Intranet Use for Management Accounting Systems in Hong Kong Public Hospitals: An Analysis Using Partial Least Square Approach

This study examines the relationships of organization support, user characteristics, task characteristics, and intranet characteristics for using intranet applications to support Management Accounting in Hong Kong public hospitals. The research attempted to identify how the interactions of these antecedents helped to achieve Intranet User Information Satisfaction (IUIS) and thus efficiency of Management Accounting in hospitals in terms of Information Quality of Management Accounting Systems (MASIQ). A mixed research approach integrating case study and survey research under a quantitative paradigm was adopted. Partial Least Squares analysis was used to examine the data. The case study results reflected that use of intranet applications could support Management Accounting in hospitals. The survey results of 157 managers and executives in Hong Kong public hospitals showed that IUIS had a direct significant impact on MASIQ. Meanwhile, user characteristics as IS Experience improved IUIS, and the extent of task characteristics also improved the performance of MASIQ. The results have several implications for Accounting Information Systems management

Non-Implementation of an IS Strategy Within A UK Hospital: Observations From a Longitudinal Case Analysis

This paper presents an in-depth longitudinal case analysis of the non-implementation of an information technology (IT) strategy within a UK hospital. The analysis covered the period from 1991 to the present day. The contents of the IT strategy are described and compared to the proposed systems and schedule is contrasted with the actual IT systems delivered. Because the case deals with the national health arrangements within the UK, we begin with a brief description of information management (IM) within the National Health Service (NHS) to provide background for readers outside the UK. This discussion is extended to consider the specific context of IS development. It notes the experience of a single patient being transported through medical procedures to illustrate the relevant systems which are enabled. The case documents the ambitions and achievements of the managers involved and concludes with the observation that their decisions did actually generate added-value to the IS implementation process even though, in the circumstances, no recognized strategy emerged

An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient's lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) a flexible telemedicine framework for the continuous upkeep o f patients' lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage o f patients' demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health JCT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/ final framework. The proposed framework may assist in achieving continual access to a patient's lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient's health history whenever required, even during the computer system's downtime and the unavailability of the landline telecommunication network

A safer place for patients: learning to improve patient safety

1 Every day over one million people are treated successfully by National Health Service (NHS) acute, ambulance and mental health trusts. However, healthcare relies on a range of complex interactions of people, skills, technologies and drugs, and sometimes things do go wrong. For most countries, patient safety is now the key issue in healthcare quality and risk management. The Department of Health (the Department) estimates that one in ten patients admitted to NHS hospitals will be unintentionally harmed, a rate similar to other developed countries. Around 50 per cent of these patient safety incidentsa could have been avoided, if only lessons from previous incidents had been learned. 2 There are numerous stakeholders with a role in keeping patients safe in the NHS, many of whom require trusts to report details of patient safety incidents and near misses to them (Figure 2). However, a number of previous National Audit Office reports have highlighted concerns that the NHS has limited information on the extent and impact of clinical and non-clinical incidents and trusts need to learn from these incidents and share good practice across the NHS more effectively (Appendix 1). 3 In 2000, the Chief Medical Officer’s report An organisation with a memory 1 , identified that the key barriers to reducing the number of patient safety incidents were an organisational culture that inhibited reporting and the lack of a cohesive national system for identifying and sharing lessons learnt. 4 In response, the Department published Building a safer NHS for patients3 detailing plans and a timetable for promoting patient safety. The goal was to encourage improvements in reporting and learning through the development of a new mandatory national reporting scheme for patient safety incidents and near misses. Central to the plan was establishing the National Patient Safety Agency to improve patient safety by reducing the risk of harm through error. The National Patient Safety Agency was expected to: collect and analyse information; assimilate other safety-related information from a variety of existing reporting systems; learn lessons and produce solutions. 5 We therefore examined whether the NHS has been successful in improving the patient safety culture, encouraging reporting and learning from patient safety incidents. Key parts of our approach were a census of 267 NHS acute, ambulance and mental health trusts in Autumn 2004, followed by a re-survey in August 2005 and an omnibus survey of patients (Appendix 2). We also reviewed practices in other industries (Appendix 3) and international healthcare systems (Appendix 4), and the National Patient Safety Agency’s progress in developing its National Reporting and Learning System (Appendix 5) and other related activities (Appendix 6). 6 An organisation with a memory1 was an important milestone in the NHS’s patient safety agenda and marked the drive to improve reporting and learning. At the local level the vast majority of trusts have developed a predominantly open and fair reporting culture but with pockets of blame and scope to improve their strategies for sharing good practice. Indeed in our re-survey we found that local performance had continued to improve with more trusts reporting having an open and fair reporting culture, more trusts with open reporting systems and improvements in perceptions of the levels of under-reporting. At the national level, progress on developing the national reporting system for learning has been slower than set out in the Department’s strategy of 2001 3 and there is a need to improve evaluation and sharing of lessons and solutions by all organisations with a stake in patient safety. There is also no clear system for monitoring that lessons are learned at the local level. Specifically: a The safety culture within trusts is improving, driven largely by the Department’s clinical governance initiative 4 and the development of more effective risk management systems in response to incentives under initiatives such as the NHS Litigation Authority’s Clinical Negligence Scheme for Trusts (Appendix 7). However, trusts are still predominantly reactive in their response to patient safety issues and parts of some organisations still operate a blame culture. b All trusts have established effective reporting systems at the local level, although under-reporting remains a problem within some groups of staff, types of incidents and near misses. The National Patient Safety Agency did not develop and roll out the National Reporting and Learning System by December 2002 as originally envisaged. All trusts were linked to the system by 31 December 2004. By August 2005, at least 35 trusts still had not submitted any data to the National Reporting and Learning System. c Most trusts pointed to specific improvements derived from lessons learnt from their local incident reporting systems, but these are still not widely promulgated, either within or between trusts. The National Patient Safety Agency has provided only limited feedback to trusts of evidence-based solutions or actions derived from the national reporting system. It published its first feedback report from the Patient Safety Observatory in July 2005

