Healthcare Analytics: Examining the Diagnosis–treatment Cycle

AbstractResearch has demonstrated that the patients’ diagnosis-treatment cycles often significantly deviate from the standardized clinical pathways. Analyzing these deviations might result in the further enhancement of the quality of care, the promotion of patient safety, an increase in patient satisfaction and an optimization of the use of resources. Understanding pathway behavior and deviations becomes possible because of an increased availability of reliable data, which originates from the hospitals information systems.In this paper we propose a clinical pathway analysis method for extracting valuable medical and organizational information on past diagnosis-treatment cycles that can be attributed to a specific clinical pathway. The method is applied on the clinical pathway processes in a Gynecologic Oncology Department

Understanding Patient Pathways in the Context of Integrated Health Care Services - Implications from a Scoping Review

Healthcare systems in western countries are continuously working to achieve efficient resource allocation and to improve access to quality medical care. The implementation of standardised care processes promises better integration and coordination of care across several healthcare providers. In this context, an increasing use of the term patient pathway is recognised within official documents provided by health authorities and within scientific publications in recent years. However, a common understanding, distinguishing the term from other pathway approaches such as care- or clinical pathways, is missing. By means of a scoping review we analysed 132 publications in order to clarify key concepts and the understanding of patient pathways. Six common themes in the literature were identified and results show that individualisatio nand care continuity are essential descriptive characteristics. Using this motivation, we discuss the main implications for research and practice by the example of comprehensive cancer care in the European Union

Intervenções de enfermagem promotoras da adaptação da mulher ao Cancro da Mama

Introdução: O cancro da mama é a doença oncológica com maior incidência na mulher. Identificar os elementos estruturantes das intervenções de enfermagem com vista a promover a adaptação da mulher ao cancro da mama é uma prioridade que carece de sistematização e proficiência para serem implementadas na prática clínica. Metodologia: Revisão integrativa da literatura, de acordo com o modelo PVO (Paciente/População/Problema, Variáveis em estudo e Outcomes/Resultados), entre os anos 2011 a 2016, com análise de 30 artigos através de um modelo de análise desenvolvido pelos investigadores que assenta em categorias indispensáveis ao desenvolvimento de intervenções de enfermagem baseadas em evidências. Objetivos: Identificar os elementos estruturantes das intervenções de enfermagem com vista a promover a adaptação da mulher ao cancro da mama. Resultados: A análise dos dados permitiu validar como referencial teórico dominante a Teoria do Autocuidado e, face às necessidades identificadas por esta população surge, em destaque, o sistema de apoio educativo. Nesta perspetiva de requisitos de desvio à saúde, as terapêuticas que se destacam são do tipo informar e educar – pretendem capacitar a mulher para a promoção das atividades de autocuidado. Neste contexto e, atendendo ao anterior, as formas de implementação predominantes são sessões informativas e educativas, individuais e em grupo e com recurso a conteúdos disponíveis em suporte verbal e escrito. A utilização de novos recursos tecnológicos de informação e comunicação foi igualmente uma estratégia descrita mas os autores alertam que a utilização destes requer, nos seus utilizadores, altos níveis de motivação. O envolvimento de elementos significativos ou familiares foi igualmente destacado como recurso externo que pode determinar a adesão e envolvimento das mulheres ao plano terapêutico. Conclusões: A identificação dos elementos estruturantes das intervenções de enfermagem, com vista a promover a adaptação da mulher ao cancro da mama, contribuirá para ajudar os enfermeiros dos contextos práticos, a conceberem e implementarem cuidados de enfermagem diferenciados no sentido de capacitar a mulher para que seja capaz de realizar todas as atividades inerentes ao autocuidado, de uma forma responsável e consciente.Introduction: Breast cancer is the oncological disease with higher incidence in women. Identify the structuring elements of nursing interventions to promoting the adaptation of women to breast cancer is a priority that lacks systematization and proficiency to be implemented in clinical practice. Objectives: Identify the structuring elements of nursing interventions to promoting the adaptation of women to breast cancer. Methodology: Integrative review of literature, according to the PVO model (Patient/Population/Problem, Variables and Outcomes/Results), between the years 2011 to 2016, with analysis of 30 articles through an analysis model developed by investigators based in categories essential to the development of evidence-based nursing interventions. Results: Data analysis made it possible to validate how dominant theoretical referential theory of Self-care and, with regard to the needs identified by this population surge, highlighted, the educational support system. In this perspective of health deviation requirements, the therapies that stand out are to inform and educate and empower the woman aim to promote self-care activities. In this context and in view of the above, the predominant implementation forms are informational and educational sessions, individual and group and using content available in verbal and written support. The use of new information and communication technology resources was also a strategy described but the authors warn that the use of these requires, in its users, high levels of motivation. The involvement of significant elements or family was also highlighted as external resource that can determine the membership and involvement of women at therapeutic plan. Conclusions: The identification of the structural elements of the nursing interventions to promote the adjustment of woman to breast cancer, will contribute to help nurses of practical contexts, to design and implement differentiated nursing care towards to enable the woman to be able to perform all activities inherent in self-care, responsibly and consciously.info:eu-repo/semantics/publishedVersio

Instruments for Patient Education: Psychometric Evaluation of the Expected Knowledge (EKhp) and the Received Knowledge of Hospital Patients (RKhp)

Purpose: In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients' expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial).Patients and methods: The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009-2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development.Results: Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care.Conclusion: EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.</p

