Regulating Pervasive e-Health Services

  • Indrit TroshaniEmail author
  • Nilmini Wickramasinghe
Part of the Healthcare Delivery in the Information Age book series (Healthcare Delivery Inform. Age)


While the development of pervasive e-health services is experiencing growth in many countries worldwide, existing regulatory regimes are ill-equipped for dealing with them. In this chapter, we investigate institutional regulatory factors that can impact pervasive e-health services. These factors are important as they can shape both the nature of these services and their diffusion trajectory. We argue that coregulation, a mixture of direct monitoring and intervention of regulators through legislation and complete industry self-regulation, can be an effective approach for regulating the pervasive e-health services industry. Given the complex and dynamic nature of this industry, coregulation can minimize monitoring costs and enhance compliance.


e-health Regulation Coregulation Institution-based view 


  1. AMTA. (2005). AMTA Response to regulation taskforece isues paper 2005. Australian Capital Territory: Australian Mobile Telecommunications Association.Google Scholar
  2. Anderson, J. G. (2007). Social, ethical and legal barriers to e-health. International Journal of Medical Informatics, 76(5–6), 480–483.PubMedCrossRefGoogle Scholar
  3. Ba, S., & Pavlou, P. A. (2002). Evidence of the effect of trust building technology in electronic markets: Price premiums and buyer behavior. MIS Quarterly, 26(3), 243–268.CrossRefGoogle Scholar
  4. Barney, J. B. (2001). Is the resource-based “view” a useful perspective for strategic management research? Yes. Academy of Management Review, 26(1), 41–56.Google Scholar
  5. Barney, J. B., Wright, M., & Ketchen, D. J. J. (2001). The resource-based view of the firm: Ten years after 1991. Journal of Management, 27, 625–641.Google Scholar
  6. Benoliel, D. (2003). Cyberspace technological standardization: An institutional theory retrospective. Berkeley Technology Law Journal, 18(4), 1259–1339.Google Scholar
  7. Bodkin, C., & Miaoulis, G. (2007). eHealth information quality and ethics issues: An exploratory study of consumer perceptions. International Journal of Pharmaceutical and Healthcare Marketing, 1(1), 27–42.CrossRefGoogle Scholar
  8. Boulding, M. E. (2000). Self-regulation: Who needs it? Health Affairs, 19(6), 133–139.CrossRefGoogle Scholar
  9. Camponovo, G., & Pigneur, Y. (2003). Business model analysis applied to mobile business. Paper presented at the 5th International Conference on Enterprise Information Systems (ICEIS 2003), Angers, France, 23–26 April.Google Scholar
  10. Choudhrie, J., Papazafeiropoulou, A., & Lee, H. (2003). A web of stakeholders and strategies: A case of broadband diffusion in South Korea. Journal of Information Technology, 18(4), 281–290.CrossRefGoogle Scholar
  11. Cudore, B. A., & Bobrowski, P. E. (2003). How effective are healthcare web sites for marketers? Marketing Health Services, 23(3), 37–41.Google Scholar
  12. Damsgaard, J., & Lyytinen, K. (2001). The role of intermediating institutions in the diffusion of electronic data interchange (EDI): How industry associations intervened in Denmark, Finland, and Hong Kong. The Information Society, 17(3), 195–210.CrossRefGoogle Scholar
  13. Eysenbach, G. (2000). Towards ethical guidelines for e-health: JMIR theme issue on eHealth Ethics. Journal of Medical Internet Research, 2(1), 1–7.CrossRefGoogle Scholar
  14. Feldmann, V. (2002). Competitive strategy for media companies in the mobile internet. Schmalenbach Business Review, 54, 351–371.Google Scholar
  15. Ferraud-Ciandet, N. (2010). Privacy and data protection in ehealth: Aa comparative approach between South African and French legal systems. In P. Cunningham & M. Cunningham (Eds.), IST-Africa 2010 Conference Proceedings: IIMC International Information Management Corporation.Google Scholar
  16. Fisher, J., & Harindranath, G. (2004). Regulation as a barrier to electronic commerce in Europe: The case of the European fund management industry. European Journal of Information Systems, 13(4), 260–272.CrossRefGoogle Scholar
