A Fit between Clinical Workflow and Health Care Information Systems: Not waiting for Godot but making the journey

Health care has long suffered from inefficiencies due to the fragmentation of patient care information and the lack of coordination between health professionals [1]. Health care information systems (HISs) have been lauded as tools to remedy such inefficiencies [2, 3]. The primary idea behind the support of their implementation in health care is that these systems support clinical workflow and thereby decrease medical errors [2]. However, their introduction to health care settings have been accompanied by a transformation of the way their primary users, care providers, carry out clinical tasks and establish or maintain work relationships [4]. Studies have shown that these transformations have not always been productive [5, 6]

Designing a Patient-Centered Clinical Workflow to Assess Cyberbully Experiences of Youths in the U.S. Healthcare System

Cyberbullying or online harassment is often defined as when someone repeatedly and intentionally harasses, mistreats, or makes fun of others aiming to scare, anger or shame them using electronic devices [296]. Youths experiencing cyberbullying report higher levels of anxiety and depression, mental distress, suicide thoughts, and substance abuse than their non-bullied peers [360, 605, 261, 354]. Even though bullying is associated with significant health problems, to date, very little youth anti-bullying efforts are initiated and directed in clinical settings. There is presently no standardized procedure or workflow across health systems for systematically assessing cyberbullying or other equally dangerous online activities among vulnerable groups like children or adolescents [599]. Therefore, I developed a series of research projects to link digital indicators of cyberbullying or online harassment to clinical practices by advocating design considerations for a patient-centered clinical assessment and workflow that addresses patients’ needs and expectations to ensure quality care. Through this dissertation, I aim to answer these high-level research questions:RQ1. How does the presence of severe online harassment on online platforms contribute to negative experiences and risky behaviors within vulnerable populations? RQ2. How efficient is the current mechanism of screening these risky online negative experiences and behaviors, specifically related to cyberbully, within at-risk populations like adolescent in clinical settings? RQ3. How might evidence of activities and negative harassing experiences on online platforms best be integrated into electronic health records during clinical treatment? I first explore how harassment is presented within different social media platforms from diverse contexts and cultural norms (study 1,2, and 3); next, by analyzing actual patient data, I address current limitations in the screening process in clinical settings that fail to efficiently address core aspect of cyberbullying and their consequences within adolescent patients (study 4 and 5); finally, connecting all my findings, I recommend specific design guidelines for a refined screening tool and structured processes for implementation and integration of the screened data into patients’ electronic health records (EHRs) for better patient assessment and treatment outcomes around cyberbully within adolescent patients (study 6)

Continuous monitoring of enterprise risks: A delphi feasibility study

A constantly evolving regulatory environment, increasing market pressure to improve operations, and rapidly changing business conditions are creating the need for ongoing assurance that organizational risks are continually and adequately mitigated. Enterprises are perpetually exposed to fraud, poor decision making and/or other inefficiencies that can lead to significant financial loss and/or increased levels of operating risk. Increasingly, Information Systems are being harnessed to reinvent the risk management process. One promising technology is Continuous Auditing, which seeks to transform the audit process from periodic reviews of a few transactions to a continuous review of all transactions. However, the highly integrated, rapidly changing and hypercompetitive business environment of many corporations spawns numerous Enterprise Risks that have been excluded from standard risk management processes. An extension of Continuous Auditing is Continuous Monitoring, which is used by management to continually review business processes for unexpected deviations. Using a Delphi, the feasibility and desirability of applying Continuous Monitoring to different Enterprise Risks is studied. This study uncovers a significant relationship between the perceived business value of Continuous Monitoring and years of experience in Risk Management and Auditing, determines that all key architectural components for a Continuous Monitoring system are known, and indicates that Continuous Monitoring may be better suited for monitoring computer crime than monitoring strategic risks such as the loss of a competitive position

The coevolution of AEC professional work practices with technology: collaborative delivery framework modelling for BIM projects

