Questionnaire

Sai Sindhura Siram

224769

Harrisburg University

Table of Contents  Table of Contents 2 Abstract 3 Introduction 4 Importance of E-Commerce in Healthcare Sector 5 I. Business to Business 5 II. Business to Consumer 5 III. Consumer to Consumer 5 Significance 6 Research Question 7 Justification 8 Literature Review 10 Importance of e-commerce in health sector 11 E-commerce in health care supply chain management 12 E-consultation Services 14 Challenges of e-commerce in health sector 16 Methods Presentation Analysis 18 Study Design : 18 I. Case studies 18 II. Interviews, Search strategies, Close-out surveys, Centralized system and Champlain Base system 18 III. Focus on Effectiveness and Convincing nature 18 Methodology 24 Sample population 24 Data collection 25 Data analysis 27 Expected outcome 28 Concluding Sections 29 Limitations 29 Proposed Timeline, 29 Conclusions/Projections 29 References 30

The purpose of the paper is to contribute on the introduction of e-commerce in health sector, its importance and the necessity in healthcare and to help identify the challenges, gaps and the unmet demands of heath care by e-commerce technologies. E-commerce technologies have proven to be important and helpful in health sector. Though e-commerce technologies present great potential and empowerment of healthcare for the implemented initiatives, the area still faces a great challenge in its remote operation and there are unmet demands. Digital divide is amongst the many challenges facing the area. The paper uses an interpretive paradigm in its research design and data collection methods. Purposive sampling is used as a sampling technique to reach the target population. Web-based questionnaires and direct observation are the data collection methods used to inform the research which are most convenient. The two methods are intended to complement each other and influence a more accurate data finding. In conclusion, e-commerce is very essential in health care and helps improve both its product and service industry though there remain challenges in figuring out the most successful implementation of e-health care systems with minimal failure.

The continuous change in global climate and rise in pollution have created a massacre global condition throughout the world. This has also led to rise of global warming at an exponential rate. All these factors have accumulated and resulted in evolution of natural conditions that are pushing human body to its limits. This has resulted in sharp increase in the demand for healthcare support and other attributes related to healthcare industry. In order to overcome this challenge related to the healthcare requirements and fulfil the gap of the rising demand for healthcare needs throughout the globe, the healthcare industry opened up new strategic approach to meet the demand by the introduction of E-Commerce platform in the field of healthcare. ("E-commerce and its role in the healthcare sector - The Care Issue", 2019).

Keywords: Global change, demand for health care, purpose of E-Commerce

E – Commerce or electronic commerce is platforms across the internet forum that help people acquire goods and services delivered to the door steps with order being placed from the comfort of the home. The E-Commerce platform usually functions across three different entity junctures they are as follow:

Even though, the healthcare structure is using the electronic functions in all the three different entity junctures. In this paper we are going to focus on the operational entity of e-commerce platform in healthcare from the perspective of business to consumer aspect. The reason for selection on focusing on a particular metrics of operation is to get more insightful perspective of impact e of E-Commerce platform in healthcare industry. ("E-commerce and its role in the healthcare sector - The Care Issue", 2019).

Healthcare industry majorly focuses on service and products that could be of use and serve the purpose of the patient, moving them towards a better health. However, there are certain aspects of healthcare industry that plays a huge role as a follow up treatment for the patient. In order to fulfil the requirement of those demand and also the rising gap of healthcare requirement related to other products E-Commerce industry has played a huge role in the field of healthcare. (Caldbick, 2001)

The purpose of the thesis is to understand how E-Commerce platform has played a major role in the healthcare sector and have been able to constantly fulfil different gap that healthcare industry faces from time to time. In order to find detailed understanding of the topic, the thesis will cover grounds on the e-commerce background as well as healthcare industry, further it will also focus on learning from usage of e-commerce platform in development of the healthcare, and also meet the demand of the people related healthcare issues. In order to carry forward the research in the paper a survey method will be used across employees of the healthcare sector and consumer who uses E-Commerce platform for their healthcare requirements. On completion of the survey and based on the understanding of the present structure and operation of the E-commerce platform in the healthcare industry, it would be possible to define the room for expansion of e-commerce platform in healthcare in order to overcome other challenges as well related to the field of the healthcare. (Caldbick, 2001)

The study will provide us with a thorough introspection on the e-commerce platform and healthcare platform and how the embracing of both the platform has been able to cut down on the gap of the rising demand in the healthcare industry. The paper will further help cover ground on different healthcare services and products that are presently not available across the e-commerce platform in spite of customer demand.