  17. Folger, M. (2001). Conduct of business and e-regulation. Paper presented at the Second Annual Conference on E-Regulation of Financial Services, Westminster and City Programmes.Google Scholar
  18. Fried, B. M., Weinreich, G., Cavalier, G. M., & Lester, K. J. (2000). E-health: Technologic revolution meets regulatory constraint. Health Affairs, 19(1), 124–131.PubMedCrossRefGoogle Scholar
  19. Galanxhi-Janaqi, H., & Nah, F. F.-H. (2004). U-commerce: Emerging trends and research issues. Industrial Management & Data Systems, 104(9), 744–755.CrossRefGoogle Scholar
  20. Gefen, D., Karahanna, E., & Straub, D. W. (2003). Trust and TAM in online shopping: An integrated model. MIS Quarterly, 27(1), 51–90.Google Scholar
  21. Goggin, G., & Spurgeon, C. (2005). Mobile message services and communications policy. Prometheus, 23(2), 181–193.CrossRefGoogle Scholar
  22. Goldsmith, J. (2000). How will the Internet change our health system? Health Affairs, 19(1), 148–156.PubMedCrossRefGoogle Scholar
  23. Holliday, I., & Tam, W.-K. (2004). E-health in the East Asian tigers. International Journal of Medical Informatics, 73(11–12), 759–769.PubMedCrossRefGoogle Scholar
  24. Houston, T. K., Sands, D. Z., Nash, B. R., & Ford, D. E. (2003). Experiences of physicians who frequently use email with patients. Health Communication, 15(4), 515–525.PubMedCrossRefGoogle Scholar
  25. Hsu, J., Huang, J., Kinsman, J., Fireman, B., Miller, R., Selby, J., et al. (2005). Use of e-health services between 1999–2002: A growing digital divide. The Journal of the American Medical Association, 12(2), 164–171.Google Scholar
  26. Huang, W., Seitz, J., & Wickramasinghe, N. (2010). Manifesto for e-health success. Proceedings of the 14th Pacific Asia Conference on Information Systems (PACIS 2010), Taipei, Taiwan, July 9–12.Google Scholar
  27. Ingram, P., & Silverman, B. (2002). Introduction. In P. Ingram & B. Silverman (Eds.), The new institionalism in strategic management (pp. 1–30). Amsterdam: Elsevier.Google Scholar
  28. Jones, R., Rogers, R., Roberts, J., Gaunt, N., Campbell, J., Thorogood, M., et al. (2004). E-health stakeholder consultation and policy context review. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO) programme of research on e-health. Plymouth: University of Plymouth.Google Scholar
  29. Kijl, B., Bouwman, H., Haaker, T., & Faber, E. (2005). Dynamic business models in mobile service value networks: A theoretical and conceptual framework (FRUX/D2.2-II). The Netherlands: TU Delft.Google Scholar
  30. Killström, U., Galli, L., Haaker, T., Immonen, O., Kijl, B., Pitkänen, O., et al. (2006). Initial marketplace dynamics (incl. business models) analysis (IST-2004-511607 MobiLife). Finland: Information Society Technologies.Google Scholar
  31. King, J. L., Gurbaxani, V., Kraemer, K. L., McFarlan, F. W., Raman, K. S., & Yap, C. S. (1994). Institutional factors in information technology innovation. Information Systems Research, 5(2), 139–169.CrossRefGoogle Scholar
  32. Kluge, E.-H. W. (2007). Secure e-health: Managing risks to patient health data. International Journal of Medical Informatics, 76(5–6), 402–406.PubMedCrossRefGoogle Scholar
  33. Lin, H. F., & Lee, G. G. (2005). Impact of organizational learning and knowledge management factors on e-business adoption. Management Decision, 43(2), 171–188.CrossRefGoogle Scholar
  34. Lin, H., & Wang, Y. (2005). Predicting consumer intention to use mobile commerce in Taiwan. In W. Brookes, E. Lawrence, R. Steele, & E. Chang (Eds.), International Conference on Mobile Business. July 11–13, 2005, Sydney, Australia: IEEE Computer Society.Google Scholar
  35. Lu, J., Yu, C., Liu, C., & Yao, J. E. (2003). Technology acceptance model for wireless internet. Internet Research: Electronic Networking Applications and Policy, 13(3), 206–222.CrossRefGoogle Scholar
  36. Lumpkin, J. R. (2000). E-health, HIPAA, and beyond. Health Affairs, 19(6), 149–151.PubMedCrossRefGoogle Scholar
