The Prioritization of Lean Techniques in Emergency Departments Using VIKOR and SAW Approaches

BackgroundConsidering various researches were carried out to implement Lean techniques in healthcare centers, this study has tried to investigate how lean principles could be prioritized in the Emergency Department (ED) by comparing physicians and nurses viewpoints.MethodologyIn the first stage, relevant Lean techniques and several criteria to evaluate the ED performance were selected by reviewing the literature. Then, weight factors for each criterion were calculated using the Entropy method, and Lean techniques were compared and ranked via a questionnaire by which the physicians'' and nurses'' opinions were obtained separately. In the last stage, the final ranking of Lean techniques was done using VIKOR and SAW methods as two powerful means of Multi-Criteria Decision-Making (MCDM).ResultsTheory of Constraints (TOC) was selected as the most appropriate principle from the physicians'' viewpoints by both decision-making methods. However, according to the nurses'' opinions, Jiduka was the best approach by the VIKOR method, while with the SAW method, 5S was chosen as the most practical Lean technique.ConclusionThis study has illustrated that although all Lean techniques are useable for ED, these techniques'' prioritization has a key role in choosing the more suitable Lean approach. Moreover, it provides a chance for the emergency wards to keep down different costs and improve staff and patient satisfaction and the quality of treatment simultaneously.     

Lean in healthcare: The unfilled promise?

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level.     

Lean healthcare: Rhetoric,ritual and resistance

This paper presents an ethnographic account of the implementation of Lean service redesign methodologies in one UK NHS hospital operating department. It is suggested that this popular management ‘technology’, with its emphasis on creating value streams and reducing waste, has the potential to transform the social organisation of healthcare work. The paper locates Lean healthcare within wider debates related to the standardisation of clinical practice, the re-configuration of occupational boundaries and the stratification of clinical communities. Drawing on the ‘technologies-in-practice’ perspective the study is attentive to the interaction of both the intent to transform work and the response of clinicians to this intent as an ongoing and situated social practice. In developing this analysis this article explores three dimensions of social practice to consider the way Lean is interpreted and articulated (rhetoric), enacted in social practice (ritual), and experienced in the context of prevailing lines of power (resistance). Through these interlinked analytical lenses the paper suggests the interaction of Lean and clinical practice remains contingent and open to negotiation. In particular, Lean follows in a line of service improvements that bring to the fore tensions between clinicians and service leaders around the social organisation of healthcare work. The paper concludes that Lean might not be the easy remedy for making both efficiency and effectiveness improvements in healthcare.     

Lean thinking in healthcare – Findings from a systematic literature network and bibliometric analysis

This paper draws on 299 published articles from six databases, and utilizes a novel methodology combining elements of a systematic literature review, citation network analysis, and bibliometric analysis, to track the development of Lean Thinking (LT) in healthcare—a popular improvement methodology increasingly being adopted by healthcare organizations.A review of the LT literature in healthcare identifies that a piecemeal approach appears to have been taken regarding LT in health, with departmental focused implementations rather than LT’s intended systems approach. In addition, tool-myopic thinking tends to be a prevalent practice and often governs implementations, with less attention provided to soft practices such as continuous improvement and employee empowerment, undermining the long-term sustainability of LT’s improvements.To fully explore the scope of LT, a parallel analysis of the Healthcare Supply Chain Management (HSCM) literature was also undertaken to determine whether these same tendencies were present. This paper identified a substantial gap between the LT and the HSCM literatures as mirrored by the citation network analysis by uncovering almost no inter-disciplinary cross-citations. Bibliometric analysis identified the same divide in terms of authors, with only three publishing in both fields.It is crucial that LT is considered a system-wide approach and implementations move beyond departmental/functional boundaries and incorporate extended supply chains to ensure waste elimination rather than waste transference to other entities in supply chains.     

