersarepersuadedtoearnincentive pointstoimprovetheirwellnessstatus.Thegreaterthestatus,themoreaccesstobenefits,suchas discountedtravelandleisureprices.WSCalsoprovidesallsortsofincentivestousee-Healthand e-Health’sNutritionCenter(Figure2).Bytheendof2005,HICwascoveringmorethan1.8million lives(Figure6)whileWSCwascoveringmorethan1.2millionlives(Figure7).Atthesametime, e-Health’sregistereduserbaseexceeded430,000(Figure8).
TheNutritionCentrewasconceivedin2002.Theobjectivewastoprovideanonlinemechanism thatpromotedhealthyeatinghabitsamongWSC’smembers.Thedesignprocesswasmanagedby awellnessnutritionpanel,composedofdieticians,cliniciansandnutritionacademics.Therewasa hugeemphasisondesigningthetoolwithastrongscientificbasis.
TheNutritionCentreprojectteamaimedtoestablishanintegratednutritionprogrammeusing ‘scientificguidelines,periodicreviews,anddatacollection’.Meanwhiletheclinicalteamwhowere nowdrivingtheprojectselectedapanelthatconsistedofthreenutritionacademicsfromthevarious UniversitiesaroundSouthAfrica.Thispanelwastaskedtoreviewthedesignoftheapplicationand provideguidance.Theywerealsoinvolvedinanumberofworkshopswiththesoftwaredevelopment team.Thedesignofthetoolhadtogettheirstampofapprovalspecificallyonthe“scientificbasis”.
Figure 1. HIC’s organisation structure
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Despitethisaim,thereweredifferentopinionsamongthepanelmembersaboutcertaintopics,such asthefibrecontentofahealthydiet,andsoon.
AtthetimetheNutritionCentrehadnotputinanyspecificprogramsthatinvolvedmembers goingtoconsultregistereddieticians.While&#x
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