  37. Lyytinen, K., & Damsgaard, J. (2001). What’s wrong with the diffusion of innovation theory: The case of a complex and networked technology. Paper presented at the IFIP 8.6, Banff, Canada.Google Scholar
  38. MacInnes, I. (2005). Dynamic business model framework for emerging technologies. International Journal of Services Technology and Management, 6(1), 3–19.CrossRefGoogle Scholar
  39. McKnight, D., Choudhury, V., & Macmar, C. (2002). The impact of initial consumer trust on intentions to transact with a web site: A trust building model. Journal of Strategic Information Systems, 11, 297–323.CrossRefGoogle Scholar
  40. Meyer, K. E., Estrin, S., Bhaumik, S. K., & Peng, M. W. (2009). Institutions, resources, and entry strategies in emerging economies. Strategic Management Journal, 30(1), 61–80.CrossRefGoogle Scholar
  41. Min, S. D., Lee, B. W., Yoon, S. W., Lee, Y. B., Kim, J. K., Lee, M., et al. (2007). Actual condition of Korean e-health: What do enterprisers want for developing e-health industry? Proceedings of the 9th International Conference on e-Health Networking, Application and Services, Taipei, Taiway, June 19–22.Google Scholar
  42. Minch, R. P. (2004). Privacy issues in location-aware mobile devices. Proceedings of the 37th Hawaii International Conference on System Sciences, Hawaii, January 5–8.Google Scholar
  43. Muzzi, C., & Kautz, K. (2004). Information and communication technologies diffusion in industrial districts. In J. Damsgaard & H. Z. Henriksen (Eds.), Networked information technologies: Diffusion and adoption (pp. 19–38). Dordrecht: Kluwer.Google Scholar
  44. Narayanan, V. K., & Fahey, L. (2005). The relevance of the institutional underpinning of Porter’s five forces framework to emerging economies: An epistemological analysis. Journal of Management Studies, 42(1), 207–223.CrossRefGoogle Scholar
  45. Newman, A. L., & Bach, D. (2004). Privacy and regulation in a digital age. In B. Preissl, H. Bouwman, & C. Steinfield (Eds.), E-life after the Dot.Com bust. Heidelberg: Physica-Verlag.Google Scholar
  46. Ng-Kruelle, G., Swatman, P. A., Rebne, D. S., & Hempe, J. F. (2001). The price of convenience: Privacy and mobile commerce. Quarterly Journal of Electronic Commerce, 3(4), 273–285.Google Scholar
  47. Niemeyer, J. (2001). An economic analysis of securities market regulation and supervision: Where to go after the Lamfalussy Report? Stockholdm School of Economics/EFI Working Paper Series in Economics and Finance. Stockholm: Stockholm School of Economics.Google Scholar
  48. North, D. C. (1990). Institutions, institutional change, and economic performance. Cambridge: Harvard University Press.CrossRefGoogle Scholar
  49. Oliver, C. (1997). Sustainable competitive advantage: Combining institutional and resource-based views. Strategic Management Journal, 18, 679–713.CrossRefGoogle Scholar
  50. Ooijevaar, J. R. (2010). The influence of national healthcare regulation on e-health business models: An exploratory comparative case study of four European healthcare markets. Unpublished Masters Thesis, University of Twente, Enschede.Google Scholar
  51. Parente, S. T. (2000). Beyond the hype: A taxonomy of e-health business models. Health Affairs, 19(6), 89–102.PubMedCrossRefGoogle Scholar
  52. Paris, J., & Ferranti, J. (2001). The changing fact of medicine: Health care on the internet. Journal of Perinatology, 21(1), 34–39.PubMedCrossRefGoogle Scholar
  53. Peng, M. W. (2002). Towards an institution-based view of business strategy. Asia Pacific Journal of Management, 19(2/3), 251–267.CrossRefGoogle Scholar
  54. Peng, M. W., & Heath, P. (1996). The growth of the firm in planned economies in transition: Institutions, organizations, and strategic choices. Academy of Management Review, 21, 492–528.Google Scholar
  55. Peng, M. W., Wang, D. Y. L., & Jiang, Y. (2008). An institution-based view of international business strategy: A focus on emerging economies. Journal of International Business Studies, 39(5), 920–936.CrossRefGoogle Scholar
  56. Peng, M. W., Sun, S. L., Pinkham, B., & Chen, H. (2009). The institution-based view as a third leg for a strategy tripod. Academy of Management Perspectives, 23(3), 63–81.CrossRefGoogle Scholar