Systematic Review of Health Economic Evaluations Focused on Artificial Intelligence in Healthcare: The Tortoise and the Cheetah

ObjectivesThis study aimed to systematically review recent health economic evaluations (HEEs) of artificial intelligence (AI) applications in healthcare. The aim was to discuss pertinent methods, reporting quality and challenges for future implementation of AI in healthcare, and additionally advise future HEEs.MethodsA systematic literature review was conducted in 2 databases (PubMed and Scopus) for articles published in the last 5 years. Two reviewers performed independent screening, full-text inclusion, data extraction, and appraisal. The Consolidated Health Economic Evaluation Reporting Standards and Philips checklist were used for the quality assessment of included studies.ResultsA total of 884 unique studies were identified; 20 were included for full-text review, covering a wide range of medical specialties and care pathway phases. The most commonly evaluated type of AI was automated medical image analysis models (n = 9, 45%). The prevailing health economic analysis was cost minimization (n = 8, 40%) with the costs saved per case as preferred outcome measure. A total of 9 studies (45%) reported model-based HEEs, 4 of which applied a time horizon >1 year. The evidence supporting the chosen analytical methods, assessment of uncertainty, and model structures was underreported. The reporting quality of the articles was moderate as on average studies reported on 66% of Consolidated Health Economic Evaluation Reporting Standards items.ConclusionsHEEs of AI in healthcare are limited and often focus on costs rather than health impact. Surprisingly, model-based long-term evaluations are just as uncommon as model-based short-term evaluations. Consequently, insight into the actual benefits offered by AI is lagging behind current technological developments.     

Implementing healthcare services on a large scale: Challenges and remedies based on blockchain technology

The accessibility of electronic healthcare data is necessary for effective treatment, policy decisions, and healthcare information exchange. Due to the intangibility of digital data, healthcare information is also prone to privacy-breach and security attacks. Further, the importance of immutability and privacy of healthcare data becomes colossal when a nationwide healthcare and wellness scheme is planned to be implemented. Providing quality healthcare services to such an enormous population size is challenging and requires proper technological infrastructure. The cooperation from the society is equally important to lay such a copious architecture on which the healthcare services should seamlessly run.ObjectiveTo assess the social and technical challenges that lie ahead in implementing large-scale comprehensive healthcare services and suggest a technology-intervening solution to serve the society at large.MethodThis study considers India's National Health Policy (2017) initiatives. The social and technical hurdles in implementation of the schemes are discussed, and AarogyaChain, a Blockchain technology-based solution is proposed to eliminate the health policy implementation hiccups.ResultWe find that the scalability is a primary concern in implementing healthcare services on blockchain at such a large scale. We experimented by creating a blockchain and found that the system throughput is a function of the number of special nodes called ordering nodes, and a trade-off is required to balance between time-to-commit and system's fault tolerance.ConclusionBlockchain provides a secure and transparent system of integrated healthcare services that keeps patients at the center and provides for corruption intolerant and efficient implementation of nationwide health-insurance programs.     

Policy strategies for personalising medicine “in the data moment”

Objective‘Data’ is relevant in evolving value-based healthcare that involves machine learning and artificial intelligence-based technologies which are increasingly changing the landscape of personalised medicine (PM). However, a lack in adequate data for decision making may lead to new forms of health inequalities spite of the advancement in the technological front. There exists a dearth in alignment between incentive structures for innovation and policy measures for collective action and data transparency. Against this background, this article identifies the legal challenges for a data-driven PM in Europe. Transparency, data protection and Intellectual property rights (IP) are major legal challenges for data-oriented personalised research in Europe. Consequently, there is a need for restructuring public policy strategies in the interest of patients.MethodLegal dogmatic analysis of structural inefficiencies within interrelated legal paradigm over data that limits a functional development of a data-driven PM.ResultEngaging in the data movement in personalised health care calls for special attention to strategic tools such as co-regulation and self-regulation that bridge the gap in law and practice.     

