Sociotechnical factors of sustainable digital health systems : a system dynamics model

Abstract

BACKGROUND : The introduction of digital health technology in a healthcare facility results in emergent and recursive interactions between new technology and existing social systems, technologies, and operating environments. OBJECTIVES : The study aims at developing a sociotechnical system dynamics model of digital health systems to assess the influence of sociotechnical factors on the sustainable use of an electronic Health Information Management System (eHMIS). METHODS : A total of 40 face-to-face interviews in 18 healthcare facilities and two separate sessions of focus group discussions were conducted to study eHMIS implementation in Ethiopia. A system dynamics modelling of digital health systems implementation is developed, tested and verified with a case of eHMIS implementation in Ethiopia. RESULTS : The long-term sustainability of the digital health system requires acceptance of technology, improved information quality to make appropriate decisions and better end-user satisfaction. The ‘individuals’ intention to use’ drives technology acceptance in the early years of the eHMIS use and social factors in the later stage. Besides, the role of technology to improve work performance determines the level of users’ satisfaction. The effort of improving ‘information quality’ is strongly influenced by the quality systems, i.e., reliable, easy to use, and capable to meet end-user requirements. CONCLUSIONS : The system's acceptance was improved through effective training and communication, whereas the ‘information quality’ was enhanced through ‘system quality’ and users’ satisfaction. The ability of technology to improve work performance and reduce the burden on end-users has increased the satisfaction of end-users.