The Future of Healthcare: The Impact of Digitalization on Healthcare Services Performance

  • Luís Velez LapãoEmail author


Healthcare systems are facing many challenges, from demographics to multi-morbidities that are associated with increasing the demand for more services. New technologies are thought to be a solution to these problems. However, to address these problems with digitalization of healthcare will imply the combination of properly using technologies, aligned with integrated working processes and skilled professionals. The first section of this chapter highlights the challenges associated with the digitalization of healthcare, the next the implementation of digital services, considering a method to design online service, and then the impact of digitalization on healthcare workforce performance. Finally, the discussion examines the challenges of digitalization for the future. Proper digitalization of healthcare will enable changes in the paradigm of healthcare delivery as well as in the mechanism for patients’ participation and engagement. The sustainability of healthcare will depend on how efficient we will make digital service design.


Digitalization Healthcare services performance Innovation Design Science eHealth mHealth Chronic diseases Future 


  1. Ahern, David. 2007. Challenges and opportunities of eHealth research. American Journal of Preventive Medicine 32: S75–S82.CrossRefGoogle Scholar
  2. Albanese, Nicole Paolini, Michael Rouse, and Marissa Schlaifer. 2010. Scope of contemporary pharmacy practice: Roles, responsibilities, and functions of pharmacists and pharmacy technicians. American Journal of Health-System Pharmacy 50: e35–e69.Google Scholar
  3. Armstrong, Natalie, and John Powell. 2008. Preliminary test of an Internet-based diabetes self-management tool. Journal of Telemedicine and Telecare 14: 114–116.CrossRefGoogle Scholar
  4. Bashshur, Rashid L., Gary W. Shannon, Elizabeth A. Krupinski, Jim Grigsby, Joseph C. Kvedar, Ronald S. Weinstein, Jay H. Sanders, et al. 2009. National telemedicine initiatives: Essential to healthcare reform. Telemedicine and e-Health 15: 600–610.CrossRefGoogle Scholar
  5. Bates, David W., and Atul A. Gawande. 2003. Improving safety with information technology. The New England Journal of Medicine 348: 2526–2534.CrossRefGoogle Scholar
  6. Black, Ashly D., Josip Car, Claudia Pagliari, Chantelle Anandan, Kathrin Cresswell, et al. 2011. The impact of eHealth on the quality and safety of health care: A systematic overview. PLoS Medicine 8: e1000387. Scholar
  7. Bodenheimer, Thomas, Edward H. Wagner, and Kevin Grumbach. 2002. Improving primary care for patients with chronic illness: The chronic care model, Part 2. JAMA 288: 1909–1914.CrossRefGoogle Scholar
  8. Callens, Stefaan. 2015. The EU legal framework on e-health. In Health systems governance in Europe: The role of EU law and policy, ed. Elias Mossialos, Govin Permanand, Rita Baeten, and Tamara K. Hervey, 561–588. Cambridge: Cambridge University Press.Google Scholar
  9. Casalino, Lawrence, Robin R. Gillies, Stephen M. Shortell, Julie A. Schmittdiel, Thomas Bodenheimer, et al. 2003. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. JAMA 289: 434–441.CrossRefGoogle Scholar
  10. Chisholm-Burns, Marie A., Joshua S. Graff Zivin, Jeannie Kim Lee, et al. 2010. Economic effects of pharmacists on health outcomes in the United States: A systematic review. American Journal of Health-System Pharmacy 67: 1624–1634.CrossRefGoogle Scholar
  11. Christensen, Clayton M., Richard M.J. Bohmer, and John Kenagy. 2000. Will disruptive innovations cure healthcare? Harvard Business Review 78: 102–112.PubMedGoogle Scholar
  12. Christiansen, Ellen, Eva Henriksen, Lise Jensen, et al. 2014. Towards a personalised blueprint – For doers, by doers: European momentum for mainstreaming telemedicine. Brussels: European Commission.Google Scholar