Models of Information Systems devoted to Medical Imaging Labs: an experience in the CNR Clinical Physiology Institute

abstract for the paper presentation about the decennal experience at IFC on information systems developped for medical imaging labsabstract per la presentazione relativa alla decennale esperienza presso IFC sui sistemi informativi sviluppati per uso dei laboratori dedicati all\u27imaging clinico e di ricerca medic

Collaborative technologies for mobile workers and virtual project teams

Information Technology is advancing at a frightening pace. Cloud computing and its subset, Software as a Service (SaaS), are rapidly challenging traditional thinking for enterprise-level application and infrastructure provision. The project-centric nature of the construction industry provides an environment where the utilisation of SaaS is commercially appropriate, given its ability to provide rapid set-up and predictable costs at the outset. Using project extranets, the construction industry has been - unusually for it as an industry sector - early-adopters of this cloud computing model. However, findings from the research highlight that there is a gap in the information and documents that pass from the construction phase into the operational phase of a building. This research considers examples of the SaaS IT model and how it has been used within a construction and facilities management industry context. A prototype system was developed to address the requirements of facilities management work order logging and tracking process. These requirements were gathered during detailed case studies of organisations within both the construction and facilities management sectors with a view to continue the use of building-specific information through its full life-cycle. The thesis includes a summary of the lessons learnt through system implementation within the construction-contracting organisation Taylor Woodrow, and it concludes with an IT strategy proposal that was developed based on a cloud computing model

Governance systems for organisations: governance information control system design and development methodology for NGO boards: executive summary

