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A holistic framework to improve the uptake and impact of eHealth technologies

A holistic framework to improve the uptake and impact of eHealth technologies. van Gemert-Pijnen, J. E. W. C. et al. J. Med. Internet Res. 13, e111 (2011).


People stop using technologies that do not correspond in any way with their daily lives, habits, or rituals. In the end, the use of new technologies appears to be time consuming and frustrating for all those involved. In this way, technology-driven approaches result in “high tech-with-a-low impact” eHealth technologies. The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector. The authors conduct a review and analysis of existing eHealth frameworks and present their own for developers, researchers, and decision makers.


  1. Stakeholder participation is essential during the full development process.
  2. By its usage, technology is reshaped (e.g. by user feedback). Evaluation is cyclical as a continuous, reflexive process.
  3. The conditions for implementation must be taken into account right from the start. Potential implementation issues should be identified and accounted for.
  4. The catalytic effect of eHealth development on healthcare organization in inherent to the eHealth development process.
  5. Via persuasive techniques, eHealth technologies can be designed to match user profiles, and to motivate or inspire patients to engage in self-management
  6. The added value of eHealth to health care and society should be assessed with advanced and holistic methods from multiple sources, using a mixed-methods research design.


This is a highly cited paper that intends to guide the development of eHealth technologies (not oriented to med ed however). It is based on the outcomes of the reviewed frameworks, on empirical insights, and on progressive insights obtained from discussing the frameworks with other researchers. Integrating persuasive health technology theories with a managerial approach (business modeling) makes this paper comprehensive and unique. Case studies are presented to bridge the theory to practice. Overall, a well-positioned and persuasive framework. 4/5 Checks.