Investigating the digital health acceptance of Korean baby boomers: Comparative study of telemedicine and wearable healthcare devices

ObjectiveIn the COVID-19 era, the importance of and need for digital health services, such as telemedicine and wearable healthcare devices, are increasing. Although these services are treasured by older adults, their acceptance rates remain low. Thus, we attempted to find ways to enhance the acceptance rates of these services by investigating factors that influence the digital health acceptance of baby boomers. Based on the behavioral model of health service use and a multi-dimensional value perspective, we developed a research model to compare the factors influencing telemedicine and wearable healthcare device acceptance.MethodsTo examine the research model, we conducted face-to-face surveys with 300 baby boomers. The survey consisted of two sections: telemedicine and wearable healthcare devices. We used measurement instruments that had been validated in previous studies.ResultsEach research model's measurement model and structural model were evaluated. The reliability and validity of the measurement items of each model were satisfactory. The structural model test illustrates that three beliefs (usefulness, information, and cost saving) are important for the acceptance of telemedicine and wearable healthcare devices. Reassurance and convenience only significantly influence telemedicine and wearable healthcare devices, respectively. Among need and enabling factors, subjective health and income affect the intention to accept telemedicine and wearable healthcare devices. Conclusions: This study has theoretical implications in that it applied multidisciplinary theories by reflecting on the convergence characteristics of digital health, which are health and digital. In addition, it provides managerial implications to promote baby boomers' acceptance of digital health services.     

Rapid assessment technology: A demonstration evaluating potential cost-benefit outcomes of U.S. hospital price transparency regulation

BackgroundIn 2019, the Centers for Medicare and Medicaid Services (CMS) mandated U.S. hospitals to publicly display their negotiated charges for health care services provided. The 2019 mandate is the second step in a CMS’ comprehensive, long-term price transparency initiative affecting several hospital pricing aspects. To date, little is known about potential implications of the 2019 CMS mandate on healthcare sector.MethodsTo address this gap, we utilized rapid assessment technology and surveyed a nationally representative panel of health policy and management researchers (N = 216).PurposeWe asked the research panel about the likelihood of a complete hospital price transparency mandate implementation and whether it will achieve its intended goals.ResultsThe majority of panelists (68.6%) perceived that the hospital price transparency policy was not likely to be fully implemented. However, if the comprehensive price transparency policy would be enacted, respondents perceived that it would help control costs, but not by engaging consumers in price shopping behaviors. Respondents noted the significant technical challenges to producing and interpreting the health services pricing information would be a barrier to bending the healthcare cost curve.ConclusionRapid assessment technology proves useful and adds value in the healthcare sector to quickly evaluate potential policy outcomes.     

Impact of health technology assessment implementation with a special focus on middle-income countries

ObjectivesBuilding an efficient health technology assessment (HTA) system requires significant effort and political commitment, in addition to human and financial resources. Expectations of what HTA can offer to middle-income countries (MICs) are continuously rising, which drives health policymakers to raise the question of whether HTA could help secure the financial sustainability needed to implement universal health coverage. In this study, we explored the impact HTA adoption may have on the countries and its impact on health system objectives, as well as transferability of benefits and drawbacks observed in higher-income to middle-income countries.MethodsWe utilized secondary data from a systematic literature review and primary data by disseminating a survey among local stakeholders in three MICs across three continents to capture their perspective on the impact of HTA implementation from a local context.ResultsIt was evident from the results of both the literature review and survey that the positive impacts of HTA implementation outweigh the negative impacts. Most of the reviewed literature discussed the impact of HTA on the intermediate objectives of the health finance policy in relation to the broad health system goals. According to the survey respondents, the most evident benefit of HTA implementation is improving the transparency and accountability of healthcare decisions.ConclusionsOverall, HTA implementation can introduce a myriad of benefits to healthcare systems in MICs as well. Our findings show that while HTA implementation may have the potential to generate cost savings in specific areas, there is no guarantee that HTA can generate savings at the macro level.Public Interest SummaryHealth technologies (medicines, devices, and interventions) are rapidly increasing in complexity and cost. Health Technology Assessment (HTA) guides healthcare decision-makers in choosing the most suitable, effective, affordable, and acceptable health technology to invest limited healthcare resources. However, healthcare decision-makers in middle-income countries (MICS) are still uncertain about whether adopting HTA would help them achieve the financial sustainability needed to achieve universal health coverage.Thereforewe sought to gather evidence on how HTA has affected the health systems of countries that have already adopted it by reviewing published research reports. In addition, healthcare decision-makers from three MICs were questioned about their perception of how HTA implementation will affect their country's health system.Wefound that the positive effects of HTA implementation outweigh the negative ones; specifically, the transparency and accountability of decisions are improved. However, although HTA implementation may generate cost savings in specific areas, it may not significantly contribute to overall financial sustainability.     