This submission reviews and examines the responsibility and role of non-executive directors in reinforcing the self-governance systems for non-government organisations (NGO). Corporate governance is an issue of great concern at Government and commercial levels and a prime topic in the media due to scandals at Enron, WorldCom, the British Museum, Tyco, and at a host of smaller organisations. This research explored the contributory systems and processes towards enterprise governance and provided new insight into how the boards of directors of NGOs can develop and be in a position to amend the parameters for their own information systems for self-governance. Unless these NGOs can govern themselves properly, their boards may eventually lose their mandate. The governance of NGOs is difficult because of the voluntary and part-time nature of directorship, a lack of information support system, and a comparatively lower level of transparency. Schools, hospitals, productivity councils, universities, social welfare institutions would be representatives of such NGOs. The research has used Hong Kong as the test base at a time when NGOs are given more authority and ownership for self-governance. A series of action-based case studies undertaken are summarised and 'used to identify the control components and processes leading to higher levels of self governance. These together with an extensive literature survey on corporate governance and on the development of governance information systems (GOVIS) were used to develop a new' process methodology for designing and developing governance information system for NGOs. Known as GISDER, the methodology links Rochart's Critical Success Factors (Rochart, 1979), cybernetics (Capra, 1997), systems thinking (Beer, 1985; Jackson, 2000), and adult learning (Ackof, 1999) concepts with control components unique to the organisation under review. The relevant control components for a particular NGO are identified from fifteen base components. Elements of the process methodology have been further tested in some NGOs. A thorough evaluation discussion and thoughts on the applicability of the derived methodology for other types of organisations have been provided. It is concluded that self-governance for NGO boards cannot be assumed and that the components for a GO VIS for self-governance can best be developed and evaluated through the GISDER methodology. The methodology is now at the core of a consultancy offering for NGOs in the Greater China region

Innovative business plan: a crowdsourcing medical data annotation platform company

In this business plan, a new crowdsourcing medical data annotation platform company is proposed. It is to help companies and research institutions which are developing medical artificial intelligence outsource medical data annotation work to professional workers. Crowdsourcing platform, as one of the intermediary platform, is a new Internet business model to provide service for large-scale enterprises. There is great demand for crowdsourcing service in medical AI field in China. However, there is no company in China could offer professional medical data annotation services. Since the development of medical artificial intelligence in China, most of the companies engaged in research and development of medical artificial intelligence can only rely on recruitment or give up research and development. The cost of the workforce and material resources is very high. The proposed company's services can better address these issues. On the one hand, the proposed company can provide more cost-effective and accurate annotation data quickly through outsourcing. On the other hand, the proposed company can provide medical professionals with part-time opportunities to increase their income and reduce unemployment. Through the analysis in the paper, we can predict that the proposed company can stabilise the profit by collecting commissions and advertising. It will enable medical AI companies, the proposed companies and medical professionals to achieve a win-win situation. Therefore, it is attractive for Chinese start-ups to develop and fill this niche market.Neste plano de negócios, uma nova empresa de plataforma de anotação de dados médicos de crowdsourcing é proposta. É para ajudar empresas e instituições de pesquisa que estão desenvolvendo inteligência artificial médica a terceirizar facilmente o trabalho de anotação de dados médicos para trabalhadores profissionais. A plataforma de crowdsourcing, como uma das plataformas intermediárias, é um novo modelo de negócios na Internet para fornecer serviços para empresas de grande escala. Existe uma grande demanda por serviços de crowdsourcing no campo da IA médica na China. No entanto, nenhuma empresa na China poderia oferecer serviços profissionais de anotação de dados médicos. Desde o desenvolvimento da inteligência artificial médica na China, a maioria das empresas envolvidas em pesquisa e desenvolvimento de inteligência artificial médica só pode contar com seu próprio recrutamento ou desistir de pesquisa e desenvolvimento. O custo de mão de obra e recursos materiais é muito alto. Os serviços da empresa proposta podem resolver melhor esses problemas. Por um lado, a empresa proposta pode fornecer dados de anotação mais econômicos e precisos rapidamente através da terceirização. Por outro lado, a empresa proposta pode oferecer aos profissionais médicos oportunidades de meio período para aumentar sua renda e reduzir o desemprego. Através da análise do artigo, podemos prever que a empresa proposta pode estabilizar o lucro coletando comissões e publicidade. Isso permitirá que as empresas de IA médica, as empresas propostas e os profissionais médicos alcancem uma situação em que todos saem ganhando. Portanto, é atraente para as empresas chinesas desenvolver e preencher esse nicho de mercado

Plague - pandemic - panic: information needs and communication strategies for infectious diseases emergencies : lessons learned from anthrax, SARS, pneumonic plague and influenza pandemic

