Underpinning a Guiding Theory of Patient-Centered E-Health

ion. E-health services are supported and transported via Internet technologies, which are dynamic and fastchanging. Our approach to ensure adequate abstraction across time in our research design was to search across the most recent five years of published studies rather than extending the search back to an era of limited bandwidth and reduced computational capabilities. Abstraction across space was ensured by the wide reach of publications indexed in the PubMed database. We argue that this approach ensures adequate abstraction in assessment of the PCEH domain. Relationships Among PCEH Characteristics To explore relationships, follow-up correlational analysis was conducted using the ordinal coded data from the patient-focus, patient-activity, and patient-empowerment columns in Table 1. We find the PCEH characteristics to be substantially intercorrelated (Spearman’s rho ranged from 0.69 to 0.77 between columns). This indicates that, although conceptually distinct, these characteristics are strongly related in the manner in which they are implemented in e-health services. The significant shared variance exhibited by these characteristics further suggests that it may be appropriate to model a distinct PCEH construct as a second-order latent factor in future theory development [Liu, Li and Zhu, 2012; Thurstone, 1944]. Further research will be necessary to confirm this interpretation; however, the initial finding is encouraging to further development and testing of our research model. Additional Implications There are two further implications from observations we made during screening and analysis in this study.