Theme Analysis

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DHA Integrative Review Project Prospectus Form Comment by miriam ross: Hi Kelly, good start to your study - we will discuss some ways to improve and strengthen your sections - I will be sending our an email.

(For Students that started the DHA program in Fall 2021 or after)

Students | Complete your DHA project planning using this form. This form must be completed exactly as instructed in the appendix to be approved. For additional information and resources, refer to the DHA Project Completion page. There are five sections on the form to complete that must be approved by your committee. The six sections include:

1. Research Problem

2. Purpose and Review Question

3. Framework

4. Significance

5. Research Alignment Table

6. Appendix (The appendix provides examples and instructions on how to complete this form)

Submit this completed form into MyDR for formal evaluation and feedback when your project mentor indicates that you are ready to do so.

Student’s Name Student ID | Click or tap here to enter text.

Program Submission Date

*Remember that your study focus must be within the realm of your program and specialization area.

Evaluators Only | Complete this section and provide feedback on responses and rubric scores in the form where noted.

Mentor’s Name | Click or tap here to enter text. Overall Assessment: Choose an item.

Co-Mentor’s Name | Click or tap here to enter text. Overall Assessment: Choose an item.

Working Title

(Click here for instructions and examples)

Provide a concise (aim for 12 words or fewer) working title for this study. (Be sure to include your HSO type and practice-based problem.)

Enhancing Telemedicine Services in Community Hospitals: Addressing Information management for improved outcome.

Section 1: Practice-based Problem

(Click here for instructions and examples)

Healthcare Services Organization (HSO) Type

With no more than 1-2 sentences identify and describe your selected HSO type.

Type: Rural Community Hospitals.

Description: These are non-profit or governmental medical institutions which are used as the main provider of healthcare services to geographically separated and underserved areas. They are characterized by special problems such as a lack of financial means, shortage of specialized clinical workforce, and poor technological provision (e.g., broadband connection).

HSO Problem of Interest

What is the healthcare services organization (HSO) problem of interest that prompted you to search the literature to find out more? Write only 1-2 complete sentences using a scholarly tone.

Problem: Rural community hospitals are facing the difficulty of utilizing telemedicine in an effective manner.

Context: The main issue is that the gap that existed between the potential of telemedicine to enhance access and the actualities of operations in implementing and managing the complex information systems that telemedicine needs to thrive is continuous.

Healthcare Administration Problem

In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.

Problem: Multifaceted information management issues in hospitals in rural communities continue to create operational inefficiencies and poor patient access.

Specific Issues: These problems include (1) insufficient user training and support among clinical staff, (2) issues of data security and patient confidentiality on digital platforms, (3) challenges on navigating regulatory and compliance issues, and (4) lack of interoperability of telemedicine platforms with the current electronic health records (EHRs).

Health Administration Research Domains

Which DHA research domain does your healthcare administration problem align with?

Primary Domain: Information Management (ACHE Domain 6).

Secondary Domain: Quality Improvement (ACHE Domain 8).

Justification: The issue lies in the application of managerial efficiency and clinical efficiency to be fostered by using hard and soft technologies to ensure the following: improved healthcare delivery and organizational performance (Quality Improvement).

Healthcare Administration Research Problem Justification Sources

Provide a minimum of 3 sources that clearly state in the conclusion or research findings of the published source that a healthcare administration problem currently exists.

Source 1

(Required)

Full APA Citation:

Hadian, M., Jelodar, Z. K., Khanbebin, M. J., Atafimanesh, P., Asiabar, A. S., & Dehagani, S. M. H. (2024). Challenges of Implementing Telemedicine Technology: A systematized Review. International Journal of Preventive Medicine, 15, 8. https://doi.org/10.4103/ijpvm.ijpvm_48_23

Purpose of Research (1 sentence only):

The study’s purpose is to systematically define and classify the research problems of the health systems with implementation of the telemedicine technology.

Author’s Conclusion or Results of Research (1 sentence only):

The authors concluded that there are great opportunities, but serious issues regarding infrastructure, interoperability, and training of users must be considered to implement telemedicine successfully.

How this relates to my study (1 sentence only):

This source directly supports the healthcare administration problem by pointing out the same fundamental problems (interoperability, training) as the challenges that have been recorded concerning the implementation of telemedicine.