Predictors of maternal vaccination in the United States: An integrative review of the literature

ObjectivesThe purpose of this literature review was to identify, analyze, and synthesize existing research related to patient, provider, and health system predictors of maternal vaccination in the United States, strategies used to increase maternal vaccination rates, and major theoretical frameworks used to guide maternal vaccination research.MethodsA search for evidence was conducted in CINAHL, PubMed, PsychINFO, Cochrane Systematic Reviews, and Google Scholar. Twenty-two articles were identified as best evidence for inclusion in this review: five randomized control trials, one cluster randomized trial, one mixed methods study, 12 observational studies, and three qualitative studies.ResultsPatient-focused predictors of maternal vaccination included provider recommendation; knowledge, attitudes, and beliefs; cues to action; and race and ethnicity. Provider-focused predictors included knowledge, attitudes, and beliefs; and multi-component intervention packages. Health system predictors included standing order protocols and practice site logistics. The major theoretical frameworks that emerged were the Health Belief Model, Theory of Reasoned Action/Theory of Planned Behavior, and Message Framing/Prospect Theory. Provider recommendation was the single most important predictor of vaccine acceptance among pregnant women.ConclusionsAn abundance of theoretically-supported, patient-focused research was found in the literature. A minimal number of U.S.-based, provider-focused research was found and none of these used a theoretical framework. Minimal research examining health system barriers to maternal vaccination was found. Additional research into the logistical barriers to maternal vaccination programs within obstetrical practice locations in other geographical locations within the U.S. is warranted. Future provider- and health system-focused research needs to be grounded in theory. The field of implementation science may offer the theoretical guidance necessary to better understand problems in obstetrical practice work flow and streamlining of vaccinations.     

A scoping review of the implementation of health in all policies at the local level

ObjectivesHealth in All Policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. HiAP implementation can involve engagement from multiple levels of government; however, factors contributing or hindering HiAP implementation at the local level are largely unexplored. Local is defined as the city or municipal level, wherein government is uniquely positioned to provide leadership for health and where many social determinants of health operate. This paper presents the results of a scoping review on local HiAP implementation.MethodsPeer reviewed articles and grey literature were systematically searched using the Arksey and O’Malley framework. Characteristics of articles were then categorized, tallied and described.Results23 scholarly articles and four government documents were identified, ranging in publication year from 2002 to 2016 and originating from 14 countries primarily from North America and Europe. A wide range of themes emerged relating to HiAP implementation locally including: funding, shared vision, national leadership, ownership and accountability, local leadership and dedicated staff, Health Impact Assessment, and indicators.ConclusionCommon themes were found in the literature regarding HiAP implementation locally. However, to better clarify these factors to contribute to theory development on HiAP implementation, further research is needed that specifically investigates the facilitators and barriers of HiAP locally within their political and policy context.     

Methods for assessing the cost-effectiveness of public health interventions: Key challenges and recommendations

RationaleIncreasing attention is being given to the evaluation of public health interventions. Methods for the economic evaluation of clinical interventions are well established. In contrast, the economic evaluation of public health interventions raises additional methodological challenges. The paper identifies these challenges and provides suggestions for overcoming them.MethodsTo identify the methodological challenges, five reviews that explored the economics of public health were consulted. From these, four main methodological challenges for the economic evaluation of public health interventions were identified. A review of empirical studies was conducted to explore how the methodological challenges had been approached in practice and an expert workshop convened to discuss how they could be tackled in the future.ResultsThe empirical review confirmed that the four methodological challenges were important. In all, 154 empirical studies were identified, covering areas as diverse as alcohol, drug use, obesity and physical activity, and smoking. However, the four methodological challenges were handled badly, or ignored in most of the studies reviewed.DiscussionThe empirical review offered few insights into ways of addressing the methodological challenges. The expert workshop suggested a number of ways forward for overcoming the methodological challenges.ConclusionAlthough the existing empirical literature offers few insights on how to respond to these challenges, expert opinion suggests a number of ways forward. Much of what is suggested here has not yet been applied in practice, and there is an urgent need both for pilot studies and more methodological research.     

