Fit-Viability Model Examination of e-Health Solutions

  • Nilmini Wickramasinghe
  • Jonathan L. Schaffer
  • Juergen Seitz
  • Imran Muhammad
  • Doug Vogel
Part of the Healthcare Delivery in the Information Age book series (Healthcare Delivery Inform. Age)


Healthcare delivery, irrespective of the region in the world, is facing the key challenges of escalating costs, aging populations, an increase in a myriad of diagnostic technologies and the rise of chronic diseases which, in turn, is leading to a more and more preventative focus. In short, the current state of healthcare delivery is not sustainable (OECD 2010,,3343,en_2649_ 34631_45549771_1_1_1_37407,00.html,; Pearce and Haikerwal, Med J Aust 193(7):397–398, 2010; Porter and Guth, Redefining German health care moving to a value-based system. Springer, Berlin, Heidelberg, 2012; Porter and Teisberg, Redefining health care: creating value-based competition on results. Harvard Business School Press, Boston, 2006; Wickramasinghe and Schaffer, Realizing value driven e-Health solutions Improving Healthcare Series. IBM Center for the Business of Government, Washington, 2010). Most countries are responding with various types of healthcare reform and turning to e-health solutions as possible efficiency tools. However, e-health is not a panacea for the maladies faced by healthcare delivery. Moreover, it is important to understand the key macro and micro issues as well as vital people, process and technology aspects if superior and sustainable healthcare delivery is to ensue. The following proffers a fit viability model as a systematic framework to assess and identify critical considerations for designing and developing sustainable e-health solutions. Current national and regional solutions are mapped onto this framework to demonstrate its usefulness and benefits.


Task technology fit Healthcare information systems E-health Designing healthcare information systems Adoption of healthcare information systems 