Source 2

(Required)

Full APA Citation:

Anawade PA, Sharma D, Gahane S. A Comprehensive Review on Exploring the Impact of Telemedicine on Healthcare Accessibility. Cureus. 2024 Mar 12; 16(3):e55996. DOI: 10.7759/cureus.55996

Purpose of Research (1 sentence only):

To test how telemedicine affects the accessibility of health care and whether it can eliminate the effects of geographical and infrastructural constraints.

Author’s Conclusion or Results of Research (1 sentence only):

The study found that although telemedicine has the potential to save costs and enhance care delivery provisions, it is critical to streamline implementation and resolve issues (including data security) to achieve the greatest benefit.

How this relates to my study (1 sentence only):

This source promotes the problem by connecting the strategies of effective implementation (such as distributing security) to better results, which is the central issue of the proposed review.

Source 3

(Required)

Full APA Citation:

Benjamin, I., Idoko, J., Alakwe, J., 3, Ugwu, O., OchanyaIdoko, F., & Ayoola, V. (2024). The role of telemedicine in rural America: Overcoming electrical and technological barriers to improve health outcomes. International Journal of Science and Research Archive, 2024, 12(02), 188–205

Purpose of Research (1 sentence only):

To understand the current situation of telemedicine in rural America and find the major barriers in its adaption in the form of infrastructure and technology.

Author’s Conclusion or Results of Research (1 sentence only):

The authors concluded that infrastructural, technological and application based challenges are common in the implementation of telemedicine in rural areas, and this impedes its potential.

How this relates to my study (1 sentence only):

This source puts the issue into the special context of the rural HSOs and it proves that the identified information management problems are especially acute in the given setting.

Practice Gap Statement

Now that you have identified a current healthcare administration problem you will compose a Practice Gap Statement (PGS) following the example and instructions in the appendix. Your PGS should not be longer that 2-3 sentences.

Although telemedicine can play the role of closing the gap in access to healthcare, there is still an enormous gap in usage. An analysis of the American Hospital Association revealed that telehealth has been used approximately twice in metropolitan areas compared to rural areas (more than 6% vs. less than 4% of primary care visits) (American Hospital Association, 2026). This disparity is further augmented by the digital divide because one out of 4 Americans in rural households does not have adequate access to high-speed broadband, versus 1.5% in urban households (Liu et al., 2025). This is a serious practice gap in which the rural community hospitals are still grappling with the inherent information management approaches necessary to develop, establish and maintain these services successfully.

Practice Gap Sources

Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.

Source 1

(Required)

Full APA Citation:

American Hospital Association. (2026, March 10). 5 Key Telehealth Insights | AHA. American Hospital Association. https://www.aha.org/aha-center-health-innovation-market-scan/2026-03-10-5-key-telehealth-insights

Desired Ideal State of Professional Practice:

The ideal scenario that should be pursued is the fair implementation of telehealth as an equal, sustainable aspect of care provision. According to the source, although telehealth has become the stable element of the healthcare ecosystem, there is still a gap between rural patients that are not using it as frequently as their urban peers (metropolitan: >6% vs. rural: <4% of primary care visits). Equity would be to bridge this gap in utilization where the benefits of virtual care can be accessed irrespective of the geographic location.

Source 1

(Required)

Full APA Citation:

Liu, L., Onega, T., Moen, E. L., Anna, Smith, R. E., Wang, Q., Cowan, L., & Wang, F. (2025). Digital divides in telehealth accessibility for cancer care in the United States. Npj Digital Medicine, 8(1). https://doi.org/10.1038/s41746-025-01931-5

Desired Ideal State of Professional Practice:

The ultimate ideology is the removal of the digital divide as an impediment to care, which can support telehealth in achieving its dream of decreasing geographic disparities. According to the study, telehealth has been advanced as a solution to spatial barriers of healthcare access, however, it also discovers that accessibility decreases gradually as one moves towards a rural location. As suggested by the authors, the ideal state is one in which the interventions that focus on both infrastructure and affordability challenges have managed to ensure that telehealth does not exacerbate the gap in access that already exist, and all populations, especially the ones in rural and socioeconomically deprived regions, are guaranteed of reliable access to virtual services.

Section 1: Feedback and Scoring

Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included on how to successfully revise the specific elements above.

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 2: Purpose and Review Questions

(Click here for instructions and examples)

The research purpose and review questions must be derived entirely by the sources provided in section 1.

Research Purpose

To address your stated problem, what is the purpose of your study using no more than 1-2 sentences??

Spreading the strategies to improve the application of telemedicine in rural healthcare and especially focusing on the issues of information management such as interoperability, user training, data protection, and compliance with the regulations, is the purpose of the integrative review.

