Improving Workflow in Home Healthcare Industry: A Case Study

Home healthcare industry is facing increasing pressure to change business processes and manage information flow electronically. With the help of a case example, this paper describes how a web- based system could improve the workflow communication problems in home healthcare companies. Every department of the case company has its own software to assist in everyday operations but is unable to communicate with one another electronically. All documents necessary in the coordination of care have to move physically between departments. The proposed solution is a web-based electronic form management system that would improve regulatory compliance and operating efficiency

Context Counts: Effects of Work versus Non-Work Context on Participants’ Perceptions of Fit in E-mail versus Face-to-Face Communication

There is a general need to understand better how context can affect evaluation, usage, and productivity of IT in research and practical settings. This paper investigates how perceived effectiveness of e-mail-style computer-mediated communication (CMC) differs between work and non-work contexts of use, and contrasts these differences with perceived effectiveness of face-to-face communication (FtFC). From the prior literature, we identified seven major activity domains that are prominent in CMC research. We developed a set of activity scales and corresponding measures of normative cognitive effort (NCE) for these domains and conducted an initial study to evaluate the overall instrument. In a second study, we measured perceived effectiveness of the communication mode within each activity domain among subjects who had communicated via e-mail and FtFC over a 15-week period. Some subjects communicated to support team-based software development (work context), and others communicated for personal interest (non-work context). We find communication technologies, activities, and contexts of use jointly determine perceived effectiveness; context influences perceived effectiveness primarily through interactions; and NCE successfully predicts perceived effectiveness based upon normative differences among activities. Our findings extend prior research in the area of task-technology fit to incorporate context effects, suggest that context is an important consideration in designing research, and introduce NCE as a method for predicting fit that can be applied even prior to system design. We conclude that the differential effects of work vs. non-work contexts are too large to be ignored, and we recommend an increased focus on context effects in CMC research and practice

Managerial factors influencing long-term Work From Home adoption in small and medium-sized enterprises post-pandemic

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Information Systems and Technologies ManagementDue to governmental restrictions in response to the pandemic in 2020, work from home (WFH) was crucial to maintain business continuity and market competitiveness. Small and medium-sized enterprises (SMEs) were especially affected by the pandemic as they were not as well equipped for WFH as larger companies due to a lack of resources or digital knowledge. Consequently, the pandemic shifted the labor market resulting in an increased demand for WFH, leading companies to be pressured into implementing WFH to stay competitive and attractive to employees. Nevertheless, the managers make the decision regarding employee requests for WFH and therefore play a crucial part in the adoption of WFH in enterprises. A systematic literature review is conducted to provide evidence-based factors that influence the longterm adoption of WFH post-pandemic from a managerial perspective. This dissertation applies a framework, guided by socio-technical systems theory and task-technology fit model, to examine the role of the individual, technological, organizational, and task characteristics on managers’ decisionmaking for long-term adoption of WFH. The findings of this research show that individual factors are weighted highest by managers for their decision-making. Those factors include their experiences with WFH and the corresponding trust toward employees, which are prerequisites for the implementation and shape the attitude of managers. Technological, organizational, and task characteristics are key enablers for WFH and are the building stock for its effective long-term adoption. Firstly, crucial technological factors include broadband connection, quality of communication and collaboration tools, and the perceived usefulness of the technology. Secondly, WFH policies, IT security, IT infrastructure, training, and employee performance are decisive organizational factors. Lastly, crucial task factors are the type of tasks being performed and the corresponding accessibility of information while working from home. If trust and positive experiences exist, the interviewed managers of SMEs indicated that they strive to introduce a hybrid model, in the long term, to cope with the changes in the labor market by staying competitive and attractive to qualified employees. Although key enabling factors form the basis for effective WFH, they are not fundamental enough for decision-making

Understanding the multidimensionality of information systems use:A study of nurses' use of a mandated electronic medical record system

This study outlines the findings of a qualitative study designed to develop an understanding of nurses’ experiences using an electronic medical record system (EMR) in a mandatory usage context. Drawing upon the Unified Theory of Acceptance and Use of Technology, a combined deductive/inductive research approach was adopted to study nurses working in an urban hospital system. This approach allowed for an in-depth study of the nature and structure of mandated information systems (IS) use in a healthcare context. We found that understanding the relationship between key technology acceptance constructs and system use required a multidimensional conceptualization of usage – something not commonly found in the IS literature. We identified three facets important to gaining a holistic understanding of nurses’ use of EMR technology: time spent using the system, timing of use, and mode of use. We empirically demonstrate that the dimensions of IS use can be mandated and internalized to varying degrees even within the same organization, and that the predictors of use can be differentially associated with the dimensions of use given the degree of the mandate