Summary: Information and communication is critical to the successful management of infectious diseases because an effective communication strategy prevents the surge of anxious patients who have not been genuinely exposed to the pathogen ('low risk patients') affecting medical infrastructures (1) and the future transmission of the infectious agent (2). Surge of low risk patients: The arrival of large numbers of low risk patients at hospitals following an infectious diseases emergency would be problematic for three main reasons. First, it would complicate the situation at hospitals receiving exposed patients, delaying the treatment of the acutely ill, creating difficulties of crowd control and tying up medical resources. Second, for the low risk patients themselves, attending hospital following an infectious disease emergency might increase their risk of exposure to the agent in question. Third, the needs of low risk patients may be poorly attended to at hospitals which are already overstretched dealing with medical casualties. Future transmission: Obtaining early information about symptoms and isolating infected patients is the most effective strategy to interrupt the chain of infection in the public in the absence of specific prophylaxis or treatment. Particularly at the beginning of an outbreak, these nonpharmaceutical interventions play an important role in enabling the early detection of signs or symptoms and in encouraging passengers to adopt appropriate preventive behaviour in order to limit the spread of the disease. This thesis includes two papers dealing with this problem: The first part is a systemic literature review of information needs following an infectious disease emergency (Anthrax, SARS, Pneumonic Plague). The key question was: what are the information needs of the public during an infectious disease emergency? The second part is an empirical investigation of information needs and communication strategies at the airport during the early stage of the Influenza Pandemic. The key question here was: what communication strategies help to meet the information needs and to enable the public to behave appropriately and responsibly? Conclusions: Evidence from the anthrax attacks in the United States suggested that a surge of low risk patients is by no means inevitable. Data from the SARS outbreak illustrated that if hospitals are seen as sources of contagion, many patients with non-bioterrorism related health care needs may delay seeking help. Finally, the events surrounding the Pneumonic Plague outbreak of 1994 in Surat, India, highlighted the need for the public to be kept adequately informed about an incident to avoid creating rumours. Clear, consistent and credible information is key to the successful management of infectious disease outbreaks. The results of the empirical investigation suggested that the desire for information is a reflection of current anxiety and does not mirror the objective scientific assessment of exposure. The airport study showed that perceived information needs were directly related to anxiety – the least anxious did not require any further information, the most anxious reported significant information needs concerning medical treatment, public health management and the assessment of the ongoing situation – irrespective of their actual exposure. A communication strategy only focussing on the 'real' exposed individuals neglects the information needs of those worrying about having contracted the virus and seeking medical attendance. Effective communication strategies should enable the general public to detect early signs or symptoms and provide them with behaviour advice to prevent the further transmission of the infectious agent. These include the provision of clear information about the incident, the symptoms and what to do to prevent the further transmission, detailed and regularly updated information in various media formats (telephone, internet, etc.) and rapid triage at hospital entrances to guide patients to the appropriate medical infrastructures. Relevance: These research findings could contribute to a shift in the organisational and communicative approach responding to infectious diseases outbreaks and could be considered relevant for future risk communication and policy decision making.Information und Kommunikation sind die zentralen Momente im Management von Infektionskrankheiten, weil eine effektive Kommunikationsstrategie zum einen den Ansturm auf die medizinischen