Experimenting innovation in telemedicine: the case of home haemodialysis

Daniele Prete, Anna Zito, Marcello Napoli, Antonio De Pascalis and Gianluca Elia

European Journal of Innovation Management, 2026, vol. 29, issue 1, 207-232

Abstract: PurposeThis study investigates the domain of telemedicine, and particularly the teledialysis (TDs), by adopting an innovation management perspective, with the aim of proposing a systemic representation of the key dimensions characterizing such a complex area. Indeed, most of the existing studies present and discuss approaches and applications from a partial point of view, by highlighting only the medical issues and the effectiveness of the treatment or the key factors determining the level of acceptance by patients or the impact on the working practices of physicians. Focusing on the TD (i.e., telemedicine applied to chronic kidney disease) for home-assisted patients, this study leverages the interaction between hospital, satellite unit and the patient's home, to propose a systemic framework that is illustrated from a both conceptual and operational perspective, highlighting the founding building blocks, the process-oriented view and a set of key performance indicators assessing the different dimensions of value creation. TD represents a promising area of innovation in telemedicine that is not widely diffused yet, but with a potential value in terms of treatment effectiveness, cost efficiency, effect on patients' quality of life and environmental impact.Design/methodology/approachThe methodological approach grounds on a cross-disciplinary scoping review followed by participant observation and a group model-building approach. The research context is represented by the Nephrology and Dialysis Department of the “Vito Fazzi” hospital of the Lecce ASL, in Italy.FindingsFindings consist of a systemic framework of TD for home-assisted patients constituted by a conceptual and operational view. The former integrates four dimensions (digital technologies, enabling technological infrastructures, management processes and interface with stakeholders), whereas the latter is grounded on four cycles spanning from the patient's profile and health needs to the caregivers' role, from the healthcare professionals to the telemedicine services for treatments' delivery and monitoring. The framework is also complemented by a set of indicators to assess different dimensions of value creation in home haemodialysis settings, including the volume, complexity, effectiveness, efficiency, quality, sustainability and the overall satisfaction of the stakeholders involved.Research limitations/implicationsThe study has some limitations mainly related to the identification and selection of experts involved in the validation of the framework, and the definition of the key performance indicators elaborated for the overall evaluation of the treatment.Practical implicationsThe study conducted contributes to define a new organizational model with dynamic coordination mechanisms and user-innovation practices that are capable to guarantee effective management of telecare independently of the geographical distance existing between the patient and physicians.Originality/valueThe value of the research consists in the definition of an integrated model that combines the conceptual and operational views of TD, with a set of key metrics assessing the different dimensions of value creation in the home haemodialysis treatment.

Keywords: Telemedicine; Teledialysis; Home haemodialysis; Conceptual framework; Model; Operational framework; Key performance indicators (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:eme:ejimpp:ejim-03-2025-0365

DOI: 10.1108/EJIM-03-2025-0365

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