Review Question(s)

Conclude with your review question. (1 sentences)

What are the methods to improve the use of telemedicine by managing the information in rural health institutions?

Section 2: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 3: Framework

(Click here for instructions and examples)

Framework (Conceptual or Theoretical)

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference.

Source 1

(Required)

Full APA Citation:

Novikova, Z., Singerb, S., & Milstein, A. (2021). Innovation Diffusion Across 13 Specialties And Associated Clinician Characteristics. Advances in Health Care Management, (22), 97–115

Purpose of Framework (1 sentence only):

To describe the way new innovations (such as telemedicine) are embraced and diffuse within a social system (such as a hospital) with time.

Key Constructs of Framework (1 sentence only):

Adopter Categories: (e.g., innovators, early adopters, majority) that can be used to customize implementation strategies.

Perceived Attributes: The perceived relative advantage of the innovation, compatibility, complexity, trialability, and observability of the innovation.

Communication Channels: The ways communication about the innovation takes place between people.

How this relates to my study (1 sentence only):

This theory puts the importance of user training of the question into perspective as the introduction to telemedicine is not a single event; rather, it occurs because of social networks, communication, and perceived value of technology within the clinical staff.

Full APA Citation:

Chen, B., Chang, Y., Wang, B., Zou, J., & Tu, S. (2024). Technology acceptance model perspective on the intention to participate in medical talents training in China. Heliyon 10 (2024) e26206,

Purpose of Framework (1 sentence only):

To get to know the elements that affect the intention of an individual to embrace a new technology.

Key Constructs of Framework (1 sentence only):

Perceived usefulness: This is the extent to which one believes that the use of a given system would improve his or her job performance.

Perceived Ease of Use: The extent to which an individual would think that he or she will not have to strain using a certain system.

How this relates to my study (1 sentence only):

This framework will supplement the problem because it will deal with the perception of the individual user. It assists in understanding the reasons why clinicians might not be willing to use telemedicine, because they do not see it helpful or because it cannot be easily added to their workflow, hence directly related to the user training and interoperability elements of the issue.

How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)

Collectively, these frameworks give a two-perspective lens of the investigation. The review will be directed by Diffusion of Innovation Theory which will classify and examine the kinds of implementation strategies (e.g. involving the use of champions, staged rollout) that can be used to enable organizational adoption of telemedicine. The technology acceptance model will assist in the analysis of strategies aimed at the individual end user, especially related to training, workflow integration (interoperability), and showing clinical value which is necessary to solve the low adoption, and inefficient operation.

Section 3: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 4: Significance

(Click here for instructions and examples)

Significance

How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change?

This research will provide a discipline-wide, critical concern in healthcare administration by bringing together evidence-based information management approaches in telemedicine. It will help benefit the field by giving rural hospital administrators and leaders and synthesized actionable guide that would enable them to enhance operational efficiencies, clinical integration, and regulatory complexities, and thus be able to implement telemedicine sustainably.

Significance of study related to social determinants?

This research can assist in positive social change through providing solutions that enhance the adoption of telemedicine as it is a direct approach to a social determinant of health: geographic access to care. The adoption of improved telemedicine will help to decrease disparities in health, provide more rural people with access to specialist consultations, and achieve better patient outcomes, which will contribute to a higher level of health equity among underserved populations.

Section 4: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 5: Research Alignment Table

(Click here for instructions and examples)

Complete the Research Design Alignment Table using the information from earlier sections of this form. Using an alignment table can assist with ensuring the alignment of your research design.

Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours

Healthcare Administration Problem

Practice Gap

Purpose

Review Question

Theoretical Framework

List the theories and/or conceptual framework.

Telemedicine is not operationally efficient and accessible to patients in rural community hospitals due to information management issues (such as user training, data security, regulatory compliance, and interoperability).

There is a gap between the opportunity of telemedicine to enhance access and its successful implementation in rural regions where information management strategies underlying integration and security are not standard practice.

This integrative review is aimed at identifying and synthesizing the possibility of improving the use of telemedicine in rural healthcare facilities, in particular, in order to resolve the issue of information management.

How can the application of telemedicine be improved in the rural healthcare environment by using the best information management strategies?

Diffusion of innovative (Rogers)

Technology Acceptance Model (Davis)

Such frameworks help the review to concentrate on the organizational (DOI) and individual (TAM) aspects that lead to adoption and integration of telemedicine information management strategies to be successful.

