Toward a Comprehensive Understanding and Evaluation of the Sustainability of E-Health Solutions

Digital health transformation (DHT) has been deployed rapidly worldwide, and many e-health solutions are being invented and improved on an accelerating basis. Healthcare already faces many challenges in terms of reducing costs and allocating resources optimally, while improving provided services. E-solutions in healthcare can be a key enabler for improvements while controlling the budget; however, if the sustainability of those solutions is not assessed, many resources directed towards e-solutions and the cost of adoption/implementation will be wasted. Thus, it is important to assess the sustainability of newly proposed or already in-use e-health solutions. In the literature, there is a paucity of empirically driven comprehensive sustainability models and assessment tools to guide practices in real-world cases. Hence, this study proposes a comprehensive sustainability model for e-health solutions to assess the essential sustainability aspects of e-health solutions and anticipate the likelihood of their sustainability. To build the model, a systematic literature review (SLR) was conducted to extract the e-health sustainability dimensions and elements. In addition, the SLR analyzes the existing definitions of sustainability in healthcare and sustainability assessment methods. The proposed sustainability model has five dimensions, namely; technology, organization, economic, social, and resources. Each dimension has aspects that provide another level of required detail to assess sustainability. In addition, an assessment method was developed for this model to assess the aspects of each dimension, resulting in the overall prediction of the e-health solution’s sustainability level. The sustainability model and the assessment method were validated by three experts in terms of comprehensiveness and applicability to be used in healthcare. Furthermore, a case study was conducted on a Hospital Information System (HIS) of a hospital in Saudi Arabia to evaluate the sustainability model and its assessment method. The sustainability model and assessment method were illustrated to be effective in evaluating the sustainability of e-solutions and more comprehensive and systematic than the evaluation used in the hospital.