Nursing Students’ Learning about an Empowering Discourse In Patient Education

The main purpose of this study was to describe and evaluate nursing students' learning about an empowering discourse in patient education. In Phase 1, the purpose was to describe an empowering discourse between a nurse and a patient. In Phase 2, the purpose was first to create a computer simulation program of an empowering discourse based on the description, and second, the purpose was to evaluate nursing students’ learning of how to conduct an empowering discourse using a computer simulation program. The ultimate goal was to strengthen the knowledge basis on empowering discourse and to develop nursing students’ knowledge about how to conduct an empowering discourse for the development of patient education. In Phase I, empowering discourse was described using a systematic literature review with a metasummary technique (n=15). Data were collected covering a period from January 1995 to October 2005. In Phase 2, the computer simulation program of empowering discourse was created based the description in 2006–2007. A descriptive comparative design was used to evaluate students’ (n=69) process of learning empowering discourse using the computer simulation program and a pretest–post-test design without a control group was used to evaluate students’ (n=43) outcomes of learning. Data were collected in 2007. Empowering discourse was a structured process and it was possible to simulate and learned with the computer simulation program. According to students’ knowledge, empowering discourse was an unstructured process. Process of learning empowering discourse using the computer simulation program was controlled by the students and it changed students’ knowledge. The outcomes of learning empowering discourse appeared as changes of students’ knowledge to more holistic and better-organized or only to more holistic or better-organized. The study strengthened knowledge base of empowering discourse and developed students to more knowledgeable in empowering discourse.Siirretty Doriast

Empowering education in surgical care of patients with spinal stenosis

Patients undergoing surgery for lumbar spinal stenosis have many preoperative educational expectations due to the complexity of the care pathway. Although empowering patient education (EPE) has proven effective in many patient groups, no previous literature exists on its use in spinal stenosis patients. The purpose of the present study was (A) to describe the use of knowledge tests in patient education, and (B) to assess the impact of a specific patient education intervention on the empowerment of patients undergoing surgery for lumbar spinal stenosis. The aim was to improve the quality of patient education in this patient group. In this randomised controlled double blinded clinical trial, 100 spinal stenosis patients were randomised into either the intervention group (IG) or the control group (CG). The intervention (Knowledge Test Feedback Intervention, KTFI) was conducted on an average 9 days before surgery, and consisted of an empowering telephone discourse based on a specifically designed knowledge test (KNOWBACK Test). Primary outcome variables were (A) preoperative knowledge level (cognitive outcome), and (B) preoperative anxiety (clinical outcome). As secondary outcomes, verbal and visual understanding of the surgical procedure as well as health-related quality of life (HRQoL), disability and pain were measured. The data were gathered at admission to hospital, at discharge, and at three and six months after surgery. A significantly higher preoperative knowledge level was noted in the IG compared to the CG. Preoperative anxiety reduced more in the IG than in the CG, but there was no statistically significant difference between the study groups at any of the measuring time points. Verbal and visual understanding of the surgical procedure increased in both study groups during follow-up with no significant differences between the groups. Similarly, HRQoL, disability and pain improved in both groups after surgery; the differences between the groups were not statistically significant. In conclusion, empowering knowledge feedback was an effective preoperative patient education method in increasing the patients´ knowledge level. Our results suggest that it may reduce preoperative anxiety. However, this finding did not reach statistical significance between the two study groups. The increased knowledge level was not reflected in the clinical outcome of surgery.Spinaalistenoosileikkaukseen tulevien potilaiden voimavaraistumista tukeva potilasohjaus Lannerangan spinaalistenoosileikkaukseen tulevilla potilailla on runsaasti tiedollisia odotuksia hoitopolun moninaisuudesta johtuen. Vaikka voimavaraistumista tukeva potilasohjaus on osoittautunut tehokkaaksi useissa potilasryhmissä, sen käytöstä selkäleikkauspotilailla ei juurikaan ole tutkimustietoa. Tutkimuksen tarkoituksena oli (A) selvittää tietotestien rooli potilasohjauksessa ja (B) arvioida tätä tutkimusta varten suunnitellun potilasohjausmenetelmän (Tietotesti-Palaute -Interventio, TTPI) vaikutusta spinaalistenoosipotilaan voimavaraistumisprosessiin sekä kognitiivisten (tiedon taso ja toimenpiteen ymmärtäminen) että kliinisten tulosmuuttujien (preoperatiivinen ahdistus, elämänlaatu, toimintakyky ja kipu) kautta. Tässä satunnaistetussa kontrolloidussa kaksoissokkoutetussa kliinisessä tutkimuksessa 100 spinaalistenoosileikkaukseen tulevaa potilasta satunnaistettiin joko interventio- tai kontrolliryhmään. TTPI toteutettiin keskimäärin 9 päivää ennen suunniteltua leikkausta ja se koostui puhelimitse toteutetusta voimavaraistumista tukevasta keskustelusta. Keskustelu pohjautui potilaan täyttämään tätä tutkimusta varten kehitettyyn tietotestiin (KNOWBACKtesti). Primaaritulosmuuttujina käytettiin (A) voimavaraistumista tukevan tiedon tasoa (kognitiivinen tulosmuuttuja) ja (B) leikkausta edeltävän ahdistuksen tasoa (kliininen tulosmuuttuja). Sekundaarisia tulosmuuttujia olivat toimenpiteen ymmärrys verbaalisesti ja visuaalisesti kuvattuna, elämänlaatu, toimintakyky ja kipu. Tietoa kerättiin potilailta sairaalan tullessa ja sieltä kotiutuessa, sekä kolmen ja kuuden kuukauden kuluttua leikkauksesta. Interventioryhmässä todettiin tilastollisesti merkittävä voimavaraistumista tukevan tiedon tason nousu. Leikkausta edeltävä ahdistus lieveni merkittävästi koeryhmässä, mutta tutkimusryhmien välillä ei missään vaiheessa todettu merkittävää eroa. lievittyminen kontrolliryhmään verrattuna. Kirurgisen toimenpiteen verbaalinen ja visuaalinen ymmärrys parani kummassakin tutkimusryhmässä seurannan aikana. Elämänlaadussa, toimintakyvyssä ja kivussa todettiin merkittävä parantuminen kummassakin ryhmässä, mutta ryhmien välillä ei ollut tilastollisesti merkittäviä eroja. Johtopäätöksenä voidaan todeta, että TTPI paransi potilaiden voimavaraistumista tukevan tiedon tasoa ja mahdollisesti lievitti preoperatiivista ahdistusta. Leikkauksen kliiniseen lopputulokseen tällä ei kuitenkaan vaikuttanut olevan merkitystä

