Information systems and healthcare XXIV: Factors affecting the EAI adoption in the healthcare sector

Recent developments in the field of integration technologies like Enterprise Application Integration (EAI) have emerged to support organizations towards improving the quality of services and reducing integration costs. Despite the importance of EAI, there is limited empirical research reported on its adoption in the healthcare sector. Khoumbati et al. [2006] developed a model for the evaluation of EAI in healthcare organizations. In doing so, the causal interrelationship of EAI adoption factors was identified by using fuzzy cognitive mapping. This paper is a progression of previous work in the area and seeks to contribute by validating the model through a different case environment. Thus, this paper contributes by deriving and proposing the MAESTRO model for EAI adoption. MAESTRO identifies a set of factors that influence EAI adoption and it is evaluated through a real-life case study. It provides an understanding of the EAI adoption process through its grounding on empirical data. In doing so, the MAESTRO model supports the management of healthcare organizations during the decision-making process for EAI adoption

Electronic Health Record Implementation Strategies for Decreasing Healthcare Costs

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training logs, activity records, and cost information. Methodological triangulation was used to validate the creditability and interpretation of the data in transcribing themes. Three themes emerged from the analysis of study data: implementation of EHRs, costs of implementing EHRs, and perceived usefulness of EHRs. Participants indicated that the implementation of EHRs depended on motivation, financial cost, and the usefulness of EHRs relating to training that reflected user-friendliness. The implications of this study for social change include the potential to lower the cost and improve the efficiency of healthcare for patients. The use of EHR systems could enhance the quality of care delivered to patients through improved accessibility, elimination of duplicative tests, and retrieval of accurate patient information. The use of EHRs can lead to a comprehensive preventative healthcare system resulting in a healthier environment

Enhancing User Acceptance of Mandated Technology Implementation in a Mobile Healthcare Setting: A Case Study

A paradigm shift is underway towards the acceptance and utility of Personal Digital Assistant (PDA) systems within mobile-based healthcare environments. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a ‘best fit’ with end user needs. It is envisaged this research will lead to the development of a framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a proposed mandated electronic point-of-care (ePOC) information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented

Understanding the processes of Information Systems deployment and evaluation: The challenges facing e-health

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Information Systems (IS) innovations in healthcare sector are seen as panacea to control burgeoning demand on healthcare resources and lack of streamlining in care delivery. Two particular manifestations of such innovations are telehealth and electronic records in its two forms: the electronic medical records and the electronic health records. Deployment efforts concerning both of these IS-innovations have encountered a rough terrain and have been slow. Problems are also faced while evaluating the effectiveness of innovations on health and care delivery outcomes through strategies such as randomised controlled trials- particularly in case of telehealth. By taking these issues into account, this research investigates the issues that affect IS innovation deployment and its evaluation. The strategy adopted in this research was informed by recursive philosophy and theoretical perspectives within IS that strived to expound this recursive relationship. It involved conducting two longitudinal case studies that are qualitative in nature. The first study involved telehealth deployment and its evaluation in the UK, while the second case study involved the deployment of electronic medical/health records in the US. Data was collected through focus group discussions, interviews and online discussion threads; and was analysed thematically. The results of this research indicate that there are nine issues that arise and affect the deployment and evaluation of IS innovation in healthcare; and these are design, efficiency and effectiveness, optimality and equity, legitimacy, acceptance, demand and efficacy, expertise, new interaction patterns, and trust. These issues are attributes of relationships between the IS innovation, context of healthcare and the user. The significance of these attributes varies during the deployment and evaluation process, and due to iterative nature of IS innovation. This research further indicates that all the attributes have either direct or indirect impact on work practices of the user.Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH

Health Information Technology Implementation Strategies in Zimbabwe

The adoption rate of health information technology (HIT) remains low in developing countries, where healthcare institutions experience high operating costs and loss of revenue, which are related to systems and processes inefficiency. The purpose of this case study was to explore strategies leaders in Zimbabwe used to implement HIT. The conceptual framework of the study was Davis\u27s technology acceptance model (TAM). Data were gathered through observations, review of organizational documents (i.e., policies, procedures, and guidelines), and in-depth interviews with a purposive sample of 10 healthcare leaders and end-users from hospitals in Zimbabwe who had successfully implemented HIT. Transcribed interview data were coded and analyzed for emerging themes. Implementation strategies, overcoming barriers to adoption, and user acceptance emerged as the themes most healthcare leaders associated with successful HIT projects. Several subthemes also emerged, including: (a) the importance of stakeholder involvement, (b) the importance of management buy-in, and (c) the low level of IT literacy among healthcare workers. The strategies identified in this study may provide a foundation on which healthcare leaders in developing countries can successfully adopt and implement HIT. The recommendations from this study could lead to positive social change by providing leaders with knowledge and skills to use information technology strategies to deliver better healthcare at lower costs while creating employment for local communities

FROM REPRESENTATIVE TO TRANSFORMATIVE USER PARTICIPATION – A CASE STUDY OF PUBLIC HEALTHCARE DIGITALIZATION

User participation in IS implementation is a core topic for the IS community. While most of our current participation theories emerged in the 1990s and 2000s, recent developments such as the emergence of large half-built products and the increased emphasis on digital transformation necessitate revisiting current understanding of participation. User participation is not anymore about merely representing the organization\u27s domain knowledge - what we call representative participation. Users participating in modern IS implementation projects need to possess additional types of knowledge and skills. This includes knowledge about the products, knowledge about the intended transformation, and leadership skills, to name a few. We investigate this emerging type of user participation - what we call transformative participation through a case study of an IS implementation project within healthcare. We discuss the knowledge and skills needed to function as transformative users as well as the challenges faced by these users

