Accessing Patient Records in Virtual Healthcare Organisations

The ARTEMIS project is developing a semantic web service based P2P interoperability infrastructure for healthcare information systems that will allow healthcare providers to securely share patient records within virtual healthcare organisations. Authorisation decisions to access patient records across organisation boundaries can be very dynamic and must occur within a strict legislative framework. In ARTEMIS we are developing a dynamic authorisation mechanism called PBAC that provides a means of contextual and process oriented access control to enforce healthcare business processes. PBAC demonstrates how healthcare providers can dynamically share patient records for care pathways across organisation boundaries

Team to Market (T2M): Creating High Performance Teams in the Digital Age

1. Teams are the essential means of product or service delivery and the fundamental building blocks of modern organisations. An effective team can produce results far outperforming a collection of even the most talented individuals when team members coalesce and jell into a single, well-functioning, fully-aligned organism. This report advances the notion of “Team to Market” (T2M) to help business leaders and knowledge workers understand, create and lead high performance teams in the digital age

Rethinking De-Perimeterisation: Problem Analysis And Solutions

For businesses, the traditional security approach is the hard-shell model: an organisation secures all its assets using a fixed security border, trusting the inside, and distrusting the outside. However, as technologies and business processes change, this model looses its attractiveness. In a networked world, “inside” and “outside” can no longer be clearly distinguished. The Jericho Forum - an industry consortium part of the Open Group – coined this process deperimeterisation and suggested an approach aimed at securing data rather than complete systems and infrastructures. We do not question the reality of de-perimeterisation; however, we believe that the existing analysis of the exact problem, as well as the usefulness of the proposed solutions have fallen short: first, there is no linear process of blurring boundaries, in which security mechanisms are placed at lower and lower levels, until they only surround data. To the contrary, we experience a cyclic process of connecting and disconnecting of systems. As conditions change, the basic trade-off between accountability and business opportunities is made (and should be made) every time again. Apart from that, data level security has several limitations to start with, and there is a big potential for solving security problems differently: by rearranging the responsibilities between businesses and individuals. The results of this analysis can be useful for security professionals who need to trade off different security mechanisms for their organisations and their information systems

Integration and Continuity of Primary Care: Polyclinics and Alternatives, a Patient-Centred Analysis of How Organisation Constrains Care Coordination

Background An ageing population, increasingly specialised of clinical services and diverse healthcare provider ownership make the coordination and continuity of complex care increasingly problematic. The way in which the provision of complex healthcare is coordinated produces – or fails to – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational, relational). Care coordination is accomplished by a combination of activities by: patients themselves; provider organisations; care networks coordinating the separate provider organisations; and overall health system governance. This research examines how far organisational integration might promote care coordination at the clinical level. Objectives To examine: 1. What differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical coordination of care. 2. What difference provider ownership (corporate, partnership, public) makes. 3. How much scope either structure allows for managerial discretion and ‘performance’. 4. Differences between networked and hierarchical governance regarding the continuity and integration of primary care. 5. The implications of the above for managerial practice in primary care. Methods Multiple-methods design combining: 1. Assembly of an analytic framework by non-systematic review. 2. Framework analysis of patients’ experiences of the continuities of care. 3. Systematic comparison of organisational case studies made in the same study sites. 4. A cross-country comparison of care coordination mechanisms found in our NHS study sites with those in publicly owned and managed Swedish polyclinics. 5. Analysis and synthesis of data using an ‘inside-out’ analytic strategy. Study sites included professional partnership, corporate and publicly owned and managed primary care providers, and different configurations of organisational integration or separation of community health services, mental health services, social services and acute in-patient care. Results Starting from data about patients' experiences of the coordination or under-coordination of care we identified: 1. Five care coordination mechanisms present in both the integrated organisations and the care networks. 2. Four main obstacles to care coordination within the integrated organisations, of which two were also present in the care networks. 3. Seven main obstacles to care coordination that were specific to the care networks. 4. Nine care coordination mechanisms present in the integrated organisations. Taking everything into consideration, integrated organisations appeared more favourable to producing continuities of care than were care networks. Network structures demonstrated more flexibility in adding services for small care groups temporarily, but the expansion of integrated organisations had advantages when adding new services on a longer term and larger scale. Ownership differences affected the range of services to which patients had direct access; primary care doctors’ managerial responsibilities (relevant to care coordination because of its impact on GP workload); and the scope for doctors to develop special interests. We found little difference between integrated organisations and care networks in terms of managerial discretion and performance. Conclusions On balance, an integrated organisation seems more likely to favour the development of care coordination, and therefore continuities of care, than a system of care networks. At least four different variants of ownership and management of organisationally integrated primary care providers are practicable in NHS-like settings

Achieving success in collaborative research: the role of virtual research environments

Due to various challenges and opportunities such as globalisation of research agenda and advancements in information and communication technologies, research collaborations (both international and national) have become popular during the last decade more than ever before. Within this context, the concept of Virtual Research Environments is an emerging concept looking at addressing the complex challenges associated with conducting collaborative research. The research reported within this paper investigated how the success factors of collaborative research can be achieved by deploying a Virtual Research Environment

Achieving success in collaborative research: the role of virtual research environments

Due to various challenges and opportunities such as globalisation of research agenda and advancements in information and communication technologies, research collaborations (both international and national) have become popular during the last decade more than ever before. Within this context, the concept of Virtual Research Environments is an emerging concept looking at addressing the complex challenges associated with conducting collaborative research. The research reported within this paper investigated how the success factors of collaborative research can be achieved by deploying a Virtual Research Environment

Redesigning work organizations and technologies: experiences from European projects

Currently distributed business process (re) design (resulting in components of business networks) basically relies on technical criteria. And that are the main purposes of most research projects supported by EC. Through the process of building a European Research Area, this means a strong influence in the national research programmes. However it is generally accepted that it should also take into account social criteria and aspects such as the quality of working life, or participation in decision processes. Those were some of the objectives of projects in de 80s decade, and framed some of the main concepts and scientific approaches to work organisation. The democratic participation of network and organisations members in the design process is a critical success factor. This is not accepted by everyone, but is based in sufficient case studies. Nevertheless, in order to achieve an optimization that can satisfying the requirements of agility of a network of enterprises, more complex design methods must be developed. Thus, the support to the collaborative design of distributed work in a network of enterprises, through a concurrent approaching business processes, work organisation and task content is a key factor to achieve such purposes. Increasing needs in terms of amounts of information, agility, and support for collaboration without time and space constrains, imposes the use of a computer-based model.business process; networks; decision processes; collaborative design;

Digital transformation in the arts : a case study

This paper considers the interaction between digital technology and cultural organisations and the challenges and opportunities this presents for practice and for policy. The paper is based on one of eight 'digital R&D' projects supported by NESTA, Arts Council England and the AHRC, designed to analyse the effects of digital innovation in UK arts organisations. The paper focuses on a series of residencies in three UK arts organisations. The research aims to identify the cultural conditions which support or prevent short-term digital innovation becoming 'embedded' in the ongoing practice of a cultural organisation. The paper considers differing practices, attitudes and expectations between creative technologists and arts organisations. These differing 'cultures of innovation' may help us to understand why digital innovations often fail to move beyond temporary and pragmatic problem-solving towards more challenging, transformational effects on organisational strategy and culture