Internet-based breast cancer patient’s pathway as an empowering patient educational tool

This three-phase study was conducted to examine the effect of the Breast Cancer Patient’s Pathway program (BCPP) on breast cancer patients’ empowering process from the viewpoint of the difference between knowledge expectations and perceptions of received knowledge, knowledge level, quality of life, anxiety and treatment-related side effects during the breast cancer treatment process. The BCPP is an Internet-based patient education tool describing a flow chart of the patient pathway during the breast treatment process, from breast cancer diagnostic tests to the follow-up after treatments. The ultimate goal of this study was to evaluate the effect of the BCPP to the breast cancer patient’s empowerment by using the patient pathway as a patient education tool. In phase I, a systematic literature review was carried out to chart the solutions and outcomes of Internet-based educational programs for breast cancer patients. In phase II, a Delphi study was conducted to evaluate the usability of web pages and adequacy of their content. In phase III, the BCPP program was piloted with 10 patients and patients were randomised to an intervention group (n=50) and control group (n=48). According to the results of this study, the Internet is an effective patient education tool for increasing knowledge, and BCPP can be used as a patient education method supporting other education methods. However, breast cancer patients’ perceptions of received knowledge were not fulfilled; their knowledge expectations exceed the perceived amount of received knowledge. Although control group patients’ knowledge expectations were met better with the knowledge they received in hospital compared to the patients in the intervention group, no statistical differences were found between the groups in terms of quality of life, anxiety and treatment-related side effects. However, anxiety decreased faster in the intervention group when looking at internal differences between the groups at different measurement times. In the intervention group the relationship between the difference between knowledge expectations and perceptions of received knowledge correlated significantly with quality of life and anxiety. Their knowledge level was also significant higher than in the control group. These results support the theory that the empowering process requires patient’s awareness of knowledge expectations and perceptions of received knowledge. There is a need to develop patient education to meet patients’ perceptions of received knowledge, including oral and written education and BCPP, to fulfil patient’s knowledge expectations and facilitate the empowering process. Further research is needed on the process of cognitive empowerment with breast cancer patients. There is a need for new patient education methods to increase breast cancer patients’ awareness of knowing.Internet-pohjainen rintasyöpäpotilaanpolku voimavaraistavan potilasohjauksen välineenä Tässä kolmivaiheisessa tutkimuksessa tarkasteltiin Rintasyöpäpotilaanpolku (RSPP) - ohjelman vaikuttavuutta rintasyöpäpotilaan tiedollisen voimavaraistumisen, tiedontason, elämänlaadun, ahdistuneisuuden ja hoitoon liittyvien sivuvaikutusten näkökulmista rintasyövän hoitoprosessin aikana. RSPP-ohjelma on Internet-pohjainen potilasohjausmenetelmä, joka perustuu vuokaavioon rintasyövän hoitoprosessista. Menetelmä kattaa hoitoprosessin rintasyövän diagnostisista testeistä aina hoitojen jälkeiseen seurantaan. Tutkimuksen tavoitteena oli selvittää RSPP-ohjelman vaikuttavuutta rintasyöpäpotilaan tiedollista voimavaraistumista tukevana potilasohjausvälineenä. Tutkimuksen ensimmäisessä vaiheessa tehtiin systemoitu kirjallisuuskatsaus aiempien Internet pohjaisten potilasohjausohjelmien ja niiden vaikuttavuuden selvittämiseksi. Tutkimuksen toisessa vaiheessa RSPP-ohjelman käytettävyyttä ja sisältöä arvioitiin delfi-tutkimuksella. Tutkimuksen kolmannessa vaiheessa tutkimusasetelma pilotoitiin (n=10) ja rintasyöpään sairastuneet potilaat satunnaistettiin koe- ja kontrolliryhmiin (n=50 ja n=48). Tutkimustulosten mukaan Internet voi olla tehokas potilasohjausväline tiedon lisäämiseksi ja RSPP-ohjelma sopii potilasohjausvälineeksi muiden ohjausmenetelmien tueksi. Rintasyöpäpotilaiden tiedolliset odotukset eivät täyttyneet, vaan heidän tiedolliset odotuksensa ovat suuremmat kuin kokemuksensa heille välitetystä tiedosta. Vaikka kontrolliryhmän potilaat kokivat tiedollisten odotusten täyttyvän paremmin sairaalassa saamastaan tiedosta kuin koeryhmän potilaat, tilastollisesti merkittäviä eroja ryhmien välillä ei löytynyt elämänlaadun, ahdistuksen ja hoidoista johtuvien sivuvaikutusten osalta Kuitenkin ahdistus väheni nopeammin koeryhmässä tarkasteltaessa ahdistuneisuutta eri mittauskertojen välillä. Koeryhmässä tiedollinen voimavaraistuneisuus korreloi tilastollisesti merkittävästi elämänlaadun ja ahdistuksen kanssa. Koeryhmässä rintasyöpään liittyvän tiedon taso oli merkittävästi korkeampi hoidon päättymisen jälkeen kuin kontrolliryhmässä. Tulokset tukevat teoriaa voimavaraistumisen prosessista, mikä edellyttää potilaan tietoisuutta tiedollisista odotuksistaan ja niiden täyttymisestä. Potilaiden tiedollisessa ohjauksessa on kuitenkin vielä parannettavaa sekä suullisen ja kirjallisen että RSPP-ohjelman osalta, jotta potilaiden tiedolliset odotukset täyttyisivät ja mahdollistaisivat potilaan voimavaraistumisen. Lisätutkimusta tarvitaan tiedollisen voimavaraistumisen prosessista rintasyöpäpotilailla. Uusia potilasohjaus-menetelmiä tarvitaan potilaan tietoisuuden lisäämiseksi.Siirretty Doriast