This will help us draw metrics on how those products and services can be implemented in the e-commerce platform in the future and also the different measures that need to be taken in order to ensure that the performance of this platform improves over time, to ensure more customers are driven towards the usage.. Further, the paper will also reflect on intricate details on the functionality of e-commerce platform in the healthcare in order to understand the present scenario and structure of the e-commerce platform and how the different product and services are being passed on to the end customer. ("E-Commerce in Healthcare: Changing the Traditional Landscape", 2019)

The paper E-Commerce in healthcare industry has been a clinical turn around in the field of healthcare to provide assistance to patient. With presently numerous healthcare product and services available to the customer the gap between demand and products has been brought under relative control. However, with the rise in the global challenges these demands are again taking longer strides that are opening p proposition for other product and services to be made available to the customers. In order to ensure that such propositions are successfully laid out this paper look represents certain questions that are exclusive to the e-commerce in healthcare. (Graham, 2002) The questions that the paper is going to cover are as follow:

Is it necessary to introduce E-commerce to the healthcare platform? This question will undermine the details of why e-commerce platform was first introduced in healthcare sector

This question of what sectors that E-Commerce in healthcare covers will put a thorough insight on the different products and services that e-commerce platform covers in the field of healthcare

The question of what are the different challenges that healthcare sector faces with the present e-commerce platform to render their services will bring under light the different challenges that healthcare industries have to overcome on a regular basis in order to ensure they can render quality service and products to the patients as per their demand through the e-commerce platform.

This question of what the different challenges are that healthcare industry comes across in recent years pertaining to the global scenario would throw light on different health related issues that have recently cropped up because of global scenario and are again pushing the gap of demand against five supply of treatment for the patient

The question of what are the different services that are presently not being delivered by the healthcare industry across e-commerce platform would bring under light the prospect of expansion that healthcare industry would hold in the future related to its e-commerce platform and structural variation that is needed to be implemented in order to ensure that the product and services that are not being delivered in the present scenario can be made possible in the future.

The question of what are the different requisition of product and services that healthcare industry comes across from customers, but are not able to be made possible to provide the same to the customers, would bring under light the product and services that healthcare industry should look forward to fulfil in order to overcome the gap.

These research questions highlighted above will ensure that all grounds regarding the challenges of e-commerce platform in healthcare is covered along with the prospect of further expansion based on which the future research can be materialised in the field of e-commerce in healthcare.

The purpose of carrying out this research is to ensure that e-commerce platform can overcome the gap between the demand of healthcare product and service related the patients demand. Further the research questions will also throw light on explaining the different challenges that the healthcare industry has to come across from time to time in order to deliver the services and products across the E-Commerce platform.

This would ensure that a plot line can be drawn so that such challenges can be mitigated in the future in order to ensure a better product and service performance in the field. Lastly the research would open up the course of action for the future research in the field of E-Commerce in healthcare and also would provide how e-commerce platform can expand in order to ensure that it covers larger ground in the field of healthcare product and services in the future.

The research also focuses on understanding the changing demand of the different product and services related to e-commerce in healthcare so that serene layout can be drawn in order to ensure that those demands can be fulfilled in the future. This would bring under consideration the proper requisition for expansion how and in what ways the expansion can be achieved and materialised to fulfil the demand of the customers with changing world of the diseases. ("Technological growth in US healthcare - E - Commerce", 2019)

The research will ensure that E-Commerce platform plays a successful role in the healthcare industry in the future to come, putting the present scenario product and services as the pivotal for future research and expansion.

Healthcare remains an important part of every society and a vital feature of every successful country’s economy (Wickramasinghe & Schaffer, 2010). People need to be health in order to contribute their maximum potential to their country’s economy. A good healthcare results to a good economy in a country. Poor healthcare means a bad economy as people get sick and are unable to work and get the proper health care. A country with a poor healthcare makes investors stay away from it. Therefore, health sector is a very fundamental part of human living and survival (Wickramasinghe & Schaffer, 2010).

Healthcare entails the maintenance and the continued enhancement of health through the diagnosis, prevention and treatment of illnesses, injuries and it comprises physical and mental impairment. Health care includes care giving services as well for the old people and the sick and guidance and counselling for those with mental issues. The innovation brought about by the e-commerce in health care helps to improve the quality of access to healthcare services (Black et al., 2011). Ecommerce refers to the purchase and sell of goods through internet. Ecommerce in health care therefore aids in access of healthcare online which improves convenience, saves time, provides lower discounted prices and offers a wide range of products.