Infrastrukturen kanalisiert (1) und zum anderen durch die Informationen zum angemessenen Verhalten die weitere Übertragung des Krankheitserregers vermeidet (2). Ansturm auf medizinische Infrastrukturen: Ein großer Ansturm von nicht direkt exponierten Patienten (sogenannte „Low Risk Patients“) auf medizinische Infrastrukturen während Infektionsausbrüchen ist aus drei Gründen problematisch: Erstens verschärft dieser Ansturm die ohnehin schon schwierige Lage in den Krankenhäusern und führt dazu, dass Schwerkranke aus Kapazitätsgründen nicht angemessen versorgt werden können. Zweitens erhöht der Aufenthalt in der Notaufnahme eines Krankenhauses während eines Infektionsgeschehens die Infektionsgefährdung. Drittens ist durch die Kapazitätsausschöpfung nicht gewährleistet, dass „Low Risk Patients“ entsprechend ihrer medizinischen Indikation adäquat versorgt werden. Weitere Übertragung des Krankheitserregers: Die frühzeitige Information über Symptome, Übertragungswege und angemessenes Verhalten führt dazu, dass symptomatische Patienten isoliert und die weitere Verbreitung des Krankheitserregers durch ein adäquates Infektionsschutzverhalten gestoppt wird. Diese nichtpharmazeutischen Maßnahmen sind insbesondere in der Frühphase von Infektionsausbrüchen, in denen noch keine Impfungen oder Therapien zur Verfügung stehen, von hoher Relevanz und helfen sowohl die symptomatischen Patienten zu identifizieren als auch die Bevölkerung mit einem angemessenen Verhalten zu schützen. In dieser Dissertation werden zwei Arbeiten zusammengefasst, die dieser Problematik nachgehen: den ersten Teil bildet eine systematische Literaturübersicht über die publizierten Daten zu den Informationsbedürfnissen und zum adäquaten Verhalten während Infektionsausbrüchen am Beispiel von Anthrax, SARS und der Lungenpest. Leitfrage dieser Studie ist: Was sind die Informationsbedürfnisse der Öffentlichkeit während eines Infektionsgeschehens? Den zweiten Teil bildet eine empirische Erhebung am Flughafen zu den Informationsbedürfnissen und Kommunikationsstrategien zu Beginn der Influenza Pandemie. Leitend bei dieser Studie ist die Frage, welche Kommunikationsstrategien den Informationsbedürfnissen adäquat sind und gleichzeitig die Öffentlichkeit in die Lage versetzt, sich angemessen zu verhalten? Ergebnisse: Die Anthrax Anschläge in den USA haben gezeigt, dass es nicht unbedingt zu einem Massenansturm von „Low Risk Patients“ kommen muss, wenn die Informationen über Diagnostik und therapeutische Maßnahmen adäquat kommuniziert werden. Aus den Erfahrungen von SARS konnte man sehen, dass auch die umgekehrte Situation Probleme schafft: wenn Patienten, die medizinische Behandlung benötigen, nicht die medizinischen Infrastrukturen aufsuchen, weil diese selbst zum Ort der Ansteckung geworden sind, kann das dramatische medizinische Folgen haben. Der Ausbruch der Lungenpest in Indien, verknüpft in ein Netz von Gerüchten, hat deutlich gemacht, wie wichtig die umfassend und aktuell korrekt informierte Öffentlichkeit ist. Die Ergebnisse aus der empirischen Arbeit am Flughaben belegen, dass das Informationsbedürfnis nicht an die wissenschaftlich-medizinische Einschätzung der Exposition und des objektiven Ansteckungsrisikos geknüpft ist, sondern vielmehr die eigene Wahrnehmung und das Gefühl einer möglichen Ansteckung reflektiert. Diejenigen, die am meisten Angst vor Ansteckung hatten, artikulierten auch den größten Informationsbedarf, während diejenigen, die sich ausreichend informiert fühlten, auch nur eine geringe Besorgnis zum Ausdruck brachten. Diese Relation wurde unabhängig der objektiven Exposition beobachtet. Eine Kommunikationsstrategie, die nur die objektiv Exponierten adressiert, zielt also an denjenigen vorbei, die – exponiert oder nicht – besorgt sind und aufgrund dieser Sorge zu einem Problem der medizinischen Infrastrukturen werden können. Eine effektive Kommunikation sollte die Öffentlichkeit in die Lage versetzen, die entsprechenden Symptome frühzeitig zu erkennen und sich sowohl bei Erkrankung, als auch bei der Unterbrechung der Infektionskette adäquat zu verhalten. Dazu braucht es klare, aktuelle und glaubwürdige Informationen über das Ausbruchsgeschehen, die Symptome und das Schutzverhalten, kontinuierliche Kommunikation über verschiedene mediale Formate (Telefon, Internet, etc.), schnelle Triage in den Krankenhäusern und eine kompetente Führung, um festlegen zu können, welcher Patient in den spezifischen medizinischen Infrastrukturen am besten aufgehoben ist. Relevanz: