ANALYZING BEST PRACTICE AND CRITICAL SUCCESS FACTORS IN A HEALTH INFORMATION SYSTEM CASE – ARE THERE ANY SHORTCUTS TO SUCCESSFUL IT IMPLEMENTATION?

This paper discusses critical success factors (CSF) and best practice in relation to IT implementation in the health sector. We have studied a University Hospital’s implementation of a health information system (HIS) and particularly one clinic which implementation process was described as very successful compared to other units at this hospital. The purpose of the paper is to gain further understanding of if and how well CSFs and best practice solutions can explain this successful case. We do this in order to explore if CSFs and best practice offer any shortcuts to successful IT implementation. By understanding the reasons behind this case’s success we can identify if CSFs and best practice potentially can explain the success, or if there are other explanations in this case. Based on our findings we discuss and question the sometimes overestimated belief in CSFs and best practice as shortcuts to success performance. An important contribution from this study is that situational and contextual factors are very critical to understand and acknowledge during HIS implementations

Physicians’ Perceptions of Facilitators and Barriers in Electronic Health Record Education

A significant focus in health care is quality documentation to lower patient safety risks. The local problem at a healthcare organization in the northeastern United States is that some physicians are falling short with quality documentation of patient care in athenaNet, a cloud-based electronic health record (EHR). This qualitative case study was conducted to explore physicians\u27 perceptions of the facilitators and barriers that impact the educational process for quality documentation in EHRs. Attention also focused on identifying physicians\u27 recommendations for enhancing the educational process for quality documentation. Knowles’ adult learning theory served as the conceptual framework. Purposeful sampling was used to select participants who had a minimum of 5 years’ experience as a physician and had worked with multiple EHRs in the past. Individual interviews with 11 physicians were supplemented with review of documents in athenaNet on milestones in physician documentation. Data analysis included coding of interview transcripts and information from documents to identify common themes: (a) preparation for implementation, (b) specialty-specific training, (c) hands-on practice, (d) time limitations on completing training, (e) preparedness for EHR go-live, and (f) additional training resources. Findings of the study were used to develop a white paper to increase the quality of the documentation entered into an EHR, and to lower patient safety risks through more effective continuing education. The study contributes to positive social change through modifications to the current training methodology for the EHR as a solution to assisting physicians to complete quality documentation

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective

Background Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients’ medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. Objectives This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. Methods We used Grounded Theory to analyse data collected in the context of Brunei’s national EHR − the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Results Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Discussion Workflow changes were significant challenges to clinicians’ confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment

Searching Success in a Successful IS Acquisition

In today’s business world, information systems (IS) are often acquired from an external vendor rather than being developed in-house. Although the number of studies related to the success of IS acquisitions has increased, there is limited understanding of the relationship between acquisition project success, the final IS success, and their role in defining whether the acquisition endeavor was ultimately successful. For instance, in public sector organizations, there is a tendency for the acquisition project to be conducted outside the acquiring unit. This means that success can be evaluated at multiple levels in the organization, and the different levels might not have identical aspirations related to the acquisition. This can cause organizational issues, especially when the evaluation of success is left in the hands of only one of these parties. In this paper, we study the facets of IS acquisition success by presenting differing aspects that are used in defining IS acquisition success, pointing out a contradiction between the formally measured success and the perceived success. As a result, we propose an IS acquisition success model. The study is conducted as a single case study of a public sector organization in Finland

Why we need biased AI -- How including cognitive and ethical machine biases can enhance AI systems

This paper stresses the importance of biases in the field of artificial intelligence (AI) in two regards. First, in order to foster efficient algorithmic decision-making in complex, unstable, and uncertain real-world environments, we argue for the structurewise implementation of human cognitive biases in learning algorithms. Secondly, we argue that in order to achieve ethical machine behavior, filter mechanisms have to be applied for selecting biased training stimuli that represent social or behavioral traits that are ethically desirable. We use insights from cognitive science as well as ethics and apply them to the AI field, combining theoretical considerations with seven case studies depicting tangible bias implementation scenarios. Ultimately, this paper is the first tentative step to explicitly pursue the idea of a re-evaluation of the ethical significance of machine biases, as well as putting the idea forth to implement cognitive biases into machines

Nursing Approaches for Use and Sustainability of Barcode Medication Administration Technology

Approximately 43.4% of medication errors occur at the time of administration despite the use of bar code medication administration (BCMA) System. This trend has prompted a national effort to mitigate this problem in the United States. Implementing BCMA in health care settings is one of those efforts. Studies focusing on the approaches employed by nurses when using this system are scant. The purpose of this qualitative case study was to investigate strategies nurses and their leaders use to ensure BCMA is implemented, maximized, and sustained. The technology acceptance model was used to guide the study. The 2 research questions addressed nurses\u27 perceptions regarding the use and optimization of BCMA, and approaches of clinical nurses and their leaders to ensure that BCMA technology is properly used, optimized, and sustained in acute care units. Data collection included semistructured interviews with 8 participants. Thematic data analysis generated themes including ease of use, reduce errors, time saving, old technology, overreliance on technology, paper backups, and hope for future development. Common barriers to system effectiveness were system errors and inadequate training; intragroup and self-monitoring were important strategies to sustain use of the system. Study results may be used by health care leadership to reduce medication errors by adopting easy to use technology, change policies regarding training of BCMA end users in hospitals, increase the culture of patient safety among nurses, and prompt technology redesign within health care settings that meets the national patient safety goals