Section 5: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Once your Research Design Alignment Table is completed, reflect on your design alignment. Ask yourself:

1. Is there a logical progression from the problem of interest to the healthcare administration problem, practice gap, purpose/review question?

2. Does the identified framework ground the investigation into the healthcare administration problem?

3. Do the problem of interest and framework align with the purpose/review question?

Appendix

The Doctoral Prospectus

The DHA Project Plan is a brief document that provides preliminary information about your doctoral research and is used in two ways:

1. It serves as the tentative plan for developing the project and is evaluated to ensure doctoral-level work (e.g., feasibility, alignment, etc.).

2. It provides information used to assign the projects mentors.

DHA Project Plan approval from the project mentor, project co-mentor, and a program-level designee is required for you to move forward and work on your project. The plan is subject to change, and parts of your research design may need to be adjusted after you complete your exhaustive review of the literature during proposal development.

Working Title Instructions and Example

Enhancing Telemedicine Services in Community Hospitals: Addressing Information management for improved outcome.

Section 1: Research Problem Instructions and Examples

Healthcare Services Organization (HSO) Type

Instructions: At the beginning of the DHA program students were asked to select an HSO type to research in each course in preparation for the Doctoral study. Identify and describe your selected HSO type and any unique characteristics that help provide specificity to your research.

With no more than 1-2 sentences identify and describe your selected HSO type.

Examples of HSO types can be located on the DHA Project Completion page.

Hospitals/Health systems – rural hospitals

HSO Problem of Interest

What is the healthcare services organization (HSO) problem of interest that prompted you to search the literature to find out more? The problem of interest is a high-level problem that all HSO of the same type are experiencing.

Write only 1-2 complete sentences using a scholarly tone.

The need to enhance telemedicine application in rural hospitals through effective information management

Healthcare Administration Problem

Instructions: A healthcare administration problem is a focused topic of concern, a condition to be improved upon, or troubling question that is supported in published research-based articles and/or grey literature like reports (annual, research, technical, project), white or working papers, government reports, and organizational evaluations.

In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.

User training, patient confidentiality , data security , regulation and compliance, and interoperability hinder operational efficiency and patient access

Which DHA research category does your healthcare administration problem align with?

A list of DHA research domains can be located on the DHA Project Completion page.

Quality improvement

Healthcare Administration Problem Justification Sources

Instructions: Students are required to provide at least 3 credible sources that state a healthcare administration problem exist. Students should read all sources completely but pay special attention to what the authors state the conclusion or research results are from their work. To build on the previous research in the field students must have at least three sources within the last 5 years that clearly state a problem exist. One example is provided below:

Provide a minimum of 3 sources that clearly state in the conclusion or research findings that a healthcare administration problem currently exists.

Source 1

(Required)

Full APA Citation:

Hadian M, Jelodar ZK, Khanbebin MJ, Atafimanesh P, Asiabar AS, Dehagani SMH. Challenges of Implementing Telemedicine Technology: A systematized Review . Int J Prev Med. 29;15:8. DOI: 10.4103/ijpvm.ijpvm_48_23

Purpose of Research (1 sentence only):

The study’s purpose is to determine the challenges facing the health system of different countries in the application of telemedicine.

Author’s Conclusion or Results of Research (1 sentence only):

The authors concluded that telemedicine presents significant opportunities in healthcare and addressing the challenges is essential for improved outcomes

How this relates to my study (1 sentence only):

The article address challenges in telemedicine application in my HSO hence direct justifies my case.

Source 2

(Required)

Full APA Citation:

Anawade PA, Sharma D, Gahane S. A Comprehensive Review on Exploring the Impact of Telemedicine on Healthcare Accessibility. Cureus. 2024 Mar 12; 16(3):e55996. DOI: 10.7759/cureus.55996

Purpose of Research (1 sentence only):

To examine impact of telemedicine on healthcare accessibility, exploring its ability to overcome geographical, financial, sociocultural, and infrastructural barriers to healthcare access

Author’s Conclusion or Results of Research (1 sentence only):

The researchers concluded that streamlining telemedicine challenges supports cost reduction, quality and improved care delivery.

How this relates to my study (1 sentence only):

This article aligns with how effective information management addresses telemedicine adoptability and challenges.

Source 3

(Required)

Full APA Citation:

Purpose of Research (1 sentence only):

The research explore the current state of telemedicine in rural America, identifying the key challenges related to infrastructure and technology that impede its widespread adoption

Author’s Conclusion or Results of Research (1 sentence only):

The authors conclude that there are infrastructural , technological and application challenges are existing in telemedicine implementation.