  1. AIHW. (2010). Retrieved December, 2014, from
  2. Bowman, R. J. (2014). Sage Health Solutions taps into a global sourcing network: Started by two sisters in South Africa, a small provider of medical supplies accepts an invitation from its biggest customer to join an electronic sourcing platform--then sees the technology as an opportunity to enable growth in a global scale. Supplychainbrain, 18(3), S42–S43.Google Scholar
  3. Bündnis ‚Stoppt die e-Card!. (2014). Aktion‚ Stoppt die e-Card! Retrieved August 8, 2014, from
  4. Chaos Computer Club e. V. (2014). Elektronische Gesundheitskarte. Retrieved August 8, 2014, from
  5. Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
  6. Department of Health. (2011). Retrieved December, 2011, from
  7. DoHA and NEHTA. (2011). Concept of operations: Relating to the introduction of a Personally Controlled Electronic Health Record System (Article) (p. 159). Retrieved from
  8. Dünnebeil, S., Sunyaev, A., Blohm, I., Leimeister, J. M., & Krcmar, H. (2012). Determinants of physicians’ technology acceptance for e-health in ambulatory care. International Journal of Medical Informatics, 2012(81), 1–15.Google Scholar
  9. Fähling, J., Köbler, F., Leimeister, J. M., & Krcmar, H. (2009a). Wahrnehmung des Wertbeitrags von Informationstechnologie in deutschen Krankenhäusern – Eine empirische Studie. Paper presented at the 9. Internationale Tagung Wirtschaftsinformatik, Wien, Austria.Google Scholar
  10. Fähling, J., Köbler, F., Leimeister, J. M., & Krcmar, H. (2009b). Wahrnehmung des Wertbeitrags von Informationstechnologie in deutschen Krankenhäusern. Krankenhaus-IT-Journal, (1), 34–36.Google Scholar
  11. Federal Ministry of Health. (2008). The electronic health card.
  12. Foster, R. (2013). Assessing the development process of the eHealth strategy for South Africa against the recommendations of the WHO/ITU National eHealth Strategy Toolkit. Journal of the International Society for Telemedicine and eHealth, 1(2), 62–72.Google Scholar
  13. Gardt, M. (2012). Was hinter der E-Gesundheitskarte steckt. In Die Welt, 04.06.2012.Google Scholar
  14. Gematik. (2008). Speicherstrukturen der eGK für Gesundheitsanwendungen. Retrieved August 8, 2014, from
  15. Gematik. (2014). Anwendungen der eGK. Retrieved August 8, 2014, from
  16. Goodhue, D. L. (1995). Understanding user evaluations of information systems. Management Science, 41(12), 1827–1844.CrossRefGoogle Scholar
  17. Goodhue, D. L. (1998). Development and measurement validity of a task-technology fit instrument for user evaluations of information systems. Decision Sciences, 29(1), 105–138.CrossRefGoogle Scholar
  18. Govender, V., McIntyre, D., & Loewenson, R. (2008). Progress towards the Abuja target for government spending on health care in East and Southern Africa. Equinet discussion paper 60, April 2008. Retrieved November 11, 2008,
  19. Gruhn, A. (2014). So wird meine Krankenversicherung gekapert. In RP Online, 26.06.2014. Re-trieved August 8, 2014, from
  20. Gruhn, A., Reisener, T. (2014). So unsicher sind Patientendaten. In RP Online, 26.06.2014. Retrieved August 8, 2014, from
  21. Handelsblatt. (2004). Reisepass und Gesundheitskarte mit Bits und Bytes. In Handelsblatt, 22.03.2004.Google Scholar
  22. Horner, V., Rautenbach, P., Mbananga, N., Mashamba, T., & Kwinda, H. (2013). An e-health decision support system for improving compliance of health workers to the maternity care protocols in South Africa. Applied Clinical Informatics, 4(1), 25–36.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Huang, Z., & Palvia, P. (2001). ERP implementation issues in advanced and developing countries. Business Process Management Journal, 7(3), 276–284. Scholar
  24. Köbler, F., Riedl, C., Vetter C., Leimeister J. M., & Krcmar, H. (2010). Social connectedness on Facebook–An explorative study on status message usage; Paper presented at the 16th Americas Conference on Information Systems; Lima, Peru. p. 247.Google Scholar
  25. Leichsenring, H. (2012). Online banking auf dem Vormarsch. Retrieved August 8, 2014, from
  26. Leon, N., Schneider, H., & Daviaud, E. (2012). Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa. BMC Medical Informatics and Decision Making, 12(1), 123.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Leslie, H. (2011). Australia’s PCEHR challenge. Retrieved from
  28. Liang, T.-P., & Wei, C.-P. (2004). Introduction to the special issue: Mobile commerce applications. International Journal of Electronic Commerce, 8(3), 7–17.CrossRefGoogle Scholar
  29. Masilela, T. C., Foster, R., & Chetty, M. (2013). The eHealth strategy for South Africa 2012-2016: How far are we? South African Health Review, 15–24.Google Scholar
  30. Molla, A., & Bhalla, A. (2006). Business transformation through ERP: A case study of an Asian company. Journal of Information Technology Case and Application Research, 8(1), 34–54. Scholar
  31. Mxoli, A., Mostert-Phipps, N., & Gerber, M. (2014). Personal health records: Design considerations for the South African context.
  32. Nel, P. S. (2011). Human resources management. Oxford: Oxford University Press.Google Scholar
  33. NHHRC. (2009). A healthier future for all Australians: National Health and Hospitals Reform Commission - Final report June 2009. Australian Government Department of Health and Ageing. Retrieved from
  34. OECD. (2010a). Growing health spending puts pressure on government budgets. Retrieved January 31, 2011, from,3343,en_2649_ 34631_45549771_1_1_1_37407,00.html
  35. OECD. (2010b). OECD health data 2010. Retrieved January 31, 2011, from
  36. Pearce, C., & Haikerwal, M. C. (2010). E-health in Australia: Time to plunge into the 21st century. The Medical Journal of Australia, 193(7), 397–398.PubMedGoogle Scholar
  37. Poon, P., & Wagner, C. (2001). Critical success factors revisited: Success and failure cases of information systems for senior executives. Decision Support Systems, 30(4), 393–418. Scholar
  38. Porter, M. E., & Guth, C. (2012). Redefining German health care moving to a value-based system. Berlin, Heidelberg: Springer.CrossRefGoogle Scholar
  39. Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: Creating value-based competition on results. Boston, MA: Harvard Business School Press.Google Scholar
  40. Schweim, H. G. (2007). Die unerträgliche Geschichte der Gesundheitskarte in Deutschland. GMS Medizinische Informatik, Biometrie und Epidemiologie, 3(1), 1–5.Google Scholar
  41. Soh, C., Kien, S. S., & Tay-yap, J. (2000). Enterprise resource planning: Cultural fits and misfits: Is ERP a universal solution? Communications of the ACM, 43(4), 47–51. Scholar
  42. Telekom Deutschland GmbH. (2014).
  43. Tjan, A. K. (2001). Finally, a way to put your internet portfolio in order. Harvard Business Review, 79(2), 76.PubMedGoogle Scholar
  44. Trochim, W., & Donnelly, J. (2008). The research methods knowledge base (3rd ed.). Mason, OH: Atomic Dog.Google Scholar
  45. Umble, E. J., Haft, R. R., & Umble, M. M. (2003). Enterprise resource planning: Implementation procedures and critical success factors. European Journal of Operational Research, 146(2), 241–257. Scholar
  46. Weichert, T. (2006). Datenschutzmanagement und Technikeinsatz. In W & S Krankenhaus, (Vol. 5, pp. 44–45).Google Scholar
  47. Wickramasinghe, N., & Schaffer, J. (2010). Realizing value driven e-Health solutions Improving Healthcare Series. Washington, DC: IBM Center for the Business of Government.Google Scholar
  48. Yin, R. K. (2014). Case study research: Design and methods (5th ed.). London: Sage.Google Scholar
  49. Yun, Y., Huang, W., Seitz, J., & Wickramasinghe, N. (2012). e-health in China: An evaluation. In N. Wickramasinghe, R. Bali, R. Suomi, & S. Kirn (Eds.), Critical Issues for the Development of Sustainable e-health Soltuions. New York: Springer.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nilmini Wickramasinghe
    • 1
    • 2
  • Jonathan L. Schaffer
    • 1
    • 3
  • Juergen Seitz
    • 4
  • Imran Muhammad
    • 1
  • Doug Vogel
    • 5
  1. 1.Faculty of HealthDeakin UniversityMelbourneAustralia
  2. 2.Health Informatics Management UnitEpworth HealthCareRichmondAustralia
  3. 3.Cleveland ClinicClevelandUSA
  4. 4.DHBWHeidenheimGermany
  5. 5.Harbin Institute of TechnologyHarbinChina

Personalised recommendations