  13. Cranor, Carole W., Barry A. Bunting, and Dale B. Christensen. 2003. The Asheville project: Long-term clinical and economic outcomes of a community pharmacy diabetes care program. Journal of the American Pharmaceutical Association 43: 173–184.PubMedGoogle Scholar
  14. Eysenbach, Gunther. 2001. What is e-health? Journal of Medical Internet Research 3: e20.CrossRefGoogle Scholar
  15. Gardner, Charles A., Tara Acharya, and Derek Yach. 2007. Technological and social innovation: A unifying new paradigm for global health. Health Affairs 26: 1052–1061.CrossRefGoogle Scholar
  16. George, Pradeep P., Joseph A. Molina, Jason Cheah, Soo Chung Chan, and Boon Lim. 2010. The evolving role of the community pharmacist in chronic disease management – A literature review. Annals of the Academy of Medicine, Singapore 39: 861–867.PubMedGoogle Scholar
  17. Gregório, João, Afonso Cavaco, and Luís V. Lapão. 2014. A scenario-planning approach to human resources for health: The case of community pharmacists in Portugal. Human Resources for Health 12: 58.CrossRefGoogle Scholar
  18. ———. 2017. How to best manage time interaction with patients? Community pharmacist workload and service provision analysis. Research in Social and Administrative Pharmacy 13: 133–147.CrossRefGoogle Scholar
  19. Hevner, Allan R., Salvatore T. March, Jinsoo Park, and Sudha Ram. 2004. Design science in information systems research. MIS Quarterly 28: 75–105.CrossRefGoogle Scholar
  20. Jorgenson, Dale W. 2001. Information technology and the US economy. American Economic Review 91: 1–32.CrossRefGoogle Scholar
  21. Katz, Steven J., and Cheryl A. Moyer. 2004. The emerging role of online communication between patients and their providers. Journal of General Internal Medicine 19: 978–983.CrossRefGoogle Scholar
  22. Kaufman, David R., Vimla L. Patel, Charlyn Hilliman, Philip C. Morin, Jenia Pevzner, et al. 2003. Usability in the real world: Assessing medical information technologies in patients’ homes. Journal of Biomedical Informatics 36: 45–60.CrossRefGoogle Scholar
  23. Kennie-Kaulbach, Natalie, Barbara Farrell, Natalie Ward, Sharon Johnston, Ashley Gubbels, et al. 2012. Pharmacist provision of primary health care: A modified Delphi validation of pharmacists’ competencies. BMC Family Practice 13: 27.CrossRefGoogle Scholar
  24. Kreps, Gary L., and Linda Neuhauser. 2010. New directions in eHealth communication: Opportunities and challenges. Patient Education and Counseling 78: 329–336.CrossRefGoogle Scholar
  25. Kuhn, K.A., D.A. Giuse, L. Lapão, and S.H.R. Wurst. 2007. Expanding the scope of health information systems: From hospitals to regional networks, to national infrastructures, and beyond. Methods of Information in Medicine 46: 500–502.CrossRefGoogle Scholar
  26. Lapão, Luís Velez. 2016. The future impact of healthcare services digitalization on health workforce: The increasing role of medical informatics. Studies in Health Technology and Informatics 228: 675–679.PubMedGoogle Scholar
  27. ———. 2018. Digitalization of healthcare: Where is the evidence of the impact on healthcare workforce's performance? Studies in Health Technology and Informatics 247: 646–650.Google Scholar
  28. Lapão, Luís Velez, Miguel Mira da Silva, and João Gregório. 2017. Implementing an online pharmaceutical service using design science research. BMC Medical Informatics and Decision Making 17: 31.CrossRefGoogle Scholar
  29. Makowsky, Mark, Theresa Schindel, Meagan Rosenthal, Katy Campbell, Ross Tsuyuki, and Helen Madill. 2009. Collaboration between pharmacists, physicians and nurse practitioners: A qualitative investigation of working relationships in the inpatient medical setting. Journal of Interprofessional Care 23: 169–184.CrossRefGoogle Scholar