How lean are the smaller ones? : Adoption of lean practices and impact measurement in medium-sized manufacturing firms in Finland

Traditionally, Lean philosophy can be summarized as “doing more with less”. Thus, having well planned and efficient operations can give manufacturing companies a competitive edge through minimizing waste and increasing quality and customer value. The whole potential of Lean manufacturing can be utilized if the ideas are comprehensively incorporated within the organization. This requires resources, which smaller-scale firms might not have available. This study aims to investigate how extensively lean is adopted across these smaller manufacturing organizations in Finland. First, background for the study is provided to give insight to lean philosophy as well as justifications for companies to measure impacts and performance. Next, the empirical part of the paper investigates the adoption of lean tools and measurement of their impact in Finnish production firms. The research limits to the study of active firms that have their own manufacturing operations and are based in Finland. In addition, they have operating turnover over 1 million, but under 10 million euros and employ 15-150 people. The findings suggest that lean philosophy is not highly adopted across smaller scale manufacturing firms in Finland. Additionally, majority of the lean users are flying blind and not measuring the progression of the desired impacts. However, one major limitation of this study is its small sample size, thus the results are merely directive

A Theory of Organization-EHR Affordance Actualization

While organizations implement information technology (IT) to effect change, current theories of IT-associated organizational change pay insufficient attention to the change goals, the role of IT in organizational change, and the multilevel nature of change processes. We take a fresh look at IT-associated organizational change using grounded theory methods. Our longitudinal study of an electronic health record (EHR) system implementation in a multi-site medical group found user behaviors that did not fit well with existing theories. Instead, we found that they fit better with the concept of affordances from ecological psychology. In developing our affordance-based theory of IT-associated organizational change from our field data, we discovered three gaps in the affordance literature; namely, the lack of theory for (1) the process of actualizing an affordance’s potential, (2) affordances in an organizational context, and (3) bundles of interrelated affordances. This paper extends the theory of affordances to handle these three gaps and, in doing so, develops a mid-range theory for EHR-associated organizational change in a healthcare organization. While the resulting theory is specific to EHR implementations, it offers a template for other mid-range affordance-actualization theories and a more general affordance-actualization lens. Our affordance-actualization lens considers the materiality of the IT artifact, the non-deterministic process by which IT leads to organizational effects, the multilevel nature of IT-associated change processes, and the intentionality of managers and users as agents of change, and thus addresses important criteria for theories of IT effects in organizations. The paper also provides practical guidance for implementing EHR systems and other organizational systems

ERP implementation methodologies and frameworks: a literature review

Enterprise Resource Planning (ERP) implementation is a complex and vibrant process, one that involves a combination of technological and organizational interactions. Often an ERP implementation project is the single largest IT project that an organization has ever launched and requires a mutual fit of system and organization. Also the concept of an ERP implementation supporting business processes across many different departments is not a generic, rigid and uniform concept and depends on variety of factors. As a result, the issues addressing the ERP implementation process have been one of the major concerns in industry. Therefore ERP implementation receives attention from practitioners and scholars and both, business as well as academic literature is abundant and not always very conclusive or coherent. However, research on ERP systems so far has been mainly focused on diffusion, use and impact issues. Less attention has been given to the methods used during the configuration and the implementation of ERP systems, even though they are commonly used in practice, they still remain largely unexplored and undocumented in Information Systems research. So, the academic relevance of this research is the contribution to the existing body of scientific knowledge. An annotated brief literature review is done in order to evaluate the current state of the existing academic literature. The purpose is to present a systematic overview of relevant ERP implementation methodologies and frameworks as a desire for achieving a better taxonomy of ERP implementation methodologies. This paper is useful to researchers who are interested in ERP implementation methodologies and frameworks. Results will serve as an input for a classification of the existing ERP implementation methodologies and frameworks. Also, this paper aims also at the professional ERP community involved in the process of ERP implementation by promoting a better understanding of ERP implementation methodologies and frameworks, its variety and history

Information security management in cloud computing:a case study

Abstract. Organizations are quickly adopting cloud computing in their daily operations. As a result, spending’s on cloud security solutions are increasing in conjunction with security threats redirecting to the cloud. Information security is a constant race against evolving security threats and it also needs to advance in order to accommodate the cloud computing adaptation. The aim of this thesis is to investigate the topics and issues that are related to information security management in cloud computing environments. Related information security management issues include risk management, security technology selection, security investment decision-making, employees’ security policy compliance, security policy development, and security training. By interviewing three different types of actors (normal employees, IT security specialists, and security managers) in a large ICT-oriented company, this study attempts to get different viewpoints related with the introduced issues and provide suggestions on how to improve information security management in cloud computing environments. This study contributes to the community by attempting to give a holistic perspective on information security management in the specific setting of cloud computing. Results of the research illustrate how investment decisions directly affect all other covered topics that in turn have an effect on one another, forming effective information security