What and Why of Technostress: Technology Antecedents and Implications

The Bureau of Labor Statistics (2002) reports that, on average, individuals worked seven hours per week from home in addition to regular work hours. This is made possible by advances in information and communication technologies (ICTs). While the increasing workload is not unusual, it has been related to stress, including the relatively new phenomenon of stress induced by technologies (technostress). Academic literature, popular press and anecdotal evidence suggest that ICTs are responsible for increased stress levels in individuals. However, it is not very clear as to how or why ICTs create stress. Prior research on technostress has been largely descriptive. As ICTs become ubiquitous, their stressful impact can be felt at all levels of an organization. Stress related health costs are increasing dramatically and there is evidence of decreased productivity in stressed individuals (Chilton et al., 2005; Cooper et al., 2001; Jex, 1998). So, organizations have incentives to better understand stressful situations at workplace. Based on the literature from management information systems, psychology, organizational behavior, and occupational stress, a model of technostress is developed to address the question of \u27how and why information and communication technologies enable stress in individuals\u27. Person-Environment fit model (Edwards, 1996) is used as a theoretical lens to explain technostress. The research model proposes that certain technology characteristics exacerbate stressors identified in occupational stress literature leading to the manifestation of stress, referred to as strain. Specifically, technology characteristics - usability (usefulness, complexity, and reliability), intrusive (presenteeism, anonymity), and dynamic (pace of change) are proposed to be related to stressors (work overload, role ambiguity, invasion of privacy, work-home conflict, and job insecurity). Survey design methodology is used to test the proposed research model. Field data for 692 working professionals was obtained from a market research firm (Zoomerang®). In general, the results from structural equation modeling supported the hypotheses from the model. The results suggest that technostress is prevalent (and a significant predictor of overall job strain). Specifically, work overload and role ambiguity are found to be the two most dominant stressors, whereas intrusive technology characteristics are found to be the dominant predictors of stressors. The results from this study have implications for both research and practice. It opens up new avenues for research by showing that ICTs are a source of stress - thereby addressing calls to understand the stressful impacts of ICTs (Nelson, 1990; Weber, 2004). To our knowledge, it is the first empirical study to address the phenomenon of technostress that is theoretically grounded in stress research. The implications of present research to other research streams such as resistance to technologies, value of technology investments are also highlighted. Based on research findings, this research proposes certain recommendations that can influence managerial action. Foremost among these, it brings attention to presence of technostress in organizations and also provides a framework which can be used to assess the extent to which technostress is prevalent

Development of an interactive tool to support the evaluation of clinic-based health information systems

