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      Academia–industry digital health collaborations: A cross-cultural analysis of barriers and facilitators

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          Abstract

          Background

          Development and uptake of digital health technologies benefit from cross-sectoral efforts from academia and industry. Our study aims to identify the barriers and facilitators associated with academia–industry collaborations in digital health in middle- and high-income countries.

          Methods

          Trained personnel conducted semi-structured interviews with 23 stakeholders who were active in industry, academia or both. Stakeholders were based in middle-income countries (including China) and high-income countries (including the United States) as defined by the World Bank. Interviews were conducted in the stakeholder’s language of choice (Chinese, n = 12; English, n = 11). Qualitative interview questions elicited perspectives on stakeholders’ experience with academia–industry collaboration, challenges faced, and factors that facilitated the process. Interviews were audiotaped, transcribed verbatim, thematically coded by bilingual coders and analyzed using inductive content analysis.

          Results

          Stakeholders in both academia and industry identified complementary roles, authentic communication between partners, and clearly outlined goals or expectations prior to the collaboration as primary facilitators for success. Misaligned goals or expectations, differences in timelines for productivity and difficulties balancing expectations for business outcomes versus generation of scientific evidence were identified as primary barriers. Stakeholders in high-income countries reported inauthentic communication as a significant barrier to collaboration, whereas those in middle-income countries did not.

          Conclusion

          Outlining and communicating openly about goals and expectations for timeline and priorities as well as establishing complementary roles will facilitate fruitful academia–industry collaborations in the future. Best practices for communication styles may be dependent on the cultural setting, and thus should be adopted accordingly.

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          Most cited references11

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          Why is it difficult to implement e-health initiatives? A qualitative study

          Background The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers -- the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives. Methods We used a case study methodology, using semi-structured interviews with implementers for data collection. Case studies were selected to provide a range of healthcare contexts (primary, secondary, community care), e-health initiatives, and degrees of normalization. The initiatives studied were Picture Archiving and Communication System (PACS) in secondary care, a Community Nurse Information System (CNIS) in community care, and Choose and Book (C&B) across the primary-secondary care interface. Implementers were selected to provide a range of seniority, including chief executive officers, middle managers, and staff with 'on the ground' experience. Interview data were analyzed using a framework derived from Normalization Process Theory (NPT). Results Twenty-three interviews were completed across the three case studies. There were wide differences in experiences of implementation and embedding across these case studies; these differences were well explained by collective action components of NPT. New technology was most likely to 'normalize' where implementers perceived that it had a positive impact on interactions between professionals and patients and between different professional groups, and fit well with the organisational goals and skill sets of existing staff. However, where implementers perceived problems in one or more of these areas, they also perceived a lower level of normalization. Conclusions Implementers had rich understandings of barriers and facilitators to successful implementation of e-health initiatives, and their views should continue to be sought in future research. NPT can be used to explain observed variations in implementation processes, and may be useful in drawing planners' attention to potential problems with a view to addressing them during implementation planning.
            • Record: found
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            WeChat: social and political development of China’s dominant messaging app

              • Record: found
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              Conversing across cultures: East-West communication styles in work and nonwork contexts.

              Four experiments provided evidence that East-West differences in attention to indirect meaning are more pronounced in work settings compared with nonwork settings as suggested by prior research on Protestant relational ideology. Study 1 compared errors in interpreting indirect messages in work and nonwork contexts across three cultures. Studies 2 and 3 examined differences in self-reported indirectness with coworkers versus nonwork acquaintances across three cultures controlling for variation in individualism--collectivism. Study 4 examined self-reported indirectness in bicultural managers and experimentally manipulated the salience of Western versus Eastern culture. The results showed that Americans, but not East Asians, were less attentive to indirect cues in work than nonwork settings and that East-West differences in indirectness were greater in work than nonwork settings.

                Author and article information

                Journal
                Digit Health
                Digit Health
                DHJ
                spdhj
                Digital Health
                SAGE Publications (Sage UK: London, England )
                2055-2076
                26 September 2019
                Jan-Dec 2019
                : 5
                : 2055207619878627
                Affiliations
                [1 ]Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
                [2 ]Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
                [3 ]ACCESS Health International, Shanghai, China
                [4 ]Duke Kunshan University, Kunshan, China
                [5 ]Duke Global Digital Health Science Center, Duke University, Durham, USA
                [6 ]Duke University School of Medicine, Durham, USA
                [7 ]Duke Global Health Institute, Durham, USA
                Author notes

                Chelsea Liu and Shuai Shao contributed equally to this article.

                [*]Janet Prvu Bettger, DUMC 2919, 40 Duke Medicine Circle, Department of Orthopaedic Surgery, Room 5339, Durham, NC 27710, USA. Email: janet.bettger@ 123456duke.edu Lijing L Yan, Duke Kunshan University, 8 Duke Avenue, Kunshan, Jiangsu 215316, China. Email: lijing.yan@ 123456dukekunshan.edu.cn Twitter: @chelsealiu96
                Author information
                https://orcid.org/0000-0001-9942-9955
                Article
                10.1177_2055207619878627
                10.1177/2055207619878627
                6767742
                31632684
                cd0bc6a7-d9db-4036-9390-76106e528bb7
                © The Author(s) 2019

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 4 February 2019
                : 30 August 2019
                Categories
                Original Research
                Custom metadata
                January-December 2019

                intersectoral collaboration,knowledge translation,telemedicine,global health,qualitative

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