Health information seeking and people with disability: A systematic search and scoping review

BackgroundHealth information and access to it are important aspects of maintaining health. There are 61 million people with disability in the U.S., many of whom experience health disparities. However, it may not be clear to health professionals how people with disability seek health information.ObjectiveAssess the breadth, examine the characteristics, and evaluate the risk of bias in the existing literature related to health information seeking and people with disability.MethodsThe authors conducted a systematic search across five databases (Pubmed, Scopus, PsycINFO, HealthSTAR, and CINAHL) to identify empirical journal articles related to health information seeking among people with disability. Analysis of data items and a quality assessment were completed.ResultsForty-two articles met the criteria for inclusion and were assessed. The articles primarily used survey methodology (50%), and primarily focused on ten disability types, including MS (19%), CP (17%) and general disability (17%). The articles primarily investigated the internet (88%), and healthcare providers (71%) as sources of health information. Trustworthiness (31%), accuracy (29%), and accessibility (29%) were also commonly assessed. The overall quality was high, with room for improvement in minimizing bias.ConclusionsThe literature addressing health information seeking among people with disability is heterogeneous, but generally of high quality. Future research may benefit from an inclusive definition of disability and a more consistent definition of health information. Focused research on best practices and interactions among sources of health information would be valuable additions.     

Challenges of Reproductive Health Management in the Camps of Internally Displaced Persons: A Systematic Review

BackgroundInternally Displaced Persons (IDPs) in the camps face many reproductive health challenges. They should meet their needs timely to save their lives. This paper outlines a systematic review to discuss the challenges of reproductive health management in the camps of internally displaced persons.MethodsFor this research, electronic databases including PubMed, Science Direct, Scopus, Pro Quest, Google Scholar and Cochrane Library till January 1, 2020 were searched. A threestage screening process was used for the selection of literature due to PRISMA checklist. Finally, a thematic synthesis approach was applied to analyze the data.ResultsIn total, 133 articles were identified; 11 articles met the inclusion criteria for entering the process of final analysis. The findings were demonstrated in six main categories of availability and accessibility of reproductive health services, sexual and gender-based issues, human rights, social and cultural issues, coordination and collaboration, and mental health issues. The remarkable result of this study highlighted that the main challenges are lack of access to health services, violence against women and lack of household education.ConclusionResults of this systematic review present valuable advice for policy makers and managers to prepare and respond effectively and timely to reproductive health challenges of internally displaces persons. Disaster preparedness plans and contingency plans for maintaining and developing reproductive health in IDPs camps are recommended.     

Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: A systematic review of peer-reviewed literature

IntroductionImmunization programs in developing countries increasingly face challenges to ensure equitable delivery of services within cities where rapid urban growth can result in informal settlements, poor living conditions, and heterogeneous populations. A number of strategies have been utilized in developing countries to ensure high community demand and equitable availability of urban immunization services; however, a synthesis of the literature on these strategies has not previously been undertaken.MethodsWe reviewed articles published in English in peer-reviewed journals between 1990 and 2013 that assessed interventions for improving routine immunization coverage in urban areas in low- and middle-income countries. We categorized the intervention in each study into one of three groups: (1) interventions aiming to increase utilization of immunization services; (2) interventions aiming to improve availability of immunization services by healthcare providers, or (3) combined availability and utilization interventions. We summarized the main quantitative outcomes from each study and effective practices from each intervention category.ResultsFifteen studies were identified; 87% from the African, Eastern Mediterranean and Southeast Asian regions of the World Health Organization (WHO). Six studies were randomized controlled trials, eight were pre- and post-intervention evaluations, and one was a cross-sectional study. Four described interventions designed to improve availability of routine immunization services, six studies described interventions that aimed to increase utilization, and five studies aiming to improve both availability and utilization of services. All studies reported positive change in their primary outcome indicator, although seven different primary outcomes indicators were used across studies. Studies varied considerably with respect to the type of intervention assessed, study design, and length of intervention assessment.ConclusionFew studies have assessed interventions designed explicitly for the unique challenges facing immunization programs in urban areas. Further research on sustainability, scalability, and cost-effectiveness of interventions is needed to fill this gap.     