Rethink Digital Health Innovation: Understanding Socio-Technical Interoperability as Guiding Concept

Diese Dissertation sucht nach einem theoretischem Grundgerüst, um komplexe, digitale Gesundheitsinnovationen so zu entwickeln, dass sie bessere Erfolgsaussichten haben, auch in der alltäglichen Versorgungspraxis anzukommen. Denn obwohl es weder am Bedarf von noch an Ideen für digitale Gesundheitsinnovationen mangelt, bleibt die Flut an erfolgreich in der Praxis etablierten Lösungen leider aus. Dieser unzureichende Diffusionserfolg einer entwickelten Lösung - gern auch als Pilotitis pathologisiert - offenbart sich insbesondere dann, wenn die geplante Innovation mit größeren Ambitionen und Komplexität verbunden ist. Dem geübten Kritiker werden sofort ketzerische Gegenfragen in den Sinn kommen. Beispielsweise was denn unter komplexen, digitalen Gesundheitsinnovationen verstanden werden soll und ob es überhaupt möglich ist, eine universale Lösungsformel zu finden, die eine erfolgreiche Diffusion digitaler Gesundheitsinnovationen garantieren kann. Beide Fragen sind nicht nur berechtigt, sondern münden letztlich auch in zwei Forschungsstränge, welchen ich mich in dieser Dissertation explizit widme. In einem ersten Block erarbeite ich eine Abgrenzung jener digitalen Gesundheitsinnovationen, welche derzeit in Literatur und Praxis besondere Aufmerksamkeit aufgrund ihres hohen Potentials zur Versorgungsverbesserung und ihrer resultierenden Komplexität gewidmet ist. Genauer gesagt untersuche ich dominante Zielstellungen und welche Herausforderung mit ihnen einhergehen. Innerhalb der Arbeiten in diesem Forschungsstrang kristallisieren sich vier Zielstellungen heraus: 1. die Unterstützung kontinuierlicher, gemeinschaftlicher Versorgungsprozesse über diverse Leistungserbringer (auch als inter-organisationale Versorgungspfade bekannt); 2. die aktive Einbeziehung der Patient:innen in ihre Versorgungsprozesse (auch als Patient Empowerment oder Patient Engagement bekannt); 3. die Stärkung der sektoren-übergreifenden Zusammenarbeit zwischen Wissenschaft und Versorgungpraxis bis hin zu lernenden Gesundheitssystemen und 4. die Etablierung daten-zentrierter Wertschöpfung für das Gesundheitswesen aufgrund steigender bzgl. Verfügbarkeit valider Daten, neuen Verarbeitungsmethoden (Stichwort Künstliche Intelligenz) sowie den zahlreichen Nutzungsmöglichkeiten. Im Fokus dieser Dissertation stehen daher weniger die autarken, klar abgrenzbaren Innovationen (bspw. eine Symptomtagebuch-App zur Beschwerdedokumentation). Vielmehr adressiert diese Doktorarbeit jene Innovationsvorhaben, welche eine oder mehrere der o.g. Zielstellung verfolgen, ein weiteres technologisches Puzzleteil in komplexe Informationssystemlandschaften hinzufügen und somit im Zusammenspiel mit diversen weiteren IT-Systemen zur Verbesserung der Gesundheitsversorgung und/ oder ihrer Organisation beitragen. In der Auseinandersetzung mit diesen Zielstellungen und verbundenen Herausforderungen der Systementwicklung rückte das Problem fragmentierter IT-Systemlandschaften des Gesundheitswesens in den Mittelpunkt. Darunter wird der unerfreuliche Zustand verstanden, dass unterschiedliche Informations- und Anwendungssysteme nicht wie gewünscht miteinander interagieren können. So kommt es zu Unterbrechungen von Informationsflüssen und Versorgungsprozessen, welche anderweitig durch fehleranfällige Zusatzaufwände (bspw. Doppeldokumentation) aufgefangen werden müssen. Um diesen Einschränkungen der Effektivität und Effizienz zu begegnen, müssen eben jene IT-System-Silos abgebaut werden. Alle o.g. Zielstellungen ordnen sich dieser defragmentierenden Wirkung unter, in dem sie 1. verschiedene Leistungserbringer, 2. Versorgungsteams und Patient:innen, 3. Wissenschaft und Versorgung oder 4. diverse Datenquellen und moderne Auswertungstechnologien zusammenführen wollen. Doch nun kommt es zu einem komplexen Ringschluss. Einerseits suchen die in dieser Arbeit thematisierten digitalen Gesundheitsinnovationen Wege zur Defragmentierung der Informationssystemlandschaften. Andererseits ist ihre eingeschränkte Erfolgsquote u.a. in eben jener bestehenden Fragmentierung begründet, die sie aufzulösen suchen. Mit diesem Erkenntnisgewinn eröffnet sich der zweite Forschungsstrang dieser Arbeit, der sich mit der Eigenschaft der 'Interoperabilität' intensiv auseinandersetzt. Er untersucht, wie