How Can Physicians’ Knowledge Be Activated To Provide Better Healthcare? Explaining Electronic Health Record Adaptation by Physicians.

Despite the rising costs of healthcare and falling quality of care, the integration of EHR (Electronic Health Records) in supporting collaboration to increase the efficiency and effectiveness of healthcare remains a challenge. It appears that the physicians are at the center of this bottleneck. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians\u27 limited interaction and adaptation of EHR. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research shows how a collaborative technology architecture can enable the physicians to better interact with their partners using the E.H.R technology for the purpose of improving healthcare provision

IT Governance Mechanisms, Employees\u27 Digital Mindset, and Behavioral Outcomes

The disruptive nature of digitalization and the complexity and ambiguity of their technical properties require many new skills from employees today. Recent research emphasizes that the employees’ digital mindset plays an essential role in digital transformation by leveraging employee engagement. This paper aims to advance the understanding of how the behavioral outcomes of digital mindset, which encompass interpersonal interaction, focus of attention, enthusiasm for development, perspective on setbacks, and construal of effort, can be positively influenced during digital initiatives. We develop a novel research model integrating two literature streams: information technology and mindset. We conceptually link back to the behavioral outcomes of digital mindset by looking at the influence of IT governance mechanisms as potential antecedents. Our model explains how IT governance mechanisms influence the behavioral outcomes of digital mindset and helps future researchers by providing propositions on the impact of IT governance mechanisms towards more employee engagement

Meaningful Use of Electronic Health Records for Physician Collaboration: A Patient Centered Health Care Perspective

EHRs (Electronic Health Records), can contribute greatly to improving care and managing the rising costs of healthcare. The use and the integration of EHRs (Electronic Health Records) in supporting collaboration to increase the efficiency and effectiveness of healthcare remains a challenge. It appears that the physicians are at the center of this bottleneck. As healthcare is provided by interdisciplinary teams of clinicians and collaboration and coordination are key to success. Literature suggests reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians\u27 limited interaction and adaptation of EHR. This paper investigates how meaningful use of EHRs by physicians enable patient centered healthcare to be achieved. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research shows how a collaborative technology architecture can enable the reduction in the costs of healthcare and improvements in the quality of care by enabling more patient centered health care

Adaptations of electronic health records to activate physicians’ knowledge: how can patient centered care be improved through technology?

The United States of America is known for the rising costs of its healthcare and declining quality of care. While the push towards the integration of the healthcare information infrastructure is seen to be an important step towards addressing problem of the rising costs of healthcare and falling quality of care, the integration of EHR (Electronic Health Records), the central component of this infrastructure, remains a challenge. It appears that physicians are at the center of this bottleneck. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians’ limited interaction and adaptation of EHR. In this paper, we argue that in order to be able to use the technology to provide better healthcare, physicians need to be able to activate their knowledge through it. We investigate process of adaptations that physicians go through when trying to use electronic health records. Our findings indicate that physician’s knowledge identities need to align with the functionalities made available through the technology. We draw upon the framework of knowledge activation in order to understand how physicians use their knowledge to provide better healthcare. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research shows how physician’s adaptations of EHR activate their knowledge for the purpose of improving healthcare provision. The key contribution of this research is in discovering the ways in which physicians’ adaptation of technology can enable knowledge activation

Exploring Critical Success Factors for Managing Complex Information Technology Projects in Federal Agencies

The problem addressed in this study was the lack of understanding about failures of government leadership in accomplishing complex information technology (IT) projects and the ways such failures can negatively affect organizational performance. The purpose was to query subject matter experts and leaders with the intent to identify methods to reduce complex IT project failure rates in government organizations. This qualitative study drew on the technology acceptance model and the capability maturity model integration framework to evaluate organizations\u27 abilities to manage complex IT projects. The research questions focused on exploring senior managers\u27 experiences, the tacit knowledge of project management methodologies, and IT governance frameworks. The Delphi method was suitable for collecting and analyzing opinions of subject matter experts to help reach group consensus. Qualitative data analysis was used to identify themes, categories, and subcategories for thematic analysis. The result of the study was the identification of critical success factors and leadership attributes to increase the success rate of complex IT projects in federal agencies. This research may be beneficial to federal government program leaders who, as the result of increased insights and knowledge, can more effectively provide online government services using technology-enabled end-users\u27 computing devices in a cost-effective and secure method

