Emergent Frameworks for Decision Support Systems

Knowledge is generated and accessed from heterogeneous spaces. The recent advances in in-formation technologies provide enhanced tools for improving the efficiency of knowledge-based decision support systems. The purpose of this paper is to present the frameworks for developing the optimal blend of technologies required in order to better the knowledge acquisition and reuse in large scale decision making environments. The authors present a case study in the field of clinical decision support systems based on emerging technologies. They consider the changes generated by the upraising social technologies and the challenges brought by the interactive knowledge building within vast online communities.Knowledge Acquisition, CDDSS, 2D Barcodes, Mobile Interface

Advanced Architectures for Transactional Workflows or Advanced Transactions in Workflow Architectures

In this short paper, we outline the workflow management systems research in the Information Systems division at the University of Twente. We discuss the two main themes in this research: architecture design and advanced transaction management. Attention is paid to the coverage of these themes in the context of the completed Mercurius and WIDE projects and in the new CrossFlow project. In the latter project, contracts are introduced as a new theme to support electronic commerce aspects in workflow management

Discipline Formation in Information Management: Case Study of Scientific and Technological Information Services

Discipline formation in information management is investigated through a case study of the origi-nation and development of information services for scientific and technical information in Australia. Particular reference is made to a case of AESIS, a national geoscience, minerals and petroleum reference database coordinated by the Australian Mineral Foundation. This study pro-vided a model for consideration of similar services and their contribution to the discipline. The perspective adopted is to consider information management at operational, analytical and strate-gic levels. Political and financial influences are considered along with analysis of scope, perform-ance and quality control. Factors that influenced the creation, transitions, and abeyance of the service are examined, and some conclusions are drawn about an information management disci-pline being exemplified by such services

Analysing Regional Sustainability Through a Systemic Approach: The Lombardy Case Study

The intrinsic complexity of the sustainability concept challenges research towards more sophisticated ways to model and assess the dimensions underlying it. However, currently adopted modelling techniques and indicators frameworks are not able to give an integrated assessment through the different components of sustainability, providing incomplete visuals of the reality that they aim to catch. This paper tries to assess how the INSURE methodology can provide a contribution in the analysis of sustainability through indicator frameworks, describing its application to the Lombardy region (Italy). Developed on the course of a 6th European Framework Program – financed project to measure sustainability in the European regions, the methodology provides two distinct sustainability representations, based on a quantitative “top-down” System Dynamics model and on a qualitative “bottom-up” System Thinking approach. The models are then linked to a hierarchical indicator framework setting policy priorities. The overall objective is thus to create a set of regional indicators, adapting the models of regional sustainability to different policy agendas. The purpose of the paper is twofold: defining a new approach to sustainability appraisal, and assessing how the Region is holistically behaving towards sustainable development. Starting from a basis analysis of the main shortcomings highlighted by the use of most adopted methodologies, the paper will verify the contribution given by the INSURE methodology to research in the fields of modelling and indicators approaches, providing insights over methodological adjustments and the results obtained from the application to Lombardy. The conclusions will show how the methodology has tried to overcome identified constraints in current models, like the strong dependence on existing datasets of the obtained representations, the under-coverage of “immaterial factors” role and the scarce integration between sustainability dimensions.ustainable Development, Regional Economics, Econometric and Input Output Models, Development Planning and Policy, Regional Analyses

Improving case study research in medical education: A systematised review

Context:Case study research (CSR) is a research approach that guides holistic investigation of a real phenomenon. This approach may be useful in medical education to provide critical analyses of teaching and learning, and to reveal the underlying elements of leadership and innovation. There are variations in the definition, design and choice of methods, which may diminish the value of CSR as a form of inquiry.Objectives:This paper reports an analysis of CSR papers in the medical education literature. The review aims to describe how CSR has been used and how more consistency might be achieved to promote understanding and value.Methods:A systematised review was undertaken to quantify the number of CSR articles published in scholarly medical education journals over the last 10 years. A typology of CSR proposed by Thomas and Myers to integrate the various ways in which CSR is constructed was applied.Results:Of the 362 full‐text articles assessed, 290 were excluded as they did not meet the eligibility criteria; 76 of these were titled ‘case study’. Of the 72 included articles, 50 used single‐case and 22 multi‐case design; 46 connected with theory and 26 were atheoretical. In some articles it was unclear what the subject was or how the subject was being analysed.Conclusions:In this study, more articles titled ‘case study’ failed than succeeded in meeting the eligibility criteria. Well‐structured, clearly written CSR in medical education has the potential to increase understanding of more complex situations, but this review shows there is considerable variation in how it is conducted, which potentially limits its utility and translation into education practice. Case study research might be of more value in medical education if researchers were to follow more consistently principles of design, and harness rich observation with connection of ideas and knowledge to engage the reader in what is most interesting

Evaluating diverse electronic consultation programs with a common framework.

BackgroundElectronic consultation is an emerging mode of specialty care delivery that allows primary care providers and their patients to obtain specialist expertise without an in-person visit. While studies of individual programs have demonstrated benefits related to timely access to specialty care, electronic consultation programs have not achieved widespread use in the United States. The lack of common evaluation metrics across health systems and concerns related to the generalizability of existing evaluation efforts may be hampering further growth. We sought to identify gaps in knowledge related to the implementation of electronic consultation programs and develop a set of shared evaluation measures to promote further diffusion.MethodsUsing a case study approach, we apply the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) and the Quadruple Aim frameworks of evaluation to examine electronic consultation implementation across diverse delivery systems. Data are from 4 early adopter healthcare delivery systems (San Francisco Health Network, Mayo Clinic, Veterans Administration, Champlain Local Health Integration Network) that represent varied organizational structures, care for different patient populations, and have well-established multi-specialty electronic consultation programs. Data sources include published and unpublished quantitative data from each electronic consultation database and qualitative data from systems' end-users.ResultsOrganizational drivers of electronic consultation implementation were similar across the systems (challenges with timely and/or efficient access to specialty care), though unique system-level facilitators and barriers influenced reach, adoption and design. Effectiveness of implementation was consistent, with improved patient access to timely, perceived high-quality specialty expertise with few negative consequences, garnering high satisfaction among end-users. Data about patient-specific clinical outcomes are lacking, as are policies that provide guidance on the legal implications of electronic consultation and ideal remuneration strategies.ConclusionA core set of effectiveness and implementation metrics rooted in the Quadruple Aim may promote data-driven improvements and further diffusion of successful electronic consultation programs