E-commerce in health care is utilized in providing consultancy services, pharmacy/telemedicine and caregiving services amongst many others. E-health is another word for ecommerce in the health sector (Black et al., 2011); it entails the use of electronic communication together with information technology to broadly avail medical information systems able to interconnect and communicate, it is the availability of medical informatics and telematics on online shop shelves. E-commerce on health sector is much more driven by medical non-professionals that is the patient’s needs (Black et al., 2011).

It is necessary to introduce e-commerce in health sector because E-health empowered healthcare has a potential to address key issues facing the health sector (Wickramasinghe & Schaffer, 2010). Some of the key pressing issues in the healthcare include: the increasing health care expenses, need for empowered consumers, need for easy health adaptability, more attention on prevention and focus on external factors such as finances and technology. Based on these issues the healthcare trends include a need for change in health insurance, healthcare standardization, technology planning and need for better healthcare services delivery.

The role of e-commerce in the health sector is devising a strategy that help meet trends in the sector through ensuring efficient, evidence-based, educational, ethical, enhanced quality, empowered patients, extended research and equitable health care. E-health involves application of different e-commerce technologies and infrastructures (Wickramasinghe & Schaffer, 2010) and most importantly the use of internet to necessitate health care practice. It entails the exploitation of information and technology to connect the health care providers with the patients and the government, it also entails educating and informing the consumers, the healthcare managers and professionals and trigger innovation in delivery and management of health care.

E-commerce in health care tackles efficiency which is possible through the reduction of the costs through improving communication between the healthcare facilities and establishments and the patients. Enhancing quality of the healthcare is another goal of e-commerce by not only reducing the costs but also ensuring its quality by making health diagnostic and therapeutic decisions. E-commerce empowers the patients as well by empowering them and availing new online avenues where they can access medical help and education (Wickramasinghe & Schaffer, 2010).

Electronic commerce famously known as e-commerce has been utilized in many organizations to aid in business and has been an area where many researchers are focusing on in the last 20 years. Regarding Business- to –Business (B2B), e-commerce encompasses utilization of internet-based technologies to support business transactions between firms in a supply chain (Sultanow et al., 2016).

Pharmaceutical industry is an example of health sector feature that has adopted e-commerce to manage its supply chain operations. Globally, the pharmaceutical sales are projected to reach $1.4 trillion by the year 2019 (Sultanow et al., 2016) which will be a remarkable increase from $870 million in 2013 (Sultanow et al., 2016). After United States, Europe is the second leading in the pharmaceutical sales owning 27% of the sales (Sultanow et al., 2016). The pharmaceutical industry has the following key players: manufactures, the wholesalers, pharmacies and lastly, point of care providers such as hospitals and clinics (Omachonu & Einspruch, N2010).

In Europe, the largest percentage of medication is distributed through a few national wholesalers and then through regional wholesalers who make the largest percentage of the suppliers. The role of wholesalers is ensuring assortment of medications, providing high medication stocks and timely and frequent supply and delivery to the pharmacies. In the supply chain management of healthcare in the traditional setting is to ensure quality (Wang et al., 2016). Quality is ensured by making the high of medications by the patients is met. Through a revelatory case study, Max Pharma (Sultanow et al., 2016) is a national pharmaceutical wholesaler in German which has adopted e-commerce to maintain high-quality of heath care.

One of the problems faced by the manufacturers and distributors is that all the drugs approaching their expiry dates ought to be destroyed and they suffer costs of the obsolete drugs. Ecommerce is a solution to obsolete inventory difficulties for Max Pharma since it came up with an e-commerce platform to help sell the short-dated drugs at discounted prices. Some customers also use the platform to order for other regular drugs but the sales of the short dated drugs cannot be compared; in this case the e-commerce platform helps both the wholesaler and the customer and saves them unnecessary costs.

However, the adoption of the e-commerce platforms should be done strategically in order to bear fruits, the adoption should not be out of competition pressure but as a response to a rising need and the company IT preparedness influences the sustainability of the platform. The success of this e-commerce platform can be traced to the (Technology, organization and environment) model. The Max Pharma teamed up with willing manufacturers to reach out customers in need of the drugs at lower prices through the distributors and the point-to-point sellers and in most occasions enabling the customers to make direct orders (Sultanow et al., 2016).

Therefore, health systems can adopt e-commerce to manage its supply chain through e-procurements through e-business platforms (Wickramasinghe & Schaffer, 2010). (Wang et al., 2016) E-commerce application in supply chain helps improve performance medical supply and distribution by ensuring timeliness and quality.