Community-Based Home Healthcare Project for Korean Older Adults

ObjectivesThe aim of this study was to identify the effects of community-based home healthcare projects that influence service performances with regard to Korean national long-term care insurance services in older adults.MethodsThe project's applicants were 18 operational agencies in national long-term care institutions in Korea, and participants were care recipients (n = 2263) registered in long-term care institutions. We applied our healthcare system to the recruited participants for a 3-month period from October 2012 to December 2012. We measured the community-based home healthcare services such as long-term care, health and medical service, and welfare and leisure service prior to and after applying the community-based home healthcare system.ResultsAfter the implementation of community-based home healthcare project, all community-based home healthcare services showed an increase than prior to the project implementation. The nutrition management service was the most increased and its increase rate was 628.6%. A comparison between the long-term care insurance beneficiaries and nonbeneficiaries showed that health and medical services’ increase rate of nonbeneficiaries was significantly higher than beneficiaries (p < 0.001).ConclusionOur community-based home healthcare project might improve the service implementation for older adults and there was a difference in the increase rate of health and medical services between Korean national long-term care insurance beneficiaries and nonbeneficiaries.     

江苏省常州市区域医疗机构服务协同案例分析

目的:分析常州市区域医疗机构服务协同的背景、主要做法和实施效果,总结典型经验,为推进整合型医疗卫生服务体系建设提供借鉴和参考。方法:运用定性访谈方法收集资料,基于管理协同理论对资料进行分析。结果:常州市通过市级层面统筹建设医疗联合体,建立信息共享平台,推动医联体内部资源整合,建立问题反馈机制等措施初步实现了区域医疗机构服务协同。结论:市政府制定政策统筹推进、促进信息互联互通和医联体内部资源整合有力促进了区域医疗机构服务协同,但仍存在协同程度不紧密,利益分配机制不完善等问题,建议扩大紧密型区域医疗服务协同实施范围,进一步完善利益分配政策。     

National Healthcare System Development of Ethiopia: A Systematic Narrative Review

Abstract

Objective: To describe the evidence on the development of the National Healthcare System in Ethiopia. Method: The databases Embase, Ovid Emcare, Ovid MEDLINE, and Scopus were searched, together with the reference lists of the identified articles, relevant reports and books were searched. Articles were included if they described health services development in Ethiopia. Results: In Ethiopia, medical care has historically been performed by traditional healers who use magic and superstition. Over time, modern medicine continued to develop, and by 2014, 5% of Ethiopia’s total Gross Domestic Product was spent on health. In 2017, nearly 1.26 healthcare workers per 1000 population provided services through 21,071 healthcare organizations, with the majority being rural health posts. There are shortages of healthcare workers and limited numbers of hospitals. However, the introduction of the Health Extension Program and Health Extension Workers has improved access to healthcare in the country and could be a model for other African nations. Conclusion: Although the health care strategies introduced by the Ethiopian government have improved some health issues, accessibility to healthcare institutions that provide curative services is limited.     

Systems medicine 2030: A Delphi study on implementation in the German healthcare system

IntroductionSystems medicine is based on approaches taken from systems biology, omics research, bio-informatics and network theory. It promises to facilitate a better understanding of the causes of diseases, detection at an earlier stage, and the use of tailor-made approaches to prevention and therapy. This study provides information on how systems medicine could be incorporated into the German healthcare system.MethodsIn a Policy Delphi, consensus and divergence was elicited on whether experts believed systems medicine could be incorporated into the German healthcare system by 2030. Additionally, factors that could influence the implementation process were analysed. 11 theses on potential systems medicine developments and 193 arguments on influencing factors were evaluated. Experts from health and health-related fields were selected using “purposive sampling”.ResultsThe experts interviewed expressed their trust in the provision of a legal-political framework, though they remained uncertain as to whether the necessary social discourse on the ethical and cultural questions surrounding systems medicine would occur. They do not (currently) expect systems medicine to be implemented by 2030.ConclusionSystems medicine is currently regarded as a visionary concept. As such, it would be premature to attempt to judge the success of the translation process at this stage. The results can help with the identification of the challenges involved in implementation, and the action required to achieve this aim.