Thesis (MEng)--Stellenbosch University, 2021.ENGLISH ABSTRACT: Primary health care is considered the foundation of the health system and the principal vehicle for achieving good health and well-being for all people. A large number of challenges are faced in delivering high-quality care in South Africa’s primary health care system due to numerous adverse factors, including the historic fragmentation of the health system, inadequate infrastructure and immense resource constraints. To mitigate these adverse factors, clinic-based health information systems (CBHIS) aim to consolidate information relevant to the primary health care environment from various stakeholders across multiple areas of interest.However, CBHIS also face various socio-technical problems which lessen their effectiveness. The evaluation of CBHIS allows for these problems to be identified and mitigated; it also helps in establishing trends of well-functioning aspects which may be disseminated for system improvement.Thus, supporting the evaluation of CBHIS would strengthen the primary health care system.In this study, an interactive tool is developed to support the evaluation of CBHIS. The interactive tool is developed, refined and validated through multiple design cycle iterations, as informed by the Design Science Research framework. Various tool components are established by leveraging insights obtained from the Monitoring and Evaluation as well as Information Systems domain. These components are refined through conducting a theoretical case study of the Stock Visibility System and critically evaluated by multiple subject-matter experts to ensure the rigour of the development process and relevance to support evaluation.The components are consolidated and implemented on a computer as the final interactive tool to support the evaluation of CBHIS. The interactive tool comprises three outputs which present a tangible set of interrelated evaluation concepts in a simple, structured and useful manner, namely,a concept inventory, responsive concept map and an evaluation support document. The interactive tool is demonstrated to illustrate its applicability and capacity to support the evaluation of CBHIS.AFRIKAANSE OPSOMMING: Primêre gesondheidsorg word beskou as die grondslag van die gesondheidstelsel en die belangrikste middel om goeie gesondheid en welstand vir alle mense te bewerkstellig. 'n Groot aantal uitdagings verhoed die lewering van hoë gehalte sorg in primêre gesondheid as gevolg van talle nadelige faktore, insluitend die historiese versplintering van die gesondheidstelsel, onvoldoende infrastruktuur en geweldige beperkings op nodige hulpbronne. Dit is clinic-based health information systems(CBHIS) se doelwit om inligting wat vir die primêre gesondheidsorg-omgewing van verskillende belanghebbendes relevant is, op verskillende terreine te konsolideer en sodoende te help om die nadelige faktore waarmee die gesondheidstelsel te kampe het, teverlig.Die stelsels het egter ook verskillende sosio-tegniese probleme wat die doeltreffendheid daarvan verminder. Die evaluering van CBHIS maak dit moontlik om hierdie probleme te identifiseer en teverlig; dithelp ook om tendense vas te stel van goed funksionerende aspekte in die stelsels wat versprei kan word vir algemene verbeterings. Daar bestaan dus ‘nbehoefte om die primêre gesondheidsorgstelsel te versterk deur die ondersteuning van die evaluering van CBHIS. In hierdie studie word 'n interaktiewe hulpmiddel ontwikkel om die evaluering van CBHIS te ondersteun. Die hulpmiddel word ontwikkel, verfyn en bekragtig deur middel van veelvuldige herhalings van die ontwerpsiklus, soos ingelig deur die Design Science Researchraamwerk. Verskeie komponente van die hulpmiddel word vasgestel deur gebruik te maak van insigte wat verkry word uit die Monitering en Evaluering asook die Inligtingstelsels domeine. Hierdie komponente word verfyn deur die uitvoering van 'n teoretiese gevallestudievandie Stock VisibilitySystemen word krities geëvalueer deur verskeie kenners op die gebiede om die noukeurigheid van die ontwikkelingsproses en die relevansie vir evaluering te verseker. Die komponente word op 'n rekenaar gekonsolideer en geïmplementeer as die finaleinteraktiewe hulpmiddel om die evaluering van CBHIS te ondersteun. Die interaktiewe hulpmiddel bevat drie funksionele uitsette wat 'n tasbare stel onderling verwante evalueringskonsepte op 'n eenvoudige, gestruktureerde en nuttige manier bied. Hierdie komponente sluit in: 'n konsepinventaris, 'n responsiewe konsepkaart en 'n ondersteuningsdokument vir evaluering. Die interaktiewe hulpmiddel word gedemonstreer om toepaslik te wees om die evaluering van CBHIS te ondersteun

Mobile technology-enabled healthcare service delivery systems for community health workers in Kenya: a technology-to-performance chain perspective