Ecommerce has necessitated consultation services through the implementation of e-consultation services that have helped to enhance the access to specialty services (Keely et al., 2013). E-consultation facilitates rapid response times and reduces the requirement for face to face consultations and appointments hence reducing the cost of physical movement. One benefit of the e-consultation services is the access to specialist’s advice in a better timely manner compared to the traditional face to face referral consultations. In addition, it helps to reduce the barriers of access to specialty services between the primary health care providers and patients (Keely et al., 2013).

Due to an increasing rise in the number of medical conditions requiring specialty advice, patients have to wait for the specialist advice before any recommendation on medication to be administered and sometimes the wait time to see a specialist can be very long, lasting up to even two months. However, provision of specialist’s healthcare services online eradicates that delay with responses just taking minutes (Keely et al., 2013). E-consultation is conducted through telephones, emails however secured web-based protected web applications are widely used to provide a meeting point for the specialist and the patient. The patients are also able to give feedback on the kind of service they received and if it pleased them, they can even refer other people (Keely et al., 2013).

Digital technology is a major driver of transformation in the health care sector by helping connect the patients to health services and data (Hollis et al., 2015). The advances in technology have empowered people to be able to communicate, share and obtain information through information and communication technology. For instance, the access to the internet through smartphones is doubling and many people own smartphones than before enabling them to buy goods and services in new ways through the online platforms (Hollis et al., 2015). Most importantly, some significant parts of the society have become familiar to using technology to perform various transactions comfortably. Health care is an important area which has not been left out too as people use mobile phones wireless and other remote monitoring devices to access its services.

Mental health care is one area that can be greatly empowered by e-commerce. Recent technology development such as sensors, on-line psychological therapy and remote video and mobile applications can help in e-consultation of mental health. For instance, the UK government has been encouraging its health professional to shift to remote consultations necessitated through video technology and replace it with face to face consultation (Hollis et al., 2015). E-health in mental health care empowers the mental health patients by giving them a wide variety of choices such the online psychological interventions which can help the younger people who find it difficult to access the traditional health care services, since the younger generation is the greatest user of internet services they can use technology to access psychiatrists, get their diagnosis and monitoring session online and pay for the services online (Hollis et al., 2015).

Therefore, ecommerce in health sector empowers remote access to health care and eradicates the face to face discomfort during consultations through e-consultations.

Despite the potential in e-health sector, many e-health projects and initiatives established are prone to failure due to various challenges (Mettler & Eurich, 2012). One of the challenges in this sector is the lack of understanding of the business logic behind the e-commerce complex environment. For instance, there is pressure in demand for quality health care with reduced healthcare costs (Mettler & Eurich, 2012). Additionally, in the developing countries there is increase in the aging populations and inadequate qualified health workers, high movement of patients and very high expectations which challenge e-commerce in health care. Digital divide is another challenge of e-commerce which is the gap between those who can access computer and internet services and those who cannot meaning that there is a group of people who face barriers in access e-health care (Hollis et al., 2015).

Keeping up with the evolving field of technology is another challenge of adopting e-commerce in health (de Lusignan, 2015). Lacking the right information at the right time to manage heath care is another challenge of e-health. Inadequate exploitation of evidence based theoretical frameworks when implementing Tele-informatics is another challenge which prevent sound decision making when managing health care through e-health systems (de Lusignan, 2015).

Privacy and trust are another key issue facing e-commerce application in health sector. Issues of consent, trust and privacy remain important in sharing of medical data (Laurenza et al., 2018). Additionally, in areas of e-services such as e-consultation entailing remote diagnosis and treatment it requires great trust such that the patients will be satisfied with the services they pay for. Contrary, the caregiver needs to be sure after giving out the health care services the consumers purchase (Laurenza et al., 2018). The proper regulation of e-health applications by government is lacking to provide invulnerable e-health platforms. The rapid development of the chronic diseases is one area which is not well managed in e-health. The health practitioners report a challenge of being to manage multi-morbidity and provision of safe care (Laurenza et al., 2018).

In conclusion, e-commerce is very important in health sector and has played a great role of availing medical services to remote areas where medical facilities and expertise is rare. The e-heath sector has greatly empowered the product and service industry in healthcare through the supply chain management and use of e-commerce to sell and buy medical products and services online. However, though the e-healthcare has such a great potential it faces various challenges.

The research will be based on the qualitative research approach since it seeks to establish how important e-commerce is to healthcare and why it should be adopted (Scotland, 2012). A qualitative research on the basis of the interpretive paradigm is based on opinions of the subjects which are then subject to interpretation by the researcher.