diese Eigenschaft eine zentrale Rolle für Innovationsvorhaben in der Digital Health Domäne einnehmen soll. Denn Interoperabilität beschreibt, vereinfacht ausgedrückt, die Fähigkeit von zwei oder mehreren Systemen miteinander gemeinsame Aufgaben zu erfüllen. Sie repräsentiert somit das Kernanliegen der identifizierten Zielstellungen und ist Dreh- und Angelpunkt, wenn eine entwickelte Lösung in eine konkrete Zielumgebung integriert werden soll. Von einem technisch-dominierten Blickwinkel aus betrachtet, geht es hierbei um die Gewährleistung von validen, performanten und sicheren Kommunikationsszenarien, sodass die o.g. Informationsflussbrüche zwischen technischen Teilsystemen abgebaut werden. Ein rein technisches Interoperabilitätsverständnis genügt jedoch nicht, um die Vielfalt an Diffusionsbarrieren von digitalen Gesundheitsinnovationen zu umfassen. Denn beispielsweise das Fehlen adäquater Vergütungsoptionen innerhalb der gesetzlichen Rahmenbedingungen oder eine mangelhafte Passfähigkeit für den bestimmten Versorgungsprozess sind keine rein technischen Probleme. Vielmehr kommt hier eine Grundhaltung der Wirtschaftsinformatik zum Tragen, die Informationssysteme - auch die des Gesundheitswesens - als sozio-technische Systeme begreift und dabei Technologie stets im Zusammenhang mit Menschen, die sie nutzen, von ihr beeinflusst werden oder sie organisieren, betrachtet. Soll eine digitale Gesundheitsinnovation, die einen Mehrwert gemäß der o.g. Zielstellungen verspricht, in eine existierende Informationssystemlandschaft der Gesundheitsversorgung integriert werden, so muss sie aus technischen sowie nicht-technischen Gesichtspunkten 'interoperabel' sein. Zwar ist die Notwendigkeit von Interoperabilität in der Wissenschaft, Politik und Praxis bekannt und auch positive Bewegungen der Domäne hin zu mehr Interoperabilität sind zu verspüren. Jedoch dominiert dabei einerseits ein technisches Verständnis und andererseits bleibt das Potential dieser Eigenschaft als Leitmotiv für das Innovationsmanagement bislang weitestgehend ungenutzt. An genau dieser Stelle knüpft nun der Hauptbeitrag dieser Doktorarbeit an, in dem sie eine sozio-technische Konzeptualisierung und Kontextualisierung von Interoperabilität für künftige digitale Gesundheitsinnovationen vorschlägt. Literatur- und expertenbasiert wird ein Rahmenwerk erarbeitet - das Digital Health Innovation Interoperability Framework - das insbesondere Innovatoren und Innovationsfördernde dabei unterstützen soll, die Diffusionswahrscheinlichkeit in die Praxis zu erhöhen. Nun sind mit diesem Framework viele Erkenntnisse und Botschaften verbunden, die ich für diesen Prolog wie folgt zusammenfassen möchte: 1. Um die Entwicklung digitaler Gesundheitsinnovationen bestmöglich auf eine erfolgreiche Integration in eine bestimmte Zielumgebung auszurichten, sind die Realisierung eines neuartigen Wertversprechens sowie die Gewährleistung sozio-technischer Interoperabilität die zwei zusammenhängenden Hauptaufgaben eines Innovationsprozesses. 2. Die Gewährleistung von Interoperabilität ist eine aktiv zu verantwortende Managementaufgabe und wird durch projektspezifische Bedingungen sowie von externen und internen Dynamiken beeinflusst. 3. Sozio-technische Interoperabilität im Kontext digitaler Gesundheitsinnovationen kann über sieben, interdependente Ebenen definiert werden: Politische und regulatorische Bedingungen; Vertragsbedingungen; Versorgungs- und Geschäftsprozesse; Nutzung; Information; Anwendungen; IT-Infrastruktur. 4. Um Interoperabilität auf jeder dieser Ebenen zu gewährleisten, sind Strategien differenziert zu definieren, welche auf einem Kontinuum zwischen Kompatibilitätsanforderungen aufseiten der Innovation und der Motivation von Anpassungen aufseiten der Zielumgebung verortet werden können. 5. Das Streben nach mehr Interoperabilität fördert sowohl den nachhaltigen Erfolg der einzelnen digitalen Gesundheitsinnovation als auch die Defragmentierung existierender Informationssystemlandschaften und trägt somit zur Verbesserung des Gesundheitswesens bei. Zugegeben: die letzte dieser fünf Botschaften trägt eher die Färbung einer Überzeugung, als dass sie ein Ergebnis wissenschaftlicher Beweisführung ist. Dennoch empfinde ich diese, wenn auch persönliche Erkenntnis als Maxim der Domäne, der ich mich zugehörig fühle - der IT-Systementwicklung des Gesundheitswesens