Exploring Blockchain Governance

Blockchain systems continue to attract significant interest from both practitioners and researchers. What is more, blockchain systems come in various types, such as cryptocurrencies or as inter-organizational systems in business networks. As an example of a cryptocurrency, Bitcoin, one of the most prominent blockchain systems to date and born at the time of a major financial crisis, spearheaded the promise of relying on code and computation instead of a central governing entity. Proponents would argue that Bitcoin stood the test of time, as Bitcoin continues to operate to date for over a decade. However, these proponents overlook the never-ending, heated debates “behind the scenes” caused by diverging goals of central actors, which led to numerous alternative systems (forks) of Bitcoin. To accommodate these actors’ interests in the pursuit of their common goal is a tightrope act, and this is where this dissertation commences: blockchain governance. Based on the empirical examples of various types and application domains of blockchain systems, it is the goal of this dissertation to 1) uncover governance patterns by showing, how blockchain systems are governed, 2) derive governance challenges faced or caused by blockchain systems, and, consequently, to 3) contribute to a better understanding to what blockchain governance is. This dissertation includes four parts, each of these covering different thematical areas: In the first part, this dissertation focuses on obtaining a better understanding of blockchain governance’s context of reference by studying blockchain systems from various application domains and system types, for example, led by inter-organizational networks, states, or an independent group of actors. The second part, then, focuses on a blockchain as an inter-organizational system called “cardossier”, a project I was involved in, and its governance as a frame of reference. Hereupon, for one, I report on learnings from my project involvement in the form of managerial guidelines, and, for two, I report on structural problems within cardossier, and problems caused by membership growth and how they can be resolved. The third part focuses on a wider study of blockchains as inter-organizational systems, where I summarize findings of an analysis of 19 blockchain consortia. The findings, for one, answer the question of why blockchain consortia adopt blockchain technology, and, for two, show internal and external challenges these systems faced to derive managerial recommendations. The fourth and last part studies blockchain governance’s evolution and contributes an analysis of blockchain’s governance features and its contrast to established modes of governance. These four parts, altogether, have scientific value as they increase our understanding on blockchain governance. Consequently, this dissertation contributes to the body of knowledge on modes of governance, distributed system governance, and blockchain governance in general. I do so, by grounding the concept of blockchain governance in empirical detail, showing how these systems are governed on various application domains and system types, and by studying empirical challenges faced or caused by these systems. This approach is relevant and necessary, as blockchain systems in general, but particularly outside of cryptocurrencies, mostly still are in pursuit of a sustainable blockchain governance. As blockchains can be expected to continue to mature, the upcoming years offer very fruitful ground for empirical research along the empirical insights and theoretical lines shown in this dissertation

Generative Mechanisms for Digital Platform Ecosystem Evolution

Despite their growing economic importance and rapid proliferation across various industries, successful digital platform ecosystems remain difficult to build and sustain over time. Facing challenges stemming from the turbulent and uncertain environment, in which they operate, and from the accumulated over time internal inefficiencies, digital platform ecosystems need to evolve and adapt rapidly. Despite the importance of understanding how and why this evolutionary process occurs, research on this topic has remained elusive. Building upon the notion of generative mechanisms, this PhD dissertation seeks to unravel the various mechanisms, which contingently shape the evolution of digital platform ecosystems. To this end, this research investigates the evolutionary process from three theoretical perspectives – Punctuated Equilibrium, Dialectical and Teleological, and by adopting multi-method approach. As a result, the PhD dissertation puts forward three process theories, each characterized by distinctive generative mechanisms, which collectively provide in-depth insights how digital platform ecosystems evolve over time in response to internal and external challenges

ICT-driven interactions: on the dynamics of mediated control

Interactions driven by Information Communications Technologies (ICT) have gained significant acceptance and momentum in contemporary organisational settings, this is illustrated by their massive adoption and varied deployment across the various levels of an organisation’s hierarchy. ICTs such as mobile telephones, Personal Digital Assistants (PDA), videoconferencing, BlackBerries and other forms of portable and immovable computing technologies provide enduring bases for mediated interactions in human activities. This thesis looks into the dynamics of ICT-driven interactions and, distinctively, focuses on the manifestations and implications of mediated control in a collaborative environment. The study draws on the concept of administrative behaviour which leads to the observation that the nature of mediated control is not static, but evolutionarily dynamic that springs from highly unpredictable contexts of work. Thus, interactions driven by ICTs influence and change the dynamics of mediated control against the background of the rhythm, structure and direction of an organisation’s purposeful undertakings. Findings indicate, quite paradoxically, that networks set up through the instrumentality of technology mediated interaction discourage domination and inspire individual discretion in spite of their promise of electronic chains. The analysis reflects the notion that mediated control is not only about the predetermination of targets that are attained at the subordinate level. Indeed, the study advocates a fundamental conceptualisation of mediated control as double-sided concept, integrating the use of discretion that, occasionally, makes subordinates drive and initiate key control techniques that steer organisational life. Therefore, through the application of philosophical hermeneutics for a rigorous data interpretation, this study develops an innovative and holistic understanding of mediated control which not only adds to, but also extends, the current organisational perception of control by the incorporation of discretion and, in the process, makes a distinctive contribution to scholarship

