Browsing by Author "Burger, Nicola"

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    Scoping review of health system software literature: How has the concept been used?
    (2023) Burger, Nicola; Gilson, Lucy
    Understanding health systems as comprising interacting elements of hardware and software acknowledges health systems as dynamic, complex adaptive systems (CAS). The hardware represents the concrete components of systems, whereas the software represents the elements which influence actions and underpin relationships, such as processes, values and norms. As a specific call for research on health system software was made in 2011, we conducted a qualitative scoping review considering how and for what purpose the concept has been used since that time. As it has remained relatively under-researched, our overall purpose was both to synthesise current knowledge and to generate lessons about how to deepen research on, and understanding of, health system software. The review consisted of two phases: first, all papers which have explicitly used the concept of health system software were mapped; second, we explored how this concept was purposively used within research. The databases Pubmed, Scopus, EBSCOhost, Web of Science and Google Scholar were systematically searched using a strategy developed by a skilled librarian. In Phase 1, data were extracted from 98 papers to understand the scope of this literature. Our analysis revealed that a third of the papers used the software concept rather superficially; a third used it to conceptualise the importance of some software elements; and a third used it in relation to another aspect of health system experience, such as preparedness or resilience. In Phase 2, our analysis confirmed the value of pro-actively using the software concept within studies, demonstrating two patterns of use. However, limited understanding of how to investigate interactions amongst hard and software elements was also revealed. Future health policy and systems research should purposively investigate hardware-software interactions, in order to gain greater understanding of the complex, adaptive nature of health systems.