Human Practice. Digital Ecologies. Our Future. : 14. Internationale Tagung Wirtschaftsinformatik (WI 2019) : Tagungsband

Erschienen bei: universi - Universitätsverlag Siegen. - ISBN: 978-3-96182-063-4Aus dem Inhalt: Track 1: Produktion & Cyber-Physische Systeme Requirements and a Meta Model for Exchanging Additive Manufacturing Capacities Service Systems, Smart Service Systems and Cyber- Physical Systems—What’s the difference? Towards a Unified Terminology Developing an Industrial IoT Platform – Trade-off between Horizontal and Vertical Approaches Machine Learning und Complex Event Processing: Effiziente Echtzeitauswertung am Beispiel Smart Factory Sensor retrofit for a coffee machine as condition monitoring and predictive maintenance use case Stakeholder-Analyse zum Einsatz IIoT-basierter Frischeinformationen in der Lebensmittelindustrie Towards a Framework for Predictive Maintenance Strategies in Mechanical Engineering - A Method-Oriented Literature Analysis Development of a matching platform for the requirement-oriented selection of cyber physical systems for SMEs Track 2: Logistic Analytics An Empirical Study of Customers’ Behavioral Intention to Use Ridepooling Services – An Extension of the Technology Acceptance Model Modeling Delay Propagation and Transmission in Railway Networks What is the impact of company specific adjustments on the acceptance and diffusion of logistic standards? Robust Route Planning in Intermodal Urban Traffic Track 3: Unternehmensmodellierung & Informationssystemgestaltung (Enterprise Modelling & Information Systems Design) Work System Modeling Method with Different Levels of Specificity and Rigor for Different Stakeholder Purposes Resolving Inconsistencies in Declarative Process Models based on Culpability Measurement Strategic Analysis in the Realm of Enterprise Modeling – On the Example of Blockchain-Based Initiatives for the Electricity Sector Zwischenbetriebliche Integration in der Möbelbranche: Konfigurationen und Einflussfaktoren Novices’ Quality Perceptions and the Acceptance of Process Modeling Grammars Entwicklung einer Definition für Social Business Objects (SBO) zur Modellierung von Unternehmensinformationen Designing a Reference Model for Digital Product Configurators Terminology for Evolving Design Artifacts Business Role-Object Specification: A Language for Behavior-aware Structural Modeling of Business Objects Generating Smart Glasses-based Information Systems with BPMN4SGA: A BPMN Extension for Smart Glasses Applications Using Blockchain in Peer-to-Peer Carsharing to Build Trust in the Sharing Economy Testing in Big Data: An Architecture Pattern for a Development Environment for Innovative, Integrated and Robust Applications Track 4: Lern- und Wissensmanagement (e-Learning and Knowledge Management) eGovernment Competences revisited – A Literature Review on necessary Competences in a Digitalized Public Sector Say Hello to Your New Automated Tutor – A Structured Literature Review on Pedagogical Conversational Agents Teaching the Digital Transformation of Business Processes: Design of a Simulation Game for Information Systems Education Conceptualizing Immersion for Individual Learning in Virtual Reality Designing a Flipped Classroom Course – a Process Model The Influence of Risk-Taking on Knowledge Exchange and Combination Gamified Feedback durch Avatare im Mobile Learning Alexa, Can You Help Me Solve That Problem? - Understanding the Value of Smart Personal Assistants as Tutors for Complex Problem Tasks Track 5: Data Science & Business Analytics Matching with Bundle Preferences: Tradeoff between Fairness and Truthfulness Applied image recognition: guidelines for using deep learning models in practice Yield Prognosis for the Agrarian Management of Vineyards using Deep Learning for Object Counting Reading Between the Lines of Qualitative Data – How to Detect Hidden Structure Based on Codes Online Auctions with Dual-Threshold Algorithms: An Experimental Study and Practical Evaluation Design Features of Non-Financial Reward Programs for Online Reviews: Evaluation based on Google Maps Data Topic Embeddings – A New Approach to Classify Very Short Documents Based on Predefined Topics Leveraging Unstructured Image Data for Product Quality Improvement Decision Support for Real Estate Investors: Improving Real Estate Valuation with 3D City Models and Points of Interest Knowledge Discovery from CVs: A Topic Modeling Procedure Online Product Descriptions – Boost for your Sales? Entscheidungsunterstützung durch historienbasierte Dienstreihenfolgeplanung mit Pattern A Semi-Automated Approach for Generating Online Review Templates Machine Learning goes Measure Management: Leveraging Anomaly Detection and Parts Search to Improve Product-Cost Optimization Bedeutung von Predictive Analytics für den theoretischen Erkenntnisgewinn in der IS-Forschung Track 6: Digitale Transformation und Dienstleistungen Heuristic Theorizing in Software Development: Deriving Design Principles for Smart Glasses-based Systems Mirroring E-service for Brick and Mortar Retail: An Assessment and Survey Taxonomy of Digital Platforms: A Platform Architecture Perspective Value of Star Players in the Digital Age Local Shopping Platforms – Harnessing Locational Advantages for the Digital Transformation of Local Retail Outlets: A Content Analysis A Socio-Technical Approach to Manage Analytics-as-a-Service – Results of an Action Design Research Project Characterizing Approaches to Digital Transformation: Development of a Taxonomy of Digital Units Expectations vs. Reality – Benefits of Smart Services in the Field of Tension between Industry and Science Innovation Networks and Digital Innovation: How