DATA GOVERNANCE STRATEGIES FOR DATA PLATFORMS – A MULTIPLE CASE STUDY IN NURSING CARE

It is long established that data from platforms can be useful for deriving patterned insights into people’s behavior and conduct. Data platforms are important in fields with limited data availability and strict regulatory and hierarchical structures, such as healthcare and nursing analytics. Hence, we carefully examine three forerunner initiatives in establishing data platforms in the context of nursing care along normative, organizational, and technical dimensions of governance. The cases were selected due to their high level of comparability and to demonstrate three different types of data governance strategies understood as actions to reconcile conflicting interests regarding data and dealing with prevalent data protection law – ranging from strictly processual approaches to the creation of synthetic data. These findings highlight the importance of considering data governance strategies concisely when building data platforms and suggest considerable variety in the configuration of data governance arrangements

Business Model Innovation For Potentially Disruptive Technologies: The Case Of Big Pharmaceutical Firms Accommodating Biotechnologies

Potenziell disruptive Technologien sind schwer zu vermarkten, weil sie mit Werten verbunden sind, die für etablierte Unternehmen neu sind. Ohne geeignete Geschäftsmodellinnovation gelingt es den etablierten Unternehmen nicht, neue, potenziell disruptive Technologien auf den Markt zu bringen. Die aufkeimende Literatur über disruptive Innovationen bietet nur begrenzte Empfehlungen zu spezifischen Geschäftsmodellelementen, die dazu dienen können, potenziell disruptive Technologien zu integrieren. Um diese Forschungslücke zu schließen, wird in dieser Arbeit untersucht, wie große Pharmaunternehmen Biotechnologien in die Gestaltung ihrer Geschäftsmodellinnovation einbezogen haben, um erfolgreiche Elemente der Geschäftsmodellgestaltung zu ermitteln. Es wird ein qualitativer Forschungsansatz gewählt, der aus drei Studien besteht. Zunächst werden nach einer systematischen Literaturrecherche zur Geschäftsmodellforschung in der pharmazeutischen Industrie 45 Arbeiten ausgewählt und qualitativ ausgewertet. Zweitens werden qualitative halbstrukturierte Interviews mit 16 Experten in großen Pharmaunternehmen geführt. Die Transkripte werden mit der Methode der Qualitativen Inhaltsanalyse ausgewertet. Schließlich wird eine Clusteranalyse durchgeführt, um den von allen digitalen Angeboten großer Pharmaunternehmen vorgeschlagenen und gelieferten Wert zu ermitteln. In dieser Arbeit werden erstmals zwei Geschäftsmodelle großer Pharmaunternehmen aus der Zeit vor und nach der Einführung der Biotechnologien beschrieben. In dieser Arbeit wird argumentiert, dass für die Anpassung an potenziell disruptive Technologien folgende Geschäftsmodellelemente empfohlen werden: Kollaborationsportfolios und digitale Servitisierung. Erstens sollten etablierte Unternehmen ein Portfolio von Kooperationsformaten entwickeln, indem sie die Breite der Partner (einschließlich der Wettbewerber) diversifizieren und alle Aktivitäten in ihrer Wertschöpfungskette abdecken. Zweitens sollten die etablierten Unternehmen den Wert, den sie anbieten, und die Art und Weise, wie sie diesen Wert für etablierte und neue Kundensegmente bereitstellen, innovativ gestalten, indem sie ihre Produkte mit ergänzenden Dienstleistungen bündeln, insbesondere mit solchen, die digital ermöglicht werden. Digitale Dienstleistungen dienen dazu, die Bedürfnisse der Kunden mit denen des Herstellers zu verknüpfen. Neben der Weiterentwicklung der Theorie über disruptive Innovationen können die empfohlenen Elemente des Geschäftsmodells von führenden mittelständischen Pharmaunternehmen (z. B. Fresenius oder Servier) und Unternehmen aus anderen Branchen direkt genutzt werden, um andere potenziell disruptive Technologien zu vermarkten. Diese Forschung unterstützt politische Entscheidungsträger bei der Entwicklung von Strategien zur Förderung der Kommerzialisierung potenziell disruptiver Innovationen in ihrem spezifischen Kontext.Potentially disruptive technologies are challenging to commercialize because they are associated with values new to established firms. Without fitting business model innovation, incumbent firms fail to bring new potentially disruptive technologies to the market. The burgeoning literature on disruptive innovation provides only limited recommendations on specific business model elements that can serve to accommodate potentially disruptive technologies. To close this research gap, this thesis explores how big pharmaceutical firms accommodated biotechnologies in the design of their business model innovation to discover successful business model design elements. A qualitative research approach consisting in three studies is adopted. First, following a systematic literature review on business model research in the pharmaceutical industry, 45 papers are selected and qualitatively analyzed. Second, qualitative semi-structured interviews are conducted with 16 experts in big pharmaceutical firms. The transcripts are analyzed using the qualitative content analysis method. Finally, a cluster analysis is conducted to identify value proposed and delivered by all digital offers of big pharmaceutical firms. This thesis is the first to describe two business model designs of big pharmaceutical firms from before and since the accommodation of biotechnologies. This research argues that business model designs recommended for the accommodation of potentially disruptive technologies are collaboration portfolios and digital servitization. First, established firms should devise a portfolio of collaboration formats by diversifying breadth of partners (including competitors), and by covering all activities in their value chain. Second, incumbent firms should innovate in the value they offer and how they deliver it to mainstream and new customer segments though bundling their products with complementary services, especially those that are digitally enabled. Digital services serve for back-coupling customers’ needs with the producer. Besides advancing theory on disruptive innovation, the recommended business model design elements can be directly used by top midsize pharmaceutical firms (e.g., Fresenius or Servier) and firms from other industries to commercialize other potentially disruptive technologies. This research supports policy makers in devising strategies for the promotion of the commercialization of potentially disruptive innovations in their specific contexts

