Investigating the barriers and facilitators to implementing an eHealth innovation into a resource-constrained setting: A South African case study

eHealth describes any healthcare innovation that makes use of information and communication technology. The implementation of eHealth into developing countries has positive impacts on their health systems. There are numerous healthcare benefits associated with eHealth innovations, such as an increase in equity, efficiency and timeliness. However, without good implementation and technology transfer practices these benefits do not materialize or are temporary. In this paper, the barriers and facilitators to successfully and sustainably implementing an eHealth innovation into a developing country's health system are investigated. Specifically, this paper investigates the implementation of an audiology eHealth innovation into a resource-constrained setting in South Africa. The investigation was conducted using a case study and was structured according to the concepts from the Conceptual Health Innovation System framework (institutions, knowledge, relations and networks, actors, resources and innovation). The barriers and facilitators identified during the investigation were analysed and categorized into the appropriate health level: community, healthcare provider, district or national level; and recommendations for future eHealth implementation programs were discussed. This paper aims to inform stakeholders who are involved with eHealth development and implementation in developing countries on the factors that should be considered to ensure success and sustainability when implementing eHealth. This study contributes to the knowledge on health innovation management and promotes improved access to eHealth.