Organizations Use Innovation Networks in a Digitized Environment Characterising Social Reading Platforms— A Taxonomy-Based Approach to Structure the Field Less Complex than Expected – What Really Drives IT Consulting Value Modularity Canvas – A Framework for Visualizing Potentials of Service Modularity Towards a Conceptualization of Capabilities for Innovating Business Models in the Industrial Internet of Things A Taxonomy of Barriers to Digital Transformation Ambidexterity in Service Innovation Research: A Systematic Literature Review Design and success factors of an online solution for cross-pillar pension information Track 7: IT-Management und -Strategie A Frugal Support Structure for New Software Implementations in SMEs How to Structure a Company-wide Adoption of Big Data Analytics The Changing Roles of Innovation Actors and Organizational Antecedents in the Digital Age Bewertung des Kundennutzens von Chatbots für den Einsatz im Servicedesk Understanding the Benefits of Agile Software Development in Regulated Environments Are Employees Following the Rules? On the Effectiveness of IT Consumerization Policies Agile and Attached: The Impact of Agile Practices on Agile Team Members’ Affective Organisational Commitment The Complexity Trap – Limits of IT Flexibility for Supporting Organizational Agility in Decentralized Organizations Platform Openness: A Systematic Literature Review and Avenues for Future Research Competence, Fashion and the Case of Blockchain The Digital Platform Otto.de: A Case Study of Growth, Complexity, and Generativity Track 8: eHealth & alternde Gesellschaft Security and Privacy of Personal Health Records in Cloud Computing Environments – An Experimental Exploration of the Impact of Storage Solutions and Data Breaches Patientenintegration durch Pfadsysteme Digitalisierung in der Stressprävention – eine qualitative Interviewstudie zu Nutzenpotenzialen User Dynamics in Mental Health Forums – A Sentiment Analysis Perspective Intent and the Use of Wearables in the Workplace – A Model Development Understanding Patient Pathways in the Context of Integrated Health Care Services - Implications from a Scoping Review Understanding the Habitual Use of Wearable Activity Trackers On the Fit in Fitness Apps: Studying the Interaction of Motivational Affordances and Users’ Goal Orientations in Affecting the Benefits Gained Gamification in Health Behavior Change Support Systems - A Synthesis of Unintended Side Effects Investigating the Influence of Information Incongruity on Trust-Relations within Trilateral Healthcare Settings Track 9: Krisen- und Kontinuitätsmanagement Potentiale von IKT beim Ausfall kritischer Infrastrukturen: Erwartungen, Informationsgewinnung und Mediennutzung der Zivilbevölkerung in Deutschland Fake News Perception in Germany: A Representative Study of People’s Attitudes and Approaches to Counteract Disinformation Analyzing the Potential of Graphical Building Information for Fire Emergency Responses: Findings from a Controlled Experiment Track 10: Human-Computer Interaction Towards a Taxonomy of Platforms for Conversational Agent Design Measuring Service Encounter Satisfaction with Customer Service Chatbots using Sentiment Analysis Self-Tracking and Gamification: Analyzing the Interplay of Motivations, Usage and Motivation Fulfillment Erfolgsfaktoren von Augmented-Reality-Applikationen: Analyse von Nutzerrezensionen mit dem Review-Mining-Verfahren Designing Dynamic Decision Support for Electronic Requirements Negotiations Who is Stressed by Using ICTs? A Qualitative Comparison Analysis with the Big Five Personality Traits to Understand Technostress Walking the Middle Path: How Medium Trade-Off Exposure Leads to Higher Consumer Satisfaction in Recommender Agents Theory-Based Affordances of Utilitarian, Hedonic and Dual-Purposed Technologies: A Literature Review Eliciting Customer Preferences for Shopping Companion Apps: A Service Quality Approach The Role of Early User Participation in Discovering Software – A Case Study from the Context of Smart Glasses The Fluidity of the Self-Concept as a Framework to Explain the Motivation to Play Video Games Heart over Heels? An Empirical Analysis of the Relationship between Emotions and Review Helpfulness for Experience and Credence Goods Track 11: Information Security and Information Privacy Unfolding Concerns about Augmented Reality Technologies: A Qualitative Analysis of User Perceptions To (Psychologically) Own Data is to Protect Data: How Psychological Ownership Determines Protective Behavior in a Work and Private Context Understanding Data Protection Regulations from a Data Management Perspective: A Capability-Based Approach to EU-GDPR On the Difficulties of Incentivizing Online Privacy through Transparency: A Qualitative Survey of the German Health Insurance Market What is Your Selfie Worth? A Field Study on Individuals’ Valuation of Personal Data Justification of Mass Surveillance: A Quantitative Study An Exploratory Study of Risk Perception for Data Disclosure to a Network of Firms Track 12: Umweltinformatik und nachhaltiges Wirtschaften Kommunikationsfäden im Nadelöhr – Fachliche Prozessmodellierung der Nachhaltigkeitskommunikation am Kapitalmarkt Potentiale und Herausforderungen der Materialflusskostenrechnung Computing Incentives for User-Based Relocation in Carsharing Sustainability’s Coming Home: Preliminary Design Principles for the Sustainable Smart District Substitution of hazardous chemical substances using Deep Learning and t-SNE A Hierarchy of DSMLs in Support of Product Life-Cycle Assessment A Survey of Smart Energy Services for Private Households Door-to-Door Mobility Integrators as Keystone Organizations of