Data Mining in Promoting Flight Safety

The incredible rapid development to huge volumes of air travel, mainly because of jet airliners that appeared to the sky in the 1950s, created the need for systematic research for aviation safety and collecting data about air traffic. The structured data can be analysed easily using queries from databases and running theseresults through graphic tools. However, in analysing narratives that often give more accurate information about the case, mining tools are needed. The analysis of textual data with computers has not been possible until data mining tools have been developed. Their use, at least among aviation, is still at a moderate level. The research aims at discovering lethal trends in the flight safety reports. The narratives of 1,200 flight safety reports from years 1994 – 1996 in Finnish were processed with three text mining tools. One of them was totally language independent, the other had a specific configuration for Finnish and the third originally created for English, but encouraging results had been achieved with Spanish and that is why a Finnish test was undertaken, too. The global rate of accidents is stabilising and the situation can now be regarded as satisfactory, but because of the growth in air traffic, the absolute number of fatal accidents per year might increase, if the flight safety will not be improved. The collection of data and reporting systems have reached their top level. The focal point in increasing the flight safety is analysis. The air traffic has generally been forecasted to grow 5 – 6 per cent annually over the next two decades. During this period, the global air travel will probably double also with relatively conservative expectations of economic growth. This development makes the airline management confront growing pressure due to increasing competition, signify cant rise in fuel prices and the need to reduce the incident rate due to expected growth in air traffic volumes. All this emphasises the urgent need for new tools and methods. All systems provided encouraging results, as well as proved challenges still to be won. Flight safety can be improved through the development and utilisation of sophisticated analysis tools and methods, like data mining, using its results supporting the decision process of the executives.Lentoliikenne kasvoi huomattavasti 1950-luvulla pääasiassa suihkumatkustajakoneiden myötä, mikä aiheutti poikkeamatietojen järjestelmällisen keräämisen ja tutkimuksen tarpeen. Määrämuotoinen tieto voidaan helposti analysoida tietokantakyselyillä esittäen tulokset käyttäen graafisia työkaluja, mutta tekstianalyysiin, jonka avulla tapauksista saadaan usein tarkempia tietoja, tarvitaan louhintatyökaluja. Tekstimuotoisen tiedon automaattinen analysointi ei ole ollut mahdollista ennen louhintatyökalujen kehittämistä. Silti niiden käyttö, ainakin ilmailun piirissä, on edelleen vähäistä. Tutkimuksen tarkoituksena oli havaita vaarallisia kehityskulkuja lentoturvallisuusraporteissa. 1 200 lentoturvallisuusraportin selostusosiot vuosilta 1994 –1996 käsiteltiin kolmella tekstinlouhintatyökalulla. Yksi näistä oli täysin kieliriippumaton, toisessa oli lisäosa, jossa oli mahdollisuus käsitellä suomen kieltä ja kolmas oli rakennettu alun perin ainoastaan englanninkielisen tekstin louhintaan, mutta espanjan kielellä saavutettujen rohkaisevien tulosten pohjalta päätettiin kokeilla myös suomenkielistä tekstiä. Lento-onnettomuuksien määrä liikenteeseen nähden on vakiintumassa maailmanlaajuisesti katsottuna ja turvallisuustaso voidaan katsoa tyydyttäväksi. Kuitenkin liikenteen kasvaessa myös onnettomuuksien määrä lisääntyy vuosittain, mikäli lentoturvallisuutta ei kyetä parantamaan. Turvallisuustiedon kerääminen ja raportointijärjestelmät ovat jo saavuttaneet huippunsa. Analysoinnin parantaminen on avain lentoturvallisuuden parantamiseen. Lentoliikenteen on ennustettu kasvavan 5 – 6 prosenttia vuodessa seuraavien kahden vuosikymmenen ajan. Samana aikana lentoliikenne saattaa kaksinkertaistua jopa vaatimattomimpien talouskasvuennusteiden mukaan. Tällainen kehitys asettaa lentoliikenteen päättäjille yhä kasvavia paineita kiristyvän kilpailun, polttoaineiden hinnannousun ja liikenteen kasvun aiheuttaman onnettomuuksien määrän vähentämiseksi. Tämä korostaa uusien menetelmien ja työkalujen kiireellistä tarvetta. Kaikilla louhintajärjestelmillä saatiin rohkaisevia tuloksia mutta ne nostivat samalla esille haasteita, jotka tulisi vielä voittaa. Lentoturvallisuutta voidaan vielä parantaa käyttämällä tässä esille tuotuja analyysimenetelmiä ja –työkaluja kuten tiedonlouhintaa ja soveltamalla näin saatuja tuloksia johdon päätöksenteon tukena.Siirretty Doriast