Big Data and the Precision Medicine Revolution

The big data revolution is making vast amounts of information available in all sectors of the economy including health care. One important type of data that is particularly relevant to medicine is observational data from actual practice. In comparison to experimental data from clinical studies, observational data offers much larger sample sizes and much broader coverage of patient variables. Properly combining observational data with experimental data can facilitate precision medicine by enabling detection of heterogeneity in patient responses to treatments and tailoring of health care to the specific needs of individuals. However, because it is high-dimensional and uncontrolled, observational data presents unique methodological challenges. The modeling and analysis tools of the production and operations management field are well-suited to these challenges and hence POM scholars are critical to the realization of precision medicine with its many benefits to society.https://deepblue.lib.umich.edu/bitstream/2027.42/145441/1/1386_Hopp.pd

Risk Governance and Deliberative Democracy in Health Care

I argue in this article that the concept of risk-centered governance is the best theoretical paradigm for understanding health law and the health care system. Over the past 20 years, an insurance-inflected discourse has migrated from the purely financial side of the health system into the heart of traditional medicine - the doctor-patient relationship. Rather than focus on doctrinal strands, I argue that scholars should analyze the law of health care as a set of governance practices organized around managing and allocating financial, as well as clinical, risk. Over the same period, the body of law that structures most private group health insurance - ERISA - has effectively delegated control of risk pooling and resource allocation to the employers that sponsor group plans. Drawing on a history of ERISA that has not been explored in legal scholarship, I demonstrate how the private welfare state of workplace-based health insurance has evolved into the creation of what amounts to corporate sovereignty in controlling access to health coverage. The discourse of managing risk bonds these two components of health law and the health care system: patient care and access to coverage. From a normative perspective, the greatest problem with risk-centered governance arises from a democracy deficit. Because almost all health insurance risk pools are based in workplaces, there is potential to draw on the social networks created by work as a mechanism for building new, localized publics engaged with health policy. Treating insurance risk pools as potential mechanisms of governance, rather than merely as actuarial units, would force the publicizing (at least within the workplace) of myriad political decisions: who gets included and excluded in the pooling process, how allocation decisions are made, and whether there are systems of accountability and checks and balances sufficient to produce a risk allocation system that is equitable, as well as efficient and flexible. The article builds on the egalitarian potential of social insurance as a technology of governance, and argues for filling a gap that exists not only in the current system, but also in all proposals for reform

Cultivating the Genetic Commons: Imperfect Patent Protection and the Network Model of Innovation

This Article enters this debate and argues the following position. Assuming that antitrust authorities persist in certain strategies to impede patent consolidation, the recent introduction of patent rights for certain biotechnological innovations is likely to encourage private investment in the genetic commons and reduce (or, at least, not enhance) the accessibility costs that could stunt technological advance. To reach this conclusion, this Article shows that the two leading theories of patent protection, the incentive theory7 and the prospect theory,8 do not explain private industry\u27s willingness to sink significant investment capital into highly uncertain biopharmaceutical projects. These theories offer insufficient explanations because patent protection for biopharmaceutical innovations is substantially incomplete and generally covers only a small portion of a particular innovation\u27s technological yield. Both the incentive and prospect theories falsely predict that the appropriability gap would drive away private investors from biotechnology projects that appear to generate a large stream of unprotected, or giveaway, benefits. In contrast, this Article argues that this imperfect form of patent protection attracts private investment in uncertain research projects by reducing two information asymmetries that impede interfirm ventures capable of efficiently spreading the high risk of biopharmaceutical product development. At the same time, the imperfect character of patent protection reduces (or, at least, does not enhance) accessibility costs by encouraging individual firms to capture the unprotected portion of an innovation project\u27s expected yield by entering into interfirm research, marketing, or production alliances