Sultanow and others (2016) uses revelatory case study analysis methodology to examine adoption of e-commerce in German oncology supply chain. The authors used the recommended case analysis practices which include use of multiple researchers, evidence and sources. The authors used interviews to collect data on the company and industry from top executives, press releases, e-commerce websites, company documents, consulting organizations, European Union, industry associations among other institutions.

The interview was conducted in German and transcribed into English. Information from the interviews were compared with theoretical information from literature and face validity verification done by one author. The authors intended to investigate on the cost cutting and efficiency improvement benefits attributed to adoption of e-commerce in the pharmaceutical sector, especially after the 2012 policy that denied the manufacturers ability to set prices and only allowed for negotiated prices. Such policy resulted to reduced profit margins and for companies to remain competitive, they had to device mechanisms to increase their sales at low cost and adoption of e-commerce is suitable.

The authors established that Germany is faced by pressure to improve efficiency and low costs for pharmaceutical products supported by policy change in 2012 as they are supposed to negotiate prices as opposed to earlier situation where they were price setters. The pharmaceutical sector in Germany, authors established have shifted to e-commerce in order to cater reduced profit margins and competition from new entrants. In addition, authors found that companies like Max Pharma have developed e-commerce solutions to sell short-dated oncology drugs at discounts. This helps the company to deal with obsolete inventory.

Max Pharma, authors realized have the only e-commerce systems for short-dated drugs motivated by changing environment rather than competition, experienced IT developers, business partner readiness. The systems have helped Max Pharma reduce costs, increase its global visibility, creation of new customer base and customer customization orders.

Since the authors used case study method, they did not have result presentation, only that they evaluated the factors based on literature review and other sources within the industry. The authors data can be subjective because and might fail to meet the required criteria to prove authenticity because they relied on a single case study and single country for their analysis on adoption of e-commerce. Though they touched on various factors and benefits of e-commerce in pharmaceutical sectors, it cannot be taken as conclusive results because they relied only on case study method.

More quantitative data is needed to achieve conclusive finding on the subject. Graphical and numeric presentation of how many orders and the profit margin Max Pharma makes from the sale of short-date drugs should be availed to help in making conclusion on the benefits of investing in the e-commerce sector. The qualitative arguments by the authors, however, can be used in the methods chapter because it gives guidance on the probable benefits of using e-commerce in the sector.

Black and colleagues (2011) investigated impact of e-health on safety and quality of health care. In their methods, the researchers established three categories for classifying e-Health technologies. The first category included managing, transmission and storing of data, second category related to clinical decision making support and the last category related to distant care facilitation. The authors then implemented methods on the relying on Cochrane Collaboration, Organization Programs and NHS services.

Authors utilized search strategies that helped map health care safety, e-Health interventions and quality to obtain relevant review published from 1997 to 2010. The researchers screened identification of reviews to 53 which they used because they supported the above categories selected. In category one, they included all electronic health records and other picture storing systems. In the second category, they included computerized physician or provider e-prescribing and order entry and in the third category, they used clinical information systems used in relation with e-Health technologies, support clinician, integrate clinical and population information.

Authors found that, most of the clinical claims concerning e-Health technology lacked empirical evidence. The authors found that the evidence base that supported e-Health technologies was inconsistent and weak and e-Health technologies cost effectiveness was insubstantial. The authors established that the many benefits could hardly be realized. On the contrary, the researchers found that introduction of new technologies in health care in most instances created new risks. Such risks include prescribers’ over-reliance on e-prescribing on clinical decision support or in other instances overestimating e-Health technologies functionality hindering practitioners’ performance. E-Health cannot depend on systems that have not evidence supporting the claims of their cost-effectiveness and patient outcome.

Although e-Health technologies have received much support, their lack of empirical evidence to support their much hyped benefits which result to large-scale funding. Even those e-Health technologies that have been identified as successful, less evidence exists to demonstrate that such tools have the capacity to remain successful beyond the mandate they were meant for.

The findings mean that e-Health technologies need to be evaluated based on broad set of factors stretching throughout the technology intended life cycle in order to maximize on the proposed patient outcomes and cost-effectiveness. Auditing existing e-Health technologies is also important because they can inform on future technology adoption.

Data presentation and analysis by the authors is relevant based on the retrieved reviews. Convenience sampling and selection of methodology is suitable for the kind of research the authors purposed in their scope. However, relying on evidence and information from other authors cannot guarantee accurate information. Validation of the systems and the e-Health technologies used should be done for one to make solid conclusion on their cost effectiveness and patient outcomes.

Literature reviews sometimes deny authors authenticity and claim for their conclusion because they use secondary data that could be subjective. It is difficult to apply such methodology in the methods section because they lack validity and can only be used to guide in the possible methods available for use. The presentation offered by the authors is not convincing and they require to validate the technologies used to conclude that they are not cost effective nor do they improve patient outcome. All systems require validation to disqualify them or qualify them which is lacking from the researchers’ methodology.

Keely and others (2013) used close-out surveys to collect all e-consultations from April 2011 to June 2012. The utilization data that the authors collected included: specialist response, time required for response by specialist and the submitted number of e-consultation. The close-out survey was used to determine the perceived benefits and the impact e-consultations had on health care delivery. Building the correspondence web on an existing web allowed for easy integration coupled with assured privacy after its impact assessment. The authors also used standardized electronic forms that were patient-specific for specialty services.

The setting of the system allowed for specialist notification and interaction with patients either through asking for more information or offering recommendation without face-to-face interaction or even recommend referral with continuation notification for both specialists and patients. The content of the electronic form was updated based on feedback from interest from specialists and primary care givers. The authors collected and coded all prospective e-consultation during the specified period. The survey results compilation only included individuals with more than 10 completed e-consultations.

The authors’ presentation of the results was systematic using tables, percentages and graphs from the surveyed participants meeting the set criteria. The results and presentation from the authors offers a quantitative analysis of e-consultation use. Their findings are informative because it is statistically verifiable and had set out variables. Authors’ conclusion such as e-consultation benefits for patients and providers are supported by evidence from the collected and analysed data.

The authors’ use of centralized system in which they determined which services required e-consultations and which service required face-to face consultations helped to screen information and data to eradicate any possible bias and errors. From their analysis, the authors were able to identify that e-consultation has resulted to about 50% face-to-face consultation. The authors reported satisfaction, short response time and utilization for using e-consultation as opposed to face-to-face consultation.

The author results also indicate that use of Champlain Base system could result to satisfactory e-consultation services with potentials of eliminating the need for face-face consultation and improved access to specialty service with rapid response. The e-consultation provides an opportunity for reduced time wastage in seeking health care. The presentation adopted by the authors is effective and convincing since the values they give can be verified from their graphical presentations. Decisions and conclusions from the authors is also reliable because it is based on analytical data.

It is a suitable methodology that can be incorporated in the methods chapter of this proposal. The methodology used by the authors provide a better mechanism of testing e-commerce systems used in health care setting. Relying on literature review without validating the system cannot provide reliable conclusion. The fact that the researchers subjected their e-consultation system to validation only improves their claim on usability of the system to solve consultation problems. Face to face consultation are time consuming and expensive but e-consultation can reduce the cost of health care and time needed to address issues and act on emergencies.

The research will be informed through an interpretive paradigm. An interpretive paradigm seeks to understand the world or the area of study from a subjective point of view of the participants and it uses meaning oriented methodologies for collecting data which portray a subjective relationship between the researcher and the participants (Scotland, 2012). Such methods include observation, interviews and questionnaires. The paper aims at establishing the importance of e-commerce in health care and find out the various areas in healthcare where e-commerce is applied. The research will be based on the qualitative research approach since it seeks to establish how important e-commerce is to healthcare and why it should be adopted (Scotland, 2012). A qualitative research on the basis of the interpretive paradigm is based on opinions of the subjects which are then subject to interpretation by the researcher.

Sampling research method will be utilized in which purposeful sampling technique will be conducted on the target population. The aim of the research is survey how important ecommerce adoption in health care is to both the patients and the primary care providers and identify the various challenges and gaps in the e-health sector. The target population entails the primary care providers and patients who have used an e-commerce platform to provide or to access health care services. (Gentles et al., 2015)Sampling method enables researchers to come up with a conclusive information about a certain population based on results from a subset of the population without necessarily having to investigate the entire population. What is fundamental is that the sampled population represent the entire populations of those accessing e-health care services. The sample population will be selected through purposive sampling strategy which entails selecting information rich cases for the purposes of the in depth analysis. Purposive sampling strategy involves picking participants in regard to how much knowledge they have concerning the area of study (Gentles et al., 2015). Purposive sampling is non-probability sampling technique which is subjective in nature and which is considered limited when representing the population being researched about. However, purposive sampling technique is essential when the researcher has limited resources for instance, in this case the technique will be very relevant since the targeted population is not directly found and the e-commerce platforms are just not adopted in all health care stakeholders. Therefore, the researcher will be required to identify the various stakeholders in supply chain management and e-consultation services and engage them in the research. The researcher will therefore choose at least five areas where e-health is operational and engage them .the survey forms will be distributed to at least 200 participants with an option of choosing to participate or not. The paper will then assess the submitted questionnaires against those not submitted.