Smart Ecosystems: Resources and Value Co-Creation – A Literature Review Ein Entscheidungsunterstützungssystem zur ökonomischen Bewertung von Mieterstrom auf Basis der Clusteranalyse Discovering Blockchain for Sustainable Product-Service Systems to enhance the Circular Economy Digitale Rückverfolgbarkeit von Lebensmitteln: Eine verbraucherinformatische Studie Umweltbewusstsein durch audiovisuelles Content Marketing? Eine experimentelle Untersuchung zur Konsumentenbewertung nachhaltiger Smartphones Towards Predictive Energy Management in Information Systems: A Research Proposal A Web Browser-Based Application for Processing and Analyzing Material Flow Models using the MFCA Methodology Track 13: Digital Work - Social, mobile, smart On Conversational Agents in Information Systems Research: Analyzing the Past to Guide Future Work The Potential of Augmented Reality for Improving Occupational First Aid Prevent a Vicious Circle! The Role of Organizational IT-Capability in Attracting IT-affine Applicants Good, Bad, or Both? Conceptualization and Measurement of Ambivalent User Attitudes Towards AI A Case Study on Cross-Hierarchical Communication in Digital Work Environments ‘Show Me Your People Skills’ - Employing CEO Branding for Corporate Reputation Management in Social Media A Multiorganisational Study of the Drivers and Barriers of Enterprise Collaboration Systems-Enabled Change The More the Merrier? The Effect of Size of Core Team Subgroups on Success of Open Source Projects The Impact of Anthropomorphic and Functional Chatbot Design Features in Enterprise Collaboration Systems on User Acceptance Digital Feedback for Digital Work? Affordances and Constraints of a Feedback App at InsurCorp The Effect of Marker-less Augmented Reality on Task and Learning Performance Antecedents for Cyberloafing – A Literature Review Internal Crowd Work as a Source of Empowerment - An Empirical Analysis of the Perception of Employees in a Crowdtesting Project Track 14: Geschäftsmodelle und digitales Unternehmertum Dividing the ICO Jungle: Extracting and Evaluating Design Archetypes Capturing Value from Data: Exploring Factors Influencing Revenue Model Design for Data-Driven Services Understanding the Role of Data for Innovating Business Models: A System Dynamics Perspective Business Model Innovation and Stakeholder: Exploring Mechanisms and Outcomes of Value Creation and Destruction Business Models for Internet of Things Platforms: Empirical Development of a Taxonomy and Archetypes Revitalizing established Industrial Companies: State of the Art and Success Principles of Digital Corporate Incubators When 1+1 is Greater than 2: Concurrence of Additional Digital and Established Business Models within Companies Special Track 1: Student Track Investigating Personalized Price Discrimination of Textile-, Electronics- and General Stores in German Online Retail From Facets to a Universal Definition – An Analysis of IoT Usage in Retail Is the Technostress Creators Inventory Still an Up-To-Date Measurement Instrument? Results of a Large-Scale Interview Study Application of Media Synchronicity Theory to Creative Tasks in Virtual Teams Using the Example of Design Thinking TrustyTweet: An Indicator-based Browser-Plugin to Assist Users in Dealing with Fake News on Twitter Application of Process Mining Techniques to Support Maintenance-Related Objectives How Voice Can Change Customer Satisfaction: A Comparative Analysis between E-Commerce and Voice Commerce Business Process Compliance and Blockchain: How Does the Ethereum Blockchain Address Challenges of Business Process Compliance? Improving Business Model Configuration through a Question-based Approach The Influence of Situational Factors and Gamification on Intrinsic Motivation and Learning Evaluation von ITSM-Tools für Integration und Management von Cloud-Diensten am Beispiel von ServiceNow How Software Promotes the Integration of Sustainability in Business Process Management Criteria Catalog for Industrial IoT Platforms from the Perspective of the Machine Tool Industry Special Track 3: Demos & Prototyping Privacy-friendly User Location Tracking with Smart Devices: The BeaT Prototype Application-oriented robotics in nursing homes Augmented Reality for Set-up Processe Mixed Reality for supporting Remote-Meetings Gamification zur Motivationssteigerung von Werkern bei der Betriebsdatenerfassung Automatically Extracting and Analyzing Customer Needs from Twitter: A “Needmining” Prototype GaNEsHA: Opportunities for Sustainable Transportation in Smart Cities TUCANA: A platform for using local processing power of edge devices for building data-driven services Demonstrator zur Beschreibung und Visualisierung einer kritischen Infrastruktur Entwicklung einer alltagsnahen persuasiven App zur Bewegungsmotivation für ältere Nutzerinnen und Nutzer A browser-based modeling tool for studying the learning of conceptual modeling based on a multi-modal data collection approach Exergames & Dementia: An interactive System for People with Dementia and their Care-Network Workshops Workshop Ethics and Morality in Business Informatics (Workshop Ethik und Moral in der Wirtschaftsinformatik – EMoWI’19) Model-Based Compliance in Information Systems - Foundations, Case Description and Data Set of the MobIS-Challenge for Students and Doctoral Candidates Report of the Workshop on Concepts and Methods of Identifying Digital Potentials in Information Management Control of Systemic Risks in Global Networks - A Grand Challenge to Information Systems Research Die Mitarbeiter von morgen - Kompetenzen künftiger Mitarbeiter im Bereich Business Analytics Digitaler Konsum: Herausforderungen und Chancen der Verbraucherinformati