How do domain diversity and healthcare system assumptions shape implementation research? A systematic review of theories, models, and frameworks for health digitalization
Abstract
Introduction: Health digitalization entails a complex array of actors and roles, including healthcare stakeholders and commercial digital-health innovators. The implementation of digital health innovations (DHIs) is notoriously prone to failure. Consequently, many theories, models, and frameworks (TMFs) have been developed to explain or guide the process of health digitalization. Depending on their scholarly origins, these TMFs differ in their perspective, origin, and terminology, leading to knowledge fragmentation and confusion. The aim of this review was to create an overview of the available TMFs, bringing together and clarifying different perspectives of healthcare stakeholders and innovators during the DHI life cycle.
Methodology: This study focused on TMFs describing, explaining, predicting, or prescribing parts of the innovation pathway considering influential factors and actors. Three databases (PubMed, EMBASE, and Web of Science) were searched using the aid of an information specialist in February 2025. We identified relevant keywords for the search by extensively reviewing eHealth and health digitalization literature. Studies were eligible for inclusion if they were published after 2000, written in English, and presented a new or significantly adapted TMF empirically tested in healthcare settings involving a commercial DHI. Studies applying only a known TMF without contextual adaptation or a DHI in the prototype phase were excluded.
Results: From the 4628…
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