Questionnaires method will be administered to aid in data collection; a survey will be conducted through answering the provided set of questions which will be informed by the research questions. Direct observation will be another method that will be utilized. The questionnaires will be web-based considering that the target population will be active users of technology in making transactions and accessing the e- services in the health (Van et al., 2010). A web based questionnaire has advantages over the traditional one which involves a paper and a pen which can be boring and tedious as well as participants have to write. The web based questionnaires can be shared directly to the participants or liaise with the owners of the e-commerce platforms in the health sector to add the survey forms after some of the services where the users can fill and submit. In addition, liaising with the key stakeholders in the e-commerce remains still necessary for the survey to be successful since independently the researcher is not able to interact with the stakeholders of the e-health (Van et al., 2010). Therefore, for the survey questionnaire forms to reach the target population will require great cooperation of the e- commerce platforms owners.

The decision to use the web-based questionnaires as a form of online survey is good because of a couple of advantages (Van et al., 2010). . Online survey provide ease of data gathering as they facilitate easy distribution to a greater number of people at just a click and eradicates the tedious process of moving from one place to another dropping the survey forms. Additionally, on-line surveys are cost efficient, they greatly reduce costs; in the traditional setting, completing a survey requires expenditure of more than a thousand dollars especially if the number of participants is large; however, in online surveys through internet necessitates a low-cost and fast data collection without much effort (Van et al., 2010). . No paperwork required or other costs of the face to face surveys. The online surveys are automated and just require the participants to input their answers online while connected in the internet and the inputted information is stored in a database for retrieval by the researcher. Online survey facilitate increase in response rates amongst the respondents because it allows them convenience through filling out the questionnaire at their own pace and time without worrying about data loss, on-line surveys allow the participant to resume whenever they feel like. Lastly, online surveys offers flexibility and allows conduction of complex data surveys since they are automated the participants do not get easily discouraged. However, online surveys have some limitations in that they do not prevent fraud surveys where people do not give helpful information to help the research but just answer for the sake of it (Krosnick, 2018).

Comparing questionnaires to other forms of data collection such as interviews they have a couple of advantages (Krosnick, 2018). Questionnaires are not expensive in terms of time consumed and cost. They are also practical and can reach a large number of people unlike the interviews which are tedious and engage one participant at a time therefore, consuming lots of time. Questionnaires are scalable and offer comparability hence giving the researcher a capability to measure change or a certain variable. They offer a quick way to get results and allow easy analysis and representation of data. Questionnaires also facilitate the respondent anonymity a very valuable aspect of data collection where respondents wish to remain anonymous. Moreover, questionnaires do not have any time constraints especially the online ones, they allow the participants to respond anytime they wish. Some of the disadvantages of questionnaires include dishonest answers, left out questionnaires which respondents leave unanswered. Questionnaires are unable to convey feeling or emotions and hey can be tedious hence, it is important that the questionnaire survey has a standard length, not too short and not too long (Krosnick, 2018). If it too short it won’t provide a considerable information and it is too long it may discourage the respondents. Therefore, weighing out the advantages of the questionnaires over its disadvantages, the web-based questionnaires are reliable and convenient.

Direct observation is another data collection method that will be employed just to complement the online questionnaires (Brandts & Charness, 2011). Direct observation will only be employed on the e-health systems that have feedback systems which allow both the primary care providers and the patients to share their experiences and based on the feedback the researcher is able to assess the importance of e-commerce in health sectors and be able to identify any gaps and any expressions of dissatisfaction or unmet demands. The advantages of the direct observation is its simplicity and the gathering of the first-hand information (Brandts & Charness, 2011).

The obtained data will be evaluated through a semantic differential scale; the semantic differential scale allows the analysis of perceptions of human mind in multidimensional manner and by giving each statement assessment a scale based on two opposite adjectives offering a range such as from bad to good with increasing points as the scale approaches the positive side (Takahashi et al., 2016). The online questionnaire should allow the participants to tell the degrees of their mind perception concerning e-health through a five point Likert scale (Takahashi et al., 2016). Semantic differential analysis will then be applied to analyse the different degrees of the mind perceptions (Takahashi et al., 2016). The obtained data can be tabulated and represented on graphs and charts for comparison purposes. The data analysis and the comparison of the data presented on the questionnaires will allow determination of the key purpose of the research on the importance of e-commerce in health care, the levels of satisfaction amongst the users of the e-commerce to access health care, the challenges, the gaps and the prospect areas and new areas of health services left out.

