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Digital transformation and rural healthcare disparities: A mixed-methods approach in India

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  • Devi, Yashoda
  • Koshta, Nitin
  • Pendyala, Sastry Sarath

Abstract

Healthcare disparity is a major issue for Universal Health Coverage (UHC) faced by countries across the globe. It results in hardship for people living in rural areas who need healthcare services, ultimately impeding their right to health. A key digital transformation component, 'Telemedicine,' has the potential to reduce this healthcare disparity by offering virtual consultation, diagnosis, and treatment, thus leading to better healthcare access. However, research and practice on telemedicine adoption in rural healthcare systems (RHS) is nascent. The present study addresses this issue by examining the barriers to telemedicine adoption and mitigation strategies through a mixed-method study of India's RHS. In the first phase, the Grey Decision Making Trial and Evaluation Laboratory (Grey-DEMATEL) method is used, which identifies seventeen barriers that impede telemedicine adoption in RHS and unearths the causal relationship between them. In the second phase, a qualitative approach is used, which helps propose barrier mitigation strategies under three heads: Patient Acceptance, Physician Buy-in, and Policy Support, referred to as the "3P framework". A total of 10 strategies are proposed under this 3P framework to strengthen the RHS. The study results provide valuable insights to policymakers and decision-makers working towards healthcare digital transformation, UHC, and improving RHS.