How this relates to my study (1 sentence only):

Identifying the challenge’s in telemedicine application resonates with my paper’s HSO

Source 1

(Required)

Although telemedicine has the capacity to reduce the gap in access to healthcare, a gap in use remains high. An American Hospital Association analysis (2026) conducted concluded that the use of telehealth in primary care was more than 6 percent in metro regions (versus less than 4 percent in rural small towns). The digital divide is a verdict to this disparity because nearly 22% of rural Americans do not have access to high-speed internet service as opposed to just 1.5% in cities (Liu et al., 2025). These statistics indicate a severe practice gap in which rural community hospital still faces the challenge of missing the underlying information management practices to be able to combine, safeguard, and maintain these services.

Practice Gap Sources

Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.

Source 1

(Required)

Ideal State Desired: Fairness of spreading telehealth as a regular and long-lasting aspect of care delivery, through which the positive aspects of virtual care become available to all, irrespective of the geographical location.

The removal of the digital divide as a hindrance to care, and specially designed actions taken to mitigate the barrier of infrastructure or affordability of virtual access to make sure that all populations, especially the rural and socioeconomically disadvantaged, are provided with a reliable virtual access infrastructure.

Section 2: Purpose and Review Questions

(Click here for instructions and examples)

The research purpose and review questions must be derived entirely by the sources provided in section 1.

Research Purpose

To address your stated problem, what is the purpose of your study using no more than 1-2 sentences??

This integrative review aims to define and summarize the methods of improving the use of telemedicine in rural health care contexts, and particularly the issues of the information management of interoperability, user training, data security, and compliance with the regulations.

Review Question(s)

Conclude with your review question. (1 sentences)

What are the measures that can be taken to improve the use of telemedicine by means of efficient information management in rural healthcare facilities?

Section 2: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 3: Framework

(Click here for instructions and examples)

Framework (Conceptual or Theoretical)

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference.

Source 1

(Required)

Full APA Citation:

Novikova, Z., Singerb, S., & Milstein, A. (2021). Innovation Diffusion Across 13 Specialties And Associated Clinician Characteristics. Advances in Health Care Management, (22), 97–115

Purpose of Framework (1 sentence only):

To describe the way new innovations (such as telemedicine) are embraced and diffuse within a social system (such as a hospital) with time

Key Constructs of Framework (1 sentence only):

Adopter Categories: (e.g., innovators, early adopters, majority) that can be used to customize implementation strategies.

Perceived Attributes: The perceived relative advantage of the innovation, compatibility, complexity, trialability, and observability of the innovation.

Communication Channels: The ways communication about the innovation takes place between people.

How this relates to my study (1 sentence only):

Full APA Citation:

Chen, B., Chang, Y., Wang, B., Zou, J., & Tu, S. (2024). Technology acceptance model perspective on the intention to participate in medical talents training in China. Heliyon 10 (2024) e26206,

Purpose of Framework (1 sentence only):

To get to know the elements that affect the intention of an individual to embrace a new technology.

Key Constructs of Framework (1 sentence only):

Perceived usefulness: This is the extent to which one believes that the use of a given system would improve his or her job performance.

Perceived Ease of Use: The extent to which an individual would think that he or she will not have to strain using a certain system.

How this relates to my study (1 sentence only):

How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)

Section 3: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 4: Significance

(Click here for instructions and examples)

Significance

Significance of study related to social determinants?

Section 4: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 5: Research Alignment Table

(Click here for instructions and examples)

Complete the Research Design Alignment Table using the information from earlier sections of this form. Using an alignment table can assist with ensuring the alignment of your research design.

Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours

Healthcare Administration Problem

Practice Gap

Purpose

Review Question

Theoretical Framework

List the theories and/or conceptual framework.

How can the application of telemedicine be improved in the rural healthcare environment by using the best information management strategies?

Diffusion of innovative (Rogers)

Technology Acceptance Model (Davis)

My Doctoral Research ( MyDR)

If you have not done so already, you should familiarize yourself with the My DR system. The MyDR system was designed to assist you and your mentors in navigating your doctoral research journey, from the very beginning through the final approval. The various landing pages in MyDR will track your progress and will serve as a central location for resources to support that progress. There is a process flow tool in which you exchange and store faculty evaluations of and feedback on your work as you progress along that journey.

You will be entered into the MyDR system when both your mentor and co-mentor are approved by the academic program.