A report card on the management of E-health in Australia: From optimistic assumptions to conflicted success of Telehealth

Abstract

Dramatically escalating healthcare costs have prompted governments around the world to increase the rate of investment and the number of health information communication technologies (HICT) projects, also known as E-health projects, in the hope of improving efficiency and effectiveness of health services. Despite the often-massive expenditures, evidence of E-health projects improving efficiency and effectiveness of service delivery and delivering positive return on investment is contradictory at best. Reviews of literature on Ehealth programs indicate that there are significant challenges, ranging from low adoption to sustainability, which are closely related to management of E-Health initiatives. This paper conducted a qualitative analysis of 29 telehealth initiatives carried out in Australia between 2009 and 2019, identifying a wide range of problematic project and change management practices in their main areas of scope: technological and non-technological implementation, change management, and user acceptance. The analysis provides a bleak picture of a project focus with high levels of unrealistic optimism regarding these initiatives among managers, resulting in near-universal mixed results indicating “conflicted success’ of such initiatives. We offer insights applying a critical lens to current perspectives on the nature of E-health programs and their management, arguing that the adoption of change management as the main framework will improve the decision making and success levels of E-health initiatives.