Management of Technological Innovation in Developing and Developed Countries

It is widely accepted that technology is one of the forces driving economic growth. Although more and more new technologies have emerged, various evidence shows that their performances were not as high as expected. In both academia and practice, there are still many questions about what technologies to adopt and how to manage these technologies. The 15 articles in this book aim to look into these questions. There are quite many features in this book. Firstly, the articles are from both developed countries and developing countries in Asia, Africa and South and Middle America. Secondly, the articles cover a wide range of industries including telecommunication, sanitation, healthcare, entertainment, education, manufacturing, and financial. Thirdly, the analytical approaches are multi-disciplinary, ranging from mathematical, economic, analytical, empirical and strategic. Finally, the articles study both public and private organizations, including the service industry, manufacturing industry, and governmental organizations. Given its wide coverage and multi-disciplines, the book may be useful for both academic research and practical management

Science in an age of globalisation : the geography of research collaboration and its effect on scientific publishing

Although scientific knowledge is considered by many a universal and context-free product, its producers are often embedded in geographically bounded networks of research collaboration. However, in an age of globalisation these local networks of knowledge production are challenged by pressures to make science more efficient and to align its priorities with problems of global relevance such as climate change and worldwide epidemics. Against this background, the dissertation sets out to examine changes in the contemporary geography of research collaboration and explores how these changes affect the publication of research findings in scientific journals. The dissertation starts with introducing a framework to understand how geographical space structures research collaboration among researchers. The two structuring principles in this framework are a logic of proximity that provides solutions for coordination problems in research practice, and a logic of stratification that provides researchers with differential means to engage in collaborations. The logic of proximity mainly follows from the importance of physical co-presence both for carrying out the complex tasks associated with scientific research and for establishing trust in research results. The logic of stratification is an outcome of the reward system in science which provides differential credit to researchers on the base of their past productivity. Globalisation affects these logics through technological advancements in ICTs and mobility, and through the harmonisation of research policies and practices across territories. It is hypothesised in this dissertation that these changes have implications for geographical patterns of research collaboration, and also for the way research findings are communicated in scientific publications. The empirical validation of this framework centers around two main themes that very much bear the imprint of globalisation in science. The first theme concerns the research policies of the European Union that are focused on the harmonisation of regional and national institutions in Europe in order to create an integrated ‘European Research Area’ (ERA) which should make the European research system more efficient and competitive. The Framework Programmes are explicitly designed to facilitate this integration process and in doing so they fund thousands of transnational research projects making it the largest transnational funding scheme in the world. Against this background, Chapter 2 evaluates the extent to which European research collaboration networks are already spatially integrated based on publication and patent data with multiple addresses. The results indicate that research collaborations in Europe are structured by geographical proximities as the choice for collaboration partners is impeded both by the kilometric distance between researchers and by national borders separating them. The chapter also presents some evidence that research collaboration networks are stratified on the base of similarity in productivity and access to resources. This logic of stratification operates irrespective of the location of researchers vis-à-vis each other. The main conclusion that follows from this analysis is that the present efforts towards the creation of ERA are well justified. The empirical study in Chapter 3 develops a dynamic approach to the geography of research collaboration by studying whether the logic of proximity is changing over time. The main argument of this chapter holds that one should make a conceptual distinction between a possible changing effect of geographical distance and a possible changing effect of territorial borders when studying proximity dynamics in research collaboration networks. When making such a distinction in the context of the European research system, the chapter shows that it is primarily the importance of regional and national borders that is decreasing over time, but that the role of geographical proximity in structuring research collaborations is remarkably stable. The findings indicate that globalisation in science is mainly realised through the harmonisation of territorial institutions, but that physical co-presence remains an important coordination device for exchanging complex forms of knowledge that cannot be easily communicated over large distances. The objective of Chapter 4 is to study to what extent the Framework Programmes (FPs), as the main funding instrument of the European Commission, are affecting the geography of European research collaboration. It is hypothesised that, in case the FPs indeed render territorial borders less important, they are likely to create (new) stratified networks of research collaboration that disproportionally consists of high-performance researchers located in Europe’s core regions. Contrary to the expectation no evidence for this hypothesis is found. The presented analysis indicates that the FPs indeed have a substantial effect on promoting international scientific collaboration networks which are still relatively uncommon in comparison to national collaboration networks. However, it is also shown that acquisition of FP funding is rather equally distributed over Europe and that the FPs are more effective in establishing ties between poorly connected researchers than in further strengthening existing ones. When stimulating already existing networks the FPs run the risk of being a substitute for other funding sources. This implies that current EU research policy is in line with the cohesion objective of the European Union. The second theme of this dissertation concerns the global standardization of medical experiments on human