Online guide for electronic health evaluation approaches: Systematic scoping review and concept mapping study

Tobias N. Bonten*, Anneloek Rauwerdink, Jeremy C. Wyatt, Marise J. Kasteleyn, Leonard Witkamp, Heleen Riper, Lisette J.E.W.C. van Gemert-Pijnen, Kathrin Cresswell, Aziz Sheikh, Marlies P. Schijven, Niels H. Chavannes

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

19 Citations (Scopus)
256 Downloads (Pure)


Background: Despite the increase in use and high expectations of digital health solutions, scientific evidence about the effectiveness of electronic health (eHealth) and other aspects such as usability and accuracy is lagging behind. eHealth solutions are complex interventions, which require a wide array of evaluation approaches that are capable of answering the many different questions that arise during the consecutive study phases of eHealth development and implementation. However, evaluators seem to struggle in choosing suitable evaluation approaches in relation to a specific study phase. Objective: The objective of this project was to provide a structured overview of the existing eHealth evaluation approaches, with the aim of assisting eHealth evaluators in selecting a suitable approach for evaluating their eHealth solution at a specific evaluation study phase. Methods: Three consecutive steps were followed. Step 1 was a systematic scoping review, summarizing existing eHealth evaluation approaches. Step 2 was a concept mapping study asking eHealth researchers about approaches for evaluating eHealth. In step 3, the results of step 1 and 2 were used to develop an "eHealth evaluation cycle" and subsequently compose the online "eHealth methodology guide." Results: The scoping review yielded 57 articles describing 50 unique evaluation approaches. The concept mapping study questioned 43 eHealth researchers, resulting in 48 unique approaches. After removing duplicates, 75 unique evaluation approaches remained. Thereafter, an "eHealth evaluation cycle" was developed, consisting of six evaluation study phases: Conceptual and planning, design, development and usability, pilot (feasibility), effectiveness (impact), uptake (implementation), and all phases. Finally, the "eHealth methodology guide" was composed by assigning the 75 evaluation approaches to the specific study phases of the "eHealth evaluation cycle." Conclusions: Seventy-five unique evaluation approaches were found in the literature and suggested by eHealth researchers, which served as content for the online "eHealth methodology guide." By assisting evaluators in selecting a suitable evaluation approach in relation to a specific study phase of the "eHealth evaluation cycle," the guide aims to enhance the quality, safety, and successful long-term implementation of novel eHealth solutions.

Original languageEnglish
Article numbere17774
JournalJournal of medical internet research
Issue number8
Publication statusPublished - 12 Aug 2020


  • Concept mapping
  • Digital health
  • eHealth
  • Evaluation
  • Health technology assessment
  • Methodology
  • mHealth
  • Scoping review
  • Study design


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