Grounding eHealth : towards a holistic framework for sustainable eHealth technologies

Today’s healthcare system faces problems such as aging, a growth in age‐related illness and multi‐morbidity, a serious decrease of available personnel and a limited budget. The grand theme within healthcare is the need to do more with less. `eHealth’, the use of advanced information and communication technologies in healthcare, may contribute to the solution of these problems by supporting a better balance between self‐care and professional care. Yet, despite the large number of eHealth projects to date and the positive outcomes of evaluation studies, the actual take‐up of eHealth services is lower than expected. This thesis presents an investigation into the factors that are critical for the development of sustainable eHealth technologies. To this end, we evaluated various interactive health communication applications in primary care. One of the main problems is that the development of healthcare technology is expert‐driven, resulting in technology that does not meet the users’ needs and that disregards the social‐cultural habits and the complexity of healthcare. In addition to this, eHealth interventions are often based on classic behavioral theories and medical models. They focus on rational decision‐making and discrete individual behavior change and neglect the very interdependencies between technology, care, context and communication. To ground eHealth, we formulated a number of key principles: ● The development of eHealth technologies should be a process of value‐creation to match the technology with needs, motivations, incentives, profiles and contexts. ● The development of eHealth technologies should be a participatory process of co‐creation in order to develop eHealth technologies that matter. ● eHealth technologies should be persuasive to increase adherence. These principles underpin our new holistic framework; the ceHRes (Center for eHealth Research) Roadmap. The ceHRes Roadmap aims to bring together the interdisciplinary fields of policy, research and practice by providing instruments related to participatory development and business modeling. Health 2.0 initiatives to advance sustainable healthcare technologies, the participation of users and stakeholders from different backgrounds and with different interests (political, medical, policy, commercial) are important for trust, commitment and creating ownership and for organizing the resources and capacities for the development of human‐centered and value‐driven eHealth technologies.