  57. Piotti, B., & Macome, E. (2007). Public healthcare in Mozambique: Strategic issues in the ICT development during managerial changes and public reforms. International Journal of Medical Informatics, 76(1), 185–194.Google Scholar
  58. Rao, S., & Troshani, I. (2007). A conceptual framework and propositions for the acceptance of mobile services. Journal of Theoretical and Applied Electronic Commerce Research, 2(2), 61–73.Google Scholar
  59. Rao Hill, S., & Troshani, I. (2010). Factors influencing the adoption of personalisation mobile services: Empirical evidence from young Australians. International Journal of Mobile Communications, 8(2), 150–168.CrossRefGoogle Scholar
  60. Scott, W. R. (1995). Institutions and organizations. Thousand Oaks: Sage.Google Scholar
  61. Sohn, M., & Lee, J. (2007). U-health in Korea: Opportunities and challenges. Proceedings of the Portland International Center for Management of Engineering and Technology (PICMET 2007), Portland, Oregon, August 5–9.Google Scholar
  62. Spiller, P. T., & Zelner, B. A. (1997). Product complementarities, capabilities and governance: A dynamic transaction cost perspective. Industrial and Corporate Change, 6(3), 561–594.CrossRefGoogle Scholar
  63. Tallberg, M., Hämmäinen, H., Töyli, J., Kamppari, S., & Kivi, A. (2007). Impacts of handset bundling on mobile data usage: The case of Finland. Telecommunications Policy, 31(10/11), 648–659.CrossRefGoogle Scholar
  64. Terry, N. (2002). Regulating health information: A US perspective. British Medical Journal, 324(7337), 602–605.PubMedCrossRefGoogle Scholar
  65. Tongia, R. (2007). Connectivity in emerging regions: The need for improved technology and business models. IEEE Communications Magazine, 45(1), 96–103.CrossRefGoogle Scholar
  66. Troshani, I., & Rao Hill, S. (2008). A proposed framework for mobile services adoption: A review of existing theories, extensions, and future research directions. In G. C. Karmakar & L. S. Dooley (Eds.), Mobile multimedia communications: Concepts, applications and challenges (pp. 85–108). Hershey: Idea Group Publishing.Google Scholar
  67. Troshani, I., & Rao Hill, S. (2009). Linking stakeholder salience with mobile services diffusion. International Journal of Mobile Communications, 7(3), 269–289.CrossRefGoogle Scholar
  68. Ubacht, J. (2004). Regulatory practice in telecommunications markets: How to grasp the ‘real world of public action’? Communications & Strategies, 54(2nd Quarter), 219–242.Google Scholar
  69. Verikoukis, C., Konstas, I., Anastasiadou, D., & Angelidis, P. (2006). Overview on telecommunications regulation framework in south-eastern Europe. Telecommunication Systems, 32(2/3), 209–221.CrossRefGoogle Scholar
  70. Wang, Y.-S., Wang, Y.-M., Lin, H.-H., & Tang, T.-I. (2003). Determinants of user acceptance of Internet banking: An empirical study. International Journal of Service Industry Management, 14(5), 501–519.CrossRefGoogle Scholar
  71. Wen, H. J., & Tan, J. (2002). The evolving face of telemedicine & e-health: Opening doors and closing gaps in e-health services: Opportunities & challenges. Proceedings of the 36th Hawaii International Conference on System Sciences, Hawaii.Google Scholar
  72. Wilks, S. (1996). Regulatory compliance and capitalist diversity in Europe Journal of European Public Policy, 3(4), 536–559.CrossRefGoogle Scholar
  73. Woolfson, M. (2005). Can self-regulation protect the mobile industry from crooks? New Media Age, 17/03/2005, 16.Google Scholar
  74. Xu, D. J. (2007). The influence of personalization in affecting consumer attitudes toward mobile advertising in China. Journal of Computer Information Systems, Winter 2006–2007, 9–19.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.University of Adelaide Business School, The University of AdelaideAdelaideAustralia
  2. 2.Epworth Chair Health Information ManagementSchool of Business Information Technology and Logistics, RMIT UniversityMelbourne VICAustralia

Personalised recommendations