Suggested Citation

  • Devi, Yashoda & Koshta, Nitin & Pendyala, Sastry Sarath, 2025. "Digital transformation and rural healthcare disparities: A mixed-methods approach in India," Technovation, Elsevier, vol. 140(C).
    • Handle: RePEc:eee:techno:v:140:y:2025:i:c:s0166497224002153
    DOI: 10.1016/j.technovation.2024.103165
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    as
    1. Luthra, Sunil & Govindan, Kannan & Mangla, Sachin Kumar, 2017. "Structural model for sustainable consumption and production adoption—A grey-DEMATEL based approach," Resources, Conservation & Recycling, Elsevier, vol. 125(C), pages 198-207.
    2. Shounak Pal & Baidyanath Biswas & Rohit Gupta & Ajay Kumar & Shivam Gupta, 2023. "Exploring the factors that affect user experience in mobile-health applications : A text-mining and machine-learning approach," Post-Print hal-04325651, HAL.
    3. Khodadad-Saryazdi, Ali, 2021. "Exploring the telemedicine implementation challenges through the process innovation approach: A case study research in the French healthcare sector," Technovation, Elsevier, vol. 107(C).
    4. Arenas Gaitán, Jorge & Ramírez-Correa, Patricio E., 2023. "COVID-19 and telemedicine: A netnography approach," Technological Forecasting and Social Change, Elsevier, vol. 190(C).
    5. Kautish, Pradeep & Siddiqui, Mujahid & Siddiqui, Aaliyah & Sharma, Veenu & Alshibani, Safiya Mukhtar, 2023. "Technology-enabled cure and care: An application of innovation resistance theory to telemedicine apps in an emerging market context," Technological Forecasting and Social Change, Elsevier, vol. 192(C).
    6. Ankur Chauhan & Suresh Kumar Jakhar & Charbel Jose Chiappetta Jabbour, 2022. "Implications for sustainable healthcare operations in embracing telemedicine services during a pandemic," Post-Print hal-03598767, HAL.
    7. Wang, Jian-Jun & Zhang, Xinmou & Shi, Jim Junmin, 2023. "Hospital dual-channel adoption decisions with telemedicine referral and misdiagnosis," Omega, Elsevier, vol. 119(C).
    8. Tinglong Dai & Sridhar Tayur, 2022. "Designing AI‐augmented healthcare delivery systems for physician buy‐in and patient acceptance," Production and Operations Management, Production and Operations Management Society, vol. 31(12), pages 4443-4451, December.
    9. Cui, Li & Chan, Hing Kai & Zhou, Yizhuo & Dai, Jing & Lim, Jia Jia, 2019. "Exploring critical factors of green business failure based on Grey-Decision Making Trial and Evaluation Laboratory (DEMATEL)," Journal of Business Research, Elsevier, vol. 98(C), pages 450-461.
    10. Lu, Wei & Hou, Hongli & Ma, Rui & Chen, Haotian & Zhang, Ran & Cui, Fangfang & Zhang, Qian & Gao, Yacong & Wang, Xinpu & Bu, Caihong & Zhao, Jie & Zhai, Yunkai, 2021. "Influencing factors of patient satisfaction in teleconsultation: A cross-sectional study," Technological Forecasting and Social Change, Elsevier, vol. 168(C).
    11. Zhang, Mengdan & Zhang, Chonghui & Shi, Qiule & Zeng, Shouzhen & Balezentis, Tomas, 2022. "Operationalizing the telemedicine platforms through the social network knowledge: An MCDM model based on the CIPFOHW operator," Technological Forecasting and Social Change, Elsevier, vol. 174(C).
    12. Pal, Shounak & Biswas, Baidyanath & Gupta, Rohit & Kumar, Ajay & Gupta, Shivam, 2023. "Exploring the factors that affect user experience in mobile-health applications: A text-mining and machine-learning approach," Journal of Business Research, Elsevier, vol. 156(C).
    13. Cannavacciuolo, Lorella & Capaldo, Guido & Ponsiglione, Cristina, 2023. "Digital innovation and organizational changes in the healthcare sector: Multiple case studies of telemedicine project implementation," Technovation, Elsevier, vol. 120(C).
    14. Kannan Govindan & Aditi & Jyoti Dhingra Darbari & Arshia Kaul & PC Jha, 2021. "Structural model for analysis of key performance indicators for sustainable manufacturer–supplier collaboration: A grey‐decision‐making trial and evaluation laboratory‐based approach," Business Strategy and the Environment, Wiley Blackwell, vol. 30(4), pages 1702-1722, May.
    15. Hessam Bavafa & Sergei Savin & Christian Terwiesch, 2021. "Customizing Primary Care Delivery Using E‐Visits," Production and Operations Management, Production and Operations Management Society, vol. 30(11), pages 4306-4327, November.
    16. Galetsi, Panagiota & Katsaliaki, Korina & Kumar, Sameer, 2023. "Exploring benefits and ethical challenges in the rise of mHealth (mobile healthcare) technology for the common good: An analysis of mobile applications for health specialists," Technovation, Elsevier, vol. 121(C).
    17. Chandwani, Rajesh & De, Rahul & Dwivedi, Yogesh K., 2018. "Telemedicine for low resource settings: Exploring the generative mechanisms," Technological Forecasting and Social Change, Elsevier, vol. 127(C), pages 177-187.
    18. Kumar, Shashank & Raut, Rakesh D. & Agrawal, Nishant & Cheikhrouhou, Naoufel & Sharma, Mahak & Daim, Tugrul, 2022. "Integrated blockchain and internet of things in the food supply chain: Adoption barriers," Technovation, Elsevier, vol. 118(C).
    19. Duarte, Paulo & Pinho, José Carlos, 2019. "A mixed methods UTAUT2-based approach to assess mobile health adoption," Journal of Business Research, Elsevier, vol. 102(C), pages 140-150.
    20. Pandey, Jatin & Gupta, Manish & Behl, Abhishek & Pereira, Vijay & Budhwar, Pawan & Varma, Arup & Hassan, Yusuf & Kukreja, Priyam, 2021. "Technology-enabled knowledge management for community healthcare workers: The effects of knowledge sharing and knowledge hiding," Journal of Business Research, Elsevier, vol. 135(C), pages 787-799.
    21. Saifur Rahman Chowdhury & Tachlima Chowdhury Sunna & Shakil Ahmed, 2021. "Telemedicine is an important aspect of healthcare services amid COVID‐19 outbreak: Its barriers in Bangladesh and strategies to overcome," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(1), pages 4-12, January.
    22. Haenssgen, Marco J., 2018. "The struggle for digital inclusion: Phones, healthcare, and marginalisation in rural India," World Development, Elsevier, vol. 104(C), pages 358-374.
    23. Lussier, Bruno & Philp, Matthew & Hartmann, Nathaniel N. & Wieland, Heiko, 2021. "Social anxiety and salesperson performance: The roles of mindful acceptance and perceived sales manager support," Journal of Business Research, Elsevier, vol. 124(C), pages 112-125.
    24. Chauhan, Ankur & Jakhar, Suresh Kumar & Jabbour, Charbel Jose Chiappetta, 2022. "Implications for sustainable healthcare operations in embracing telemedicine services during a pandemic," Technological Forecasting and Social Change, Elsevier, vol. 176(C).
    25. Sims, Julian M., 2018. "Communities of practice: Telemedicine and online medical communities," Technological Forecasting and Social Change, Elsevier, vol. 126(C), pages 53-63.
    26. Mathiyazhagan, Kaliyan & Agarwal, Vernika & Appolloni, Andrea & Saikouk, Tarik & Gnanavelbabu, A, 2021. "Integrating lean and agile practices for achieving global sustainability goals in Indian manufacturing industries," Technological Forecasting and Social Change, Elsevier, vol. 171(C).
    Full references (including those not matched with items on IDEAS)

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