A thesis submitted to the Faculty of Engineering and the Built Environment, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy (PhD). Johannesburg, 2018Despite BIM’s potential to alleviate persistent construction industry challenges, its use does not guarantee results. Therefore, it was argued and established from a theoretical and practical standpoint that the implementation of BIM, an evolving technology, within pre-BIM organisational and project team work practices (as activity systems), induces their evolution through dysfunctions created in the systems and their resolution. A multi-stage\multi-method research design involving a study of BIM implementation cases, documents analysis, swimlane modelling and multi-domain-mapping (MDM) of pre-BIM and BIM-enabled project delivery processes was employed. This was to develop an understanding of how construction professional work practices evolve with the implementation of BIM. The findings show that evolutionary change of work practices within organisations precedes that of project teams. The findings further suggest a link between organisational attitude towards BIM as a method of working and success at implementing it. Using activity theory, a novel conceptual analysis of BIM induced change in professional work practices aided a theoretical understanding of the implications of implementing BIM on construction professional work practices. The theory provided a basis for analysing historical and future change patterns in professional work practices with BIM and indeed similar work mediating tools. An in-depth conceptualisation and new theoretical insight were developed on the phenomenon of new role legitimation, establishing that new BIM role takers are legitimated to exercise authority within project teams and organisations mainly because they leverage knowledge as a strategic resource. By implication, they will remain legitimate only as long as the constraint or dysfunction prompting their creation subsists. Furthermore, using swimlane and MDM modelling methods in complement, the BIM change impact on pre-BIM workflows was modelled. An objective evaluation of the BIM change impact at the pre-construction phase showed that the BIM-enabled project delivery workflows structure, compared to the pre-BIM is more connected and integrated.MT 201

Evaluation of an organisational change intervention in the energy services industry.

Thesis (M.B.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.No abstract available

Fostering Participation and Capacity Building with Neighborhood Information Systems.

Applying information to decision making, monitoring neighborhood conditions, targeting resources, and recommending action have long been key urban planning functions. Increasingly, nonprofit organizations like community development corporations (CDCs) carry out these functions in distressed urban areas. Scholars in multiple disciplines argue that “data democratization”—increased access to data—would support a wide range of community change efforts. Proponents of a specific data delivery tool—neighborhood information systems (NIS)—claim that the technology can increase public participation and build capacity in distressed urban neighborhoods. This research evaluates these claims in Cleveland where the mortgage foreclosure crisis has left a glut of vacant and abandoned properties and a dire need to prioritize activities with limited resources. The research provides an integrated theoretical framework, bringing together four distinct bodies of knowledge for the first time: science and technology studies; participation, capacity, and capacity building; geographic information systems; and management information systems. The mixed-methods approach employed includes interviews with sixty community development professionals in Cleveland and a longitudinal regression analysis of thirty CDCs’ housing rehabilitation outcomes between July 1, 2007 to June 30, 2011. NIS increased the networking capacity of CDCs engaged in the city’s Code Enforcement Partnership by improving communication between partners. NIS also increased programmatic capacity, especially as measured by the percentage of CDC-owned properties sold to new owners who pay taxes on those properties. Staff in one CDC successfully leveraged NIS to improve public participation, a measure of political capacity. The findings also suggest that access to NIS does not fundamentally change CDC priorities. This research helps to fill specific gaps in multiple bodies of knowledge and features an in depth analysis of threats to validity, practical implications for decision-making with NIS, and recommendations for NIS developers and funders. Developers and funders in other cities may wish to consider their role as not just democratizing data—but providing a platform for partnerships by enabling organizations to better share data in order to achieve shared objectives.PHDUrban and Regional PlanningUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111415/1/davideps_1.pd

Succession planning relating to the Millennial generation in private four-year universities

The workplace is in a transition with age demographics (Mann, 2006). The baby boomers, once a large and dominating force in the workplace are now in their initial years of a decade’s move into retirement. And with such a large demographic change, there is a vacuum that is created and then filled. Many industry analysts have deemed this transition as the Great shift change. In the workplace, vacancies are being created en mass at the managerial and executive levels. Due to the recession of 2008-2012, the baby boomers remained in the marketplace for an extended period of time, some say to rebound with their depleted retirements. As the economy made its way back to normalcy, an intersection of market forces hit. This collision of market forces is the emergence of an economy out of recession and an age demographic beginning an advanced pace of retirements that analysts say will last up to 20 years. Due to a high turnover of the baby boomer generation with the Millennial generation in the market, succession planning is key to maintain productivity and smooth the transition in demographics while providing services to increasing student populations. This dissertation will utilize case studies to analyze this market event and see how private higher education institutions located in Los Angeles, California are handling succession planning in an aggressive employment demographic change