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, School of Economic & Business Sciences, November 2016Community Health Workers or “CHWs” are often the only link to healthcare for millions of people in the developing world. They are the first point of contact with the formal care system, and represent the most immediate and cost effective way to save lives and improve healthcare outcomes in low-resource contexts. Mobile-health or ‘mHealth’ technologies may have potential to support CHWs at the point-of-care and enhance their performance. Yet, there is a gap in substantive empirical evidence on whether the use of mHealth tools enhances CHW performance, and how their use contributes to enhanced healthcare service delivery, especially in low-resource communities. This is a problem because a lack of such evidence would pose an obstacle to the effective large-scale implementation of mHealth-enabled CHW projects in low-resource settings. This thesis was motivated to address this problem in the Kenyan community health worker context. First, it compared the performance of CHWs using mHealth tools to those using traditional paper-based systems. Second, it developed and tested a replicable Technology-to-Performance Chain (TPC) model linking a set of CHW task and mHealth tool characteristics, to use and user performance outcomes, through four perspectives of Task-Technology Fit (TTF), namely Matching, Moderation, Mediation, and Covariation. A quasi-experimental post-test only research design was adopted to compare performance of CHWs using an mHealth tool to those using traditional paper-based systems. A primary structured questionnaire survey instrument was used to collect data from CHWs operating in the counties of Siaya, Nandi, and Kilifi, who were using an mHealth tool to perform their tasks (n = 257), and from CHWs operating in the counties of Nairobi and Nakuru using traditional paper-based systems to perform their tasks (n = 353). Results showed that CHWs using mHealth tools outperform their counterparts using paper-based systems, as they were observed to spend much less time completing their monitoring, prevention, and referral reports weekly, and report higher percentages of both timeous and complete monthly cases. In addition, mHealth tool users were found to have more positive perceptions of the effects of the technology on their performance, compared to those using traditional paper-based systems. An explanatory, predictive, research design was adopted to empirically assess the effects of a ‘fit’ between the CHW task and mHealth technology (TTF) on use of the mHealth technology and on CHW user performance. TTF was tested from the Matching, Moderation, Mediation, and Covariation ‘fit’ perspectives using the cross-sectional survey data collected from the mHealth tool users (n = 257). Results revealed that there are various unique ways in which a ‘fit’ between the task and technology can have significant impacts on use and user performance. Specifically, results showed that the paired-match of time criticality task and technology characteristics impacts use, while that of time criticality and information dependency task and technology characteristics impacts user performance. Results also showed that the cross-product interaction of mobility task and interdependence technology characteristics impacts use, and that of mobility task and interdependence and information dependency technology characteristics, impacts user performance. Similarly, the cross-product interaction of information dependency task and time criticality technology characteristics impacts user performance. Moreover, results showed that a perceived ‘fit’ between CHW task and mHealth technology characteristics partially and fully mediates the effects of user needs and tool functions on use and user performance, whereas ‘fit’ as an observed pattern of holistic configuration among these task and technology characteristics impacts use and user performance. It was also found that the perfect ‘fit’ between CHW task and mHealth tool technology characteristics leads to the highest levels of use and user performance, while a misfit leads to a decline in use and user performance. Notably, an over-fit of mHealth technology support to the CHW task leads to declining use levels, while an under-fit leads to diminishing user performance. Of the four ‘fit’ perspectives tested, the matching and cross-product interaction of task and technology characteristics offer the most dynamic insights into use and user performance impacts, whereas user-perception and holistic configuration, were also shown to be significant, thus further reinforcing these effects. Tests of a full TPC model revealed that greater mHealth tool use had a positive effect on the effectiveness, efficiency, and quality of CHW performance in the delivery of patient care. Moreover, it was found that ‘facilitating conditions’ and ‘affect toward use’ had positive effects on mHealth tool use. Furthermore, a perceptual TTF was found to have positive effects on mHealth tool use and CHW performance. Of note, this perceived TTF construct was found to be simultaneously a stronger predictor of mHealth tool use than ‘facilitating conditions’ and ‘affect toward use’, and a stronger predictor of CHW performance than mHealth tool use. Consequently, TTF was confirmed as the central construct of the TPC. The findings constitute significant empirical insights into the use of mHealth tools amongst CHWs in low resource settings and the extent to which mHealth contributes to the enhancement of their overall performance in the capture, storage, transmission, and retrieval, of health data as part of their typical workflows. This study has provided much needed evidence of the importance of a ‘fit’ between CHW task and mHealth technology characteristics for enabling mHealth impacts on CHW performance. The study also shows how these inter-linkages could improve the use of mHealth tools and the performance of CHWs in their delivery of healthcare services in low-resource settings, within the Kenyan context. Findings can inform the design of mHealth tools to render more adequate support functions for the most critical CHW user task needs in a developing world context. This study has contributed to the empowerment of CHWs at the point-of-care using mHealth technology-enabled service delivery in low-resource settings, and contributes to the proper and successful ‘scaling-up’ of implemented mHealth projects in the developing world.MT 201

Multifaceted understanding of user behaviour and implementation success of electronic medication management system

This study aims to comprehensively understand user behaviour and the implementation success of an electronic medication management system (eMMS) with multiple perspectives, such as user resistance, assimilation, changes in user perceptions, etc. Two cross-sectional surveys were conducted in an Australian hospital, one at the time of implementation and another one at one year after the implementation. The data collected were quantitatively analysed with SEM. FsQCA (fuzzy set Qualitative Comparative Analysis) was also employed to complement SEM-based analysis. User resistance study indicated that performance expectancy, switching costs, and facilitating conditions are direct predictors of clinician resistance, whereas effort expectancy and social influence showed indirect effects on clinician resistance through performance expectancy or switching costs. The study of changes in user perceptions indicated that most expectations had been positively confirmed in the assimilation stage. More importantly, while performance expectancy and social influence remain important one year after the implementation, effort expectancy and facilitating conditions are moving toward a decrease in importance to the success of eMMS. IT assimilation study showed that nurses with more absorptive capacity are more deeply and widely assimilated. For doctors, their direct supervisors and intrinsic motivation influence their depth of assimilation. Interestingly, nurses with a more favourable perception of performance expectancy have assimilated more deeply, whereas more deeply assimilated doctors are those with a less favourable perception of performance expectancy. FsQCA analysis showed that doctors should have a high general ability and high selfmotivation, and they should be rewarded in their performance evaluation for both high assimilation width and depth. In contrast, nurses should have a high general ability for high assimilation width and high self-motivation for high assimilation depth