subjects. In recent years, proponents of an evidence-based medicine have pushed for standards concerning the conduct of clinical trials and subsequent publication of research findings in clinical trial registers and scientific publications. This standardization process is closely linked to an increase in the number and size of clinical trials that involve scientific researchers and patients from across the globe. The empirical chapters address whether this standardization process has an effect on several aspects of scientific publishing including the constitution of authorship on publications, the communication of evidence after study completion, and the presence of error in scientific publications. In order to analyse these questions, a database is created that links information on registered clinical trial projects (www.clinicaltrials.gov) to scientific publications of the main findings after study completion. Chapter 5 focuses in this respect on the standardization of good clinical practice (ICH-GCP) which has made the exchange of clinical data between geographically dispersed research sites less complicated. This has resulted in a process of global outsourcing with increasing enrolment of patients from emerging economies, especially in Central and Eastern Europe, Latin America and Asia. The chapter describes this globalisation tendency and studies whether worldwide patient involvement in clinical trials is reflected in the geographical composition of scientific management teams in those trials. The chapter develops an empirical strategy to determine the geographical distribution of management teams by using authorship data from publications reporting on primary outcomes. On the basis of this data it is shown that, given patient involvement, authorships are disproportionally granted to researchers in a few leading countries. The chapter discusses possible adverse consequences of this situation especially concerning the monitoring of clinical trial quality and (the lack of) interactions between researchers that are in immediate contact with patients and researchers that design trials and interpret their results. Chapter 6 concentrates on the publication behaviour of pharmaceutical companies who are well known for their strategy to withhold negative research findings from the scientific literature. To remedy this situation several authorities have recently mandated both registration of clinical trials before study onset and publication of major research findings after study completion. The main question holds under what conditions pharmaceutical companies decide to publish their clinical trial findings either in scientific journals or on the web. The main hypothesis is that under the new institutional context pharmaceutical companies will continue to highlight positive results in the scientific literature as it provides them with certification that their research findings are scientifically sound, methodologically rigourous and thus credible. Negative results, by contrast, are expected to be published on the web. This hypothesis is tested against a sample of clinical trials that assess the efficacy of glucose lowering agents in diabetes patients. The results indicate that firms continue to highlight positive results in scientific journals which results in an ongoing and persistent bias of evidence in the literature. Finally, Chapter 7 studies the production and detection of error in scientific publications on the basis of published errata and retractions. It is derived from earlier chapters that geographical proximity remains an important coordination device in research practice. This begs the question whether researchers operating in geographically dispersed research projects are also more likely to produce error because effective peer-control may be lacking and the establishment of mutual understanding hindered. The chapter addresses this question by making a conceptual distinction between modes of coordination that influence error production, and the prestige of research findings that influences error detection. With respect to prestige of research the chapter shows that editorial policies of scientific journals may actively steer the process of error detection by organising impact around particular findings and by enforcing strict publication guidelines. After controlling for these factors the analysis finds that geographically distributed research results in less accurate scientific publication. Globalisation tendencies thus put increasing responsibility on the publication system to correct errors in publications. Based on the findings of the empirical chapters, the overall conclusion of the dissertation is three-fold. The first conclusion holds that changes in the contemporary geography of research collaboration are mainly visible in institutional harmonisation across territories, rather than in a tendency towards a ‘death of distance’ per se. This paradoxical process provides new prospects for worldwide research collaborations, but limits at the same time the possibilities to make these prospects work in actual research practice. Second, the presented analysis indicates that in an age of globalisation, science does not become a global level playing field where chances of success level off. Rather, stratified structures are reproduced at different spatial scales via the creation of new reward systems and global research collaboration network that exhibit high entry barriers. Third, globalised science reveals new publication practices that concern authorship norms, the prevalence and correction of error in scientific publications and the conditions under which disclosure of research findings takes place. In this respect, new global contexts have often been cited as contributors to the quality, impact and practical application of research findings. The results presented here do not support the argument and at least point to some potential side-effects of geographically distributed research. These effects require a rethinking of science’s institutions in light of globalisation

HIV/AIDS Pandemic in Africa: Trends and Challenges

Three-quarters of the world’s AIDS population lives in Sub-Saharan Africa; most have no access to lifesaving drugs, testing facilities or even basic preventative health care. One of the major factors inhibiting medical professionals in Africa from treating this disease is the inability to access vast areas of the continent with adequately equipped medical facilities. To meet this need, Architecture for Humanity challenged the world’s architects and health care professionals to submit designs for a mobile HIV/AIDS health clinic. The pandemic is changing the demographic structure of Africa and wiping out life expectancy gains. Indeed, in many African countries, life expectancy is dropping from more than 60 years to around 45 years or even less. In this paper, we highlight the uniqueness of factors associated with HIV/AIDS pandemic in Africa and present its impact and challenges.HIV/AIDS, Africa