Causes of Challenges in Implementing Computer-Based Knowledge Management Systems in Healthcare Institutions: A Case Study of Private Hospitals in Johannesburg, South Africa

The advent of computer-based knowledge management systems has changed the world, especially in the way businesses operate, making them an integral aspect to modern economies and the drivers of success. Studies show that the implementation of computer-based knowledge management systems is challenging, particularly in healthcare institutions. This paper presents a study that was undertaken to identify the causes of challenges encountered when implementing computer-based knowledge management systems in healthcare institutions. A case was used as this study’s research methodology in which three private hospitals based in Johannesburg, South Africa, were utilized. Six participants, two from each private hospital, were purposively selected and interviewed. Researchers collected data in the form of notes and qualitatively analyzed it. The following findings were identified: failure to make organizational culture change to align with computer-based knowledge management systems; no support, commitment and accountability; knowledge gap between medical and knowledge management designers; fast-changing of technology; shortage of skilled human resources; failure to convert tacit and explicit information into systematic knowledge; and failure to comprehend healthcare complexity. The aim of this study is to present a comprehensive synopsis of the causes of challenges encountered when implementing computer-based knowledge management systems in Johannesburg healthcare organizations

A Multiple Case Exploration Of Designers And Reflection In The Design Space

For decades, scholars have searched for ways to more effectively teach and practice instructional design. A variety of strategies have been employed to address the ambiguity in and challenges of the field. Much of the focus in the education of instructional designers has been on teaching students how best to use the many models developed for the field (Rowling, 1992). These efforts, while meant to help the new instructional designer succeed, have often been stifled by the ever-changing landscape of what instructional designers are asked to do in their roles after graduation (Kenny, Zhang, Schwier, & Campbell, 2005). Other research centers around the ways students can fuse their new instructional design knowledge with practical activities. While many scholars have begun to focus on alternative methods for preparing instructional designers and improving instructional design processes, instructional designers themselves have been neglected. We teach instructional designers about the profession before we have truly understood the professional. From a teaching standpoint, this approach contradicts the very foundation of instructional design education: that of recognizing that the learners/users are at the center of instructional design (Cennamo & Kalk, 2004). The purpose of this qualitative study was to examine instructional designers during design by engaging them in structured reflection as (a.) a way to better understand instructional designers in the design space and (b.) a technique for instructional designers to improve their design. Seven designers were asked to explore their thoughts, feelings, and experiences over six weeks while engaged in a design project. This study used various data collection methods including reflection journals, interviews, and surveys. The Self-Reflection Insight Scale (SRIS) and REFLECT rubric were utilized to measure reflection abilities, and grounded theory was employed to conceptualize the data (Strauss & Corbin, 1990), while concentrating on discovery and the development of theory (Charmaz, 1983). Results showed that each designer is unique; designers rely on distinctive designer precedents; designers perceive reflection to positively impact their design products; designers\u27 depth of reflection waxes and wanes; and designers reflect more deeply when provided with feedback

Security Specialists are from Mars; Healthcare Practitioners are from Venus: The Case for a Community-of-Practice Approach to Security Architectures for Healthcare

Information security is a necessary requirement of information sharing in the healthcare environment. Research shows that the application of security in this setting is sometimes subject to work-arounds where healthcare practitioners feel forced to incorporate practices that they have not had an input into and with which they have not engaged with. This can result in a sense of security practitioners and healthcare practitioners being culturally very different in their approach to information systems. As a result such practices do not constitute part of their community of practice nor their identity. In order to respond to this, systems designers typically deploy user-centred, participatory approaches to design using various forms of consultation and engagement in order to ensure that the needs of users are responded to within the design. Learning from international implementations of e-health, the development of the Australian electronic health records (EHR) system has been a participatory process. However, the more participatory approach has not been used as part of the technical security design of the e-health system and the functionality of the security governance architecture was not included in the process of consultation. Such exclusions result in a design-reality gap in so far as the healthcare systems as envisioned by designers are not easily related to by “front-line” clinical staff. Despite repeated design-reality issues in healthcare systems design, there is no fundamental change in the development paradigm to address the socio-technical security aspects of such systems. Indeed, the security perspective of system designers seems to originate from a very different perspective to that of front-line clinical staff. This discussion paper characterises the problem, uses examples from both the UK and Australian EHR experience, and proposes an alternative start-point to healthcare systems design

Radical Technological Innovation and Perception: A Non-Physician Practitioners’ Perspective

Radical technological innovations, such as chatbots, fundamentally alter many aspects of healthcare organizations. For example, they transform how clinicians care for their patients. Despite the potential benefits, they cannot be integrated into practice without the support of the clinicians whose jobs are affected. While previous research shed important light on physicians’ perceptions, little is known on nonphysician practitioners view said innovations. This paper reports on a qualitative study, involving 10 nonphysician clinicians from Ontario, Canada, conducted to determine the perceptions and cognitions of clinicians regarding radical innovation and their previous experiences with technological change. Results indicate that clinicians as semi-autonomous agents can interpret and act upon their environment with regard to determining how innovations such as chatbots are implemented