  30. Marques, Rita, João Gregório, Fernando Pinheiro, Pedro Póvoa, Miguel Mira da Silva, and Luís Velez Lapão. 2017. How can information systems provide support to nurses’ hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections. BMC Medical Informatics and Decision Making 17: 15.CrossRefGoogle Scholar
  31. McAfee, Andrew, and Erik Brynjolfsson. 2017. Machine, platform, crowd: Harnessing our digital future. New York: WW Norton & Company.Google Scholar
  32. Moullin, Joanna C., Daniel Sabater-Hernandez, Fernando Fernandez-Llimos, and Shalom Benrimoj. 2013. Defining professional pharmacy services in community pharmacy. Research in Social and Administrative Pharmacy 9: 989–995.CrossRefGoogle Scholar
  33. Neuhauser, Linda, and Gary Kreps. 2010. eHealth communication and behavior change: Promise and performance. Social Semiotics 20: 9–27.CrossRefGoogle Scholar
  34. Paulo, Marília Silva, Tom Loney, and Luís Velez Lapão. 2017. The primary health care in the emirate of Abu Dhabi: Are they aligned with the chronic care model elements? BMC Health Services Research 17: 725.CrossRefGoogle Scholar
  35. Peffers, Ken, Tuure Tuunanen, Marcus Rothenberger, and Samir Chatterjee. 2007. A design science research methodology for information systems research. Journal of Management Information Systems 24: 45–77.CrossRefGoogle Scholar
  36. Petrakaki, Dimitra, Nick Barber, and Justin Waring. 2012. The possibilities of technology in shaping healthcare professionals: (re/de-)professionalisation of pharmacists in England. Social Science & Medicine 75: 429–437.CrossRefGoogle Scholar
  37. Piot, Peter. 2012. Innovation and technology for global public health. Global Public Health 7: S46–S53.CrossRefGoogle Scholar
  38. Quaglio, Gianluca, Claudio Dario, Panos Stafylas, Madis Tiik, Sarah McCormack, Pēteris Zilgalvis, et al. 2016. E-Health in Europe: Current situation and challenges ahead. Health Policy and Technology 5: 314–317.CrossRefGoogle Scholar
  39. Rothman, Arlyss A., and Edward H. Wagner. 2003. Chronic illness management: What is the role of primary care? Annals of Internal Medicine 138: 256–261.CrossRefGoogle Scholar
  40. Teece, David J. 2010. Business models, business strategy and innovation. Long Range Planning 43: 172–194.CrossRefGoogle Scholar
  41. Thursky, Karin A., and Michael Mahemoff. 2007. User-centered design techniques for a computerised antibiotic decision support system in an intensive care unit. International Journal of Medical Informatics 76: 760–768.CrossRefGoogle Scholar
  42. Tian, Maoyi, Jing Zhang, Rong Luo, Shi Chen, et al. 2017. Mhealth interventions for health system strengthening in China: A systematic review. JMIR 5: e32.Google Scholar
  43. Tsiknakis, Manolis, and Angelina Kouroubali. 2009. Organizational factors affecting successful adoption of innovative eHealth services. International Journal of Medical Informatics 78: 39–52.CrossRefGoogle Scholar
  44. van Deursen, Alexander, and Jan van Dijk. 2011. Internet skills performance tests: Are people ready for eHealth? Journal of Medical Internet Research 13: e35.CrossRefGoogle Scholar
  45. WHO – World Health Organization. 2008. World health report – Primary health care: Now more than ever. Geneve: World Health Organization.Google Scholar
  46. ———. 2010. Global status report on non-communicable diseases. Geneve: World Health Organization.Google Scholar
  47. ———. 2013. Health 2020: A European policy framework & strategy for the 21st century. Copenhagen: WHO Europe.Google Scholar
  48. ———. 2016. Global strategy on human resources for health: Workforce 2030. Geneva: WHO Document Production Services.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Global Health and Tropical Medicine, Instituto de Higiene e Medicina TropicalUniversidade Nova de LisboaLisbonPortugal

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