The finding of the research after the data collection and analysis should reveal the importance of embracing e-healthcare and portray people’s appreciation of it compared to the traditional health care system. It is expected that there will be dissatisfaction as well due to the unmet demands and the challenges in adoption of information and communication technology. It is expected that through the questionnaire survey there will be a positive feedback on the benefits of e-healthcare and also a provision of insights on other possible gaps to be addressed from a consumer perspective which can help inform the health care providers to enhance their e-commerce technologies.

Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., & Sheikh, A. (2011). The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS medicine, 8(1), e1000387. Brandts, J., & Charness, G. (2011). The strategy versus the direct-response method: a first survey of experimental comparisons. Experimental Economics, 14(3), 375-398. Caldbick, M. (2001). E-Commerce Legislative Initiatives in Canada: Implications for Healthcare Institutions. Healthcare Quarterly, 4(4), 59-64. doi: 10.12927/hcq..17438 De Lusignan, S. (2015). Unleashing the power of e-Health requires the development of an evidence base for interventions that improve care. J Innov Health Inform, 22(1), 143 E-commerce and its role in the healthcare sector - The Care Issue. (2019). Retrieved from https://thecareissue.jaga-me.com/ecommerce-healthcare-sector/ E-Commerce in Healthcare: Changing the Traditional Landscape. (2019). Retrieved from https://www.himss.org/e-commerce-healthcare-changing-traditional-landscape. Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American journal of theoretical and applied statistics, 5(1), 1-4. Graham, W. (2002). HealthPRO Electronic Commerce Alliance with Global Healthcare Exchange (GHX); A GPO Strategic Alliance with an Open Exchange Accelerates Electronic Commerce Benefits. Healthcare Quarterly, 6(1), 85-87. doi: 10.12927/hcq..16651 Gentles, S. J., Charles, C., Ploeg, J., & McKibbon, K. (2015). Sampling in qualitative research: Insights from an overview of the methods literature. The Qualitative Report, 20(11), 1772-1789. Hollis, C., Morriss, R., Martin, J., Amani, S., Cotton, R., Denis, M., & Lewis, S. (2015). Technological innovations in mental healthcare: harnessing the digital revolution. The British Journal of Psychiatry, 206(4), 263-265. Keely, E., Liddy, C., & Afkham, A. (2013). Utilization, benefits, and impact of an e-consultation service across diverse specialties and primary care providers. Telemedicine and e-Health, 19(10), 733-738. Krosnick, J. A. (2018). Questionnaire design. In The Palgrave Handbook of Survey Research (pp. 439-455). Palgrave Macmillan, Cham. Laurenza, E., Quintano, M., Schiavone, F., & Vrontis, D. (2018). The effect of digital technologies adoption in healthcare industry: a case based analysis. Business Process Management Journal, 24(5), 1124-1144. Mettler, T., & Eurich, M. (2012). A “design-pattern”-based approach for analyzing e-health business models. Health Policy and Technology, 1(2), 77-85. Omachonu, V. K., & Einspruch, N. G. (2010). Innovation in healthcare delivery systems: a conceptual framework. The Innovation Journal: The Public Sector Innovation Journal, 15(1), 1-20. Scotland, J. (2012). Exploring the Philosophical Underpinnings of Research: Relating Ontology and Epistemology to the Methodology and Methods of the Scientific, Interpretive, and Critical Research Paradigms. English language teaching, 5(9), 9-16. Sultanow, E., Chircu, A., & Chircu, F. (2016). E-commerce Adoption: A Revelatory Case Study in the German Oncology Pharmaceutical Supply Chain'. In Proceedings of the Conference on Information Systems Applied Research ISSN (Vol. 2167, p. 1508). Takahashi, H., Ban, M., & Asada, M. (2016). Semantic differential scale method can reveal multi-dimensional aspects of mind perception. Frontiers in psychology, 7, 1717. Technological growth in US healthcare - E - Commerce. (2019). Retrieved from https://www.ecommercetimes.com/story/83198.html Van Gelder, M. M., Bretveld, R. W., & Roeleveld, N. (2010). Web-based questionnaires: the future in epidemiology? American journal of epidemiology, 172(11), 1292-1298. Wang, C., Mao, Z., Johansen, J., Luxhøj, J. T., O'kane, J., Wang, J., & Chen, X. (2016). Critical success criteria for B2B E-commerce systems in Chinese medical supply chain. International Journal of Logistics Research and Applications, 19(2), 105-124. Wickramasinghe, N., & Schaffer, J. (2010). Realizing value driven e-health solutions. Report for IBM. Washington DC.

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