Institutional perspective on introducing enterprise architecture : The case of the Norwegian hospital sector

Paper I, II, and III are not available as a part of the dissertation due to the copyright.The findings from this thesis point to the incongruence between the characteristics of EA and the healthcare domain as specific tensions among the EA logic and different professional logics as a source of deviation. The incongruence comes from the long-term plan-driven EA approach versus healthcare traditions and needs for ad-hoc initiatives. Other themes stem from the EA logic of process standardisation, which poses challenges in gaining acceptance and trust that the processes dinscribe appropriate clinical knowledge and provide support for local variations. Moreover, the EA vision of data integration across organisational units and across IS has implications for concerns about privacy and protection of sensitive data, but this can collide with the healthcare view on patient safety and the need for mission-critical data. This dissertation makes several contributions to research and practice. First, it augments the EA research stream by offering rich insights and specific implications related to challenges of EA institutionalisation in healthcare. A description of the enterprise architects’ logics and the EA logic supplements the EA knowledge base. Likewise, it presents a model of a predicted evolution of the EA initiatives through the phases of optimism, resistance, decline and finally, reconsolidation of the most persistent ones, unless firm mandates are established from the start. Furthermore, the study provides a model that illustrates how coexisting institutional logics maintain their distinct character while allowing compromises that shape EA operationalisation. The model shows a set of scenarios for settling tensions in project decisions. In these scenarios, EA is foregrounded, blended with other available institutional logics or suppressed. Second, this dissertation contributes to an enhanced theoretical and empirical understanding of EA institutionalisation, where regulative, normative and culturalcognitive elements create and maintain EA as an institution, and unsurprisingly, the organisational response impedes the institutionalisation process. The organisational response can be explained by selective activated institutional logics among the actors. However, with targeted institutional work from the actors that want EA to be institutionalised, the process can be reinforced. This thesis also offers some practical suggestions at the national policy level. First, financial arrangements should be assessed to encourage broader involvement from the sub-organisations. Second, through active ownership, they can address the need for enhanced EA understanding and should secure the education of the actors, not the least at the executive level, together with the targeted hires. Furthermore, the need for organisational changes related to EA is under-communicated. The thesis also makes practical suggestions to deal with the challenges, the incongruence and the consequent tensions, mainly by finding solutions that balance between the institutional logics of EA and of healthcare.publishedVersio

Assessing Trustworthy AI in times of COVID-19. Deep Learning for predicting a multi-regional score conveying the degree of lung compromise in COVID-19 patients

Abstract—The paper's main contributions are twofold: to demonstrate how to apply the general European Union’s High-Level Expert Group’s (EU HLEG) guidelines for trustworthy AI in practice for the domain of healthcare; and to investigate the research question of what does “trustworthy AI” mean at the time of the COVID-19 pandemic. To this end, we present the results of a post-hoc self-assessment to evaluate the trustworthiness of an AI system for predicting a multi-regional score conveying the degree of lung compromise in COVID-19 patients, developed and verified by an interdisciplinary team with members from academia, public hospitals, and industry in time of pandemic. The AI system aims to help radiologists to estimate and communicate the severity of damage in a patient’s lung from Chest X-rays. It has been experimentally deployed in the radiology department of the ASST Spedali Civili clinic in Brescia (Italy) since December 2020 during pandemic time. The methodology we have applied for our post-hoc assessment, called Z-Inspection®, uses socio-technical scenarios to identify ethical, technical and domain-specific issues in the use of the AI system in the context of the pandemic.</p

Assessing Trustworthy AI in Times of COVID-19: Deep Learning for Predicting a Multiregional Score Conveying the Degree of Lung Compromise in COVID-19 Patients

This article's main contributions are twofold: 1) to demonstrate how to apply the general European Union's High-Level Expert Group's (EU HLEG) guidelines for trustworthy AI in practice for the domain of healthcare and 2) to investigate the research question of what does "trustworthy AI" mean at the time of the COVID-19 pandemic. To this end, we present the results of a post-hoc self-assessment to evaluate the trustworthiness of an AI system for predicting a multiregional score conveying the degree of lung compromise in COVID-19 patients, developed and verified by an interdisciplinary team with members from academia, public hospitals, and industry in time of pandemic. The AI system aims to help radiologists to estimate and communicate the severity of damage in a patient's lung from Chest X-rays. It has been experimentally deployed in the radiology department of the ASST Spedali Civili clinic in Brescia, Italy, since December 2020 during pandemic time. The methodology we have applied for our post-hoc assessment, called Z-Inspection®, uses sociotechnical scenarios to identify ethical, technical, and domain-specific issues in the use of the AI system in the context of the pandemic

Cross-sectoral hybridization as a strategy to turn institutional voids into opportunity spaces

Organizations that aim at delivering essential goods and services to low-income populations a the base of the pyramid increasingly blend the social welfare and the commercial logics in an effort to create financially sustainable solutions to social problems. Scholars have portrayed these cross-sectoral hybrid organizations as particularly agentic and resilient in institutionally complex settings, highlighting their ability to turn institutional voids into opportunity spaces. At the same time, the reconciliation of two antagonistic goals, namely poverty alleviation and financial value creation, as well as the multiple institutional voids that hybrid organizations face at the base of the pyramid (BoP) expose them to severe tensions. By investigating eight hybrid organizations in four countries, namely Colombia, Mexico, Kenya and South Africa, the present study contributes to a better understanding of cross-sectoral hybrid organizations in BoP settings in two ways. First, it shows that hybrid organizations not only face tensions between sector logics, but also between formal and informal, as well as between “Western-style” and “local style” strategic action fields. In settings which do not effectively provide guidance on the prioritization of social vs. financial objectives, these institutional voids manifest as tensions over goals and tensions over means in hybrid organizations. Second, the study sheds light on how field-level dynamics influence the ability of hybrid organizations to strategically employ factors that spur legitimacy advantages in an effort to turn institutional voids into opportunity spaces. Two different scenarios have been identified. One scenario refers to Colombia, Mexico and Kenya, which have been classified as fields that don’t effectively enforce a dominant sector logic concerning the legitimate way that health services should be provided to low-income populations. The present study has shown that in such fields, an organization’s logic of origin as well as the personal background of founders are factors that may spur legitimacy advantages in hybrid organizations. In effect, organizations which strategically employ these factors can select more freely from competing logics and ultimately overcome the prevailing tensions. This resonates with previous research, which has suggested that in fields with a dominant logic, hybrid organizations may take advantage of legitimacy advantages if their logic of origin corresponds to the dominant logic at the field level (Pache and Santos, 2012). However, the present study suggests that the factors leading to legitimacy advantages are more complex in fields with no effective dominant logic regarding social service provision. Here, the dominant logics among funding organizations, possible legitimacy spill-over effects from other market players, as well as the specifications of the commercial and the social welfare logics become important sources of possible legitimacy advantages. However, the study suggests that an organization’s ability to employ them strategically is dependent on their time of founding and their size. In addition to these findings, the study also provides insights on cross-sectoral hybridization in fields with a weakly enforced dominant logic, which is the second scenario that has been identified in South Africa. In particular, the study suggests that in such settings, hybrid organizations are more restricted to freely draw from competing logics, given that they face effective, normative imperatives about the goals they should pursue. However, the empirical investigation also indicates that an organization’s resource dependence structure is more influential than the encountered normative claims of audiences in health fields at the BoP. Further research is needed to refine these insights and explore cross-sectoral hybridization in social service provision fields in contexts of a weakly enforced dominant logic. Based on these findings, the author derives a range of practical recommendations that may themselves be interpreted as paradoxical. As the empirical study suggests, blended value creating hybrid organizations in Colombia, Mexico and Kenya currently face legitimacy advantages when originating from a commercial origin. The researcher is thus, on the one hand, inclined to recommend them to position themselves as commercially oriented organizations as to take advantage of the legitimacy advantages that the commercial logic currently entails. On the other hand, she cautions actors in the field of blended value creation, particularly funding entities, not to neglect the actual role of nonprofit organizations. The establishment of (health) markets that provide low-income populations in developing and emerging economies with affordable, high-quality products and services is likely to require significant unprofitable efforts. Finally, hybrid organizations in South Africa need to be more careful when adopting structures or practices from the commercial logic given the low legitimacy that this logic has in the health market at the BoP. There, organizations need to thoroughly analyze the institutional claims in the specific context of post-Apartheid South Africa

CHORUS Deliverable 2.1: State of the Art on Multimedia Search Engines

Based on the information provided by European projects and national initiatives related to multimedia search as well as domains experts that participated in the CHORUS Think-thanks and workshops, this document reports on the state of the art related to multimedia content search from, a technical, and socio-economic perspective. The technical perspective includes an up to date view on content based indexing and retrieval technologies, multimedia search in the context of mobile devices and peer-to-peer networks, and an overview of current evaluation and benchmark inititiatives to measure the performance of multimedia search engines. From a socio-economic perspective we inventorize the impact and legal consequences of these technical advances and point out future directions of research

Urban food strategies in Central and Eastern Europe: what's specific and what's at stake?

Integrating a larger set of instruments into Rural Development Programmes implied an increasing focus on monitoring and evaluation. Against the highly diversified experience with regard to implementation of policy instruments the Common Monitoring and Evaluation Framework has been set up by the EU Commission as a strategic and streamlined method of evaluating programmes’ impacts. Its indicator-based approach mainly reflects the concept of a linear, measure-based intervention logic that falls short of the true nature of RDP operation and impact capacity on rural changes. Besides the different phases of the policy process, i.e. policy design, delivery and evaluation, the regional context with its specific set of challenges and opportunities seems critical to the understanding and improvement of programme performance. In particular the role of local actors can hardly be grasped by quantitative indicators alone, but has to be addressed by assessing processes of social innovation. This shift in the evaluation focus underpins the need to take account of regional implementation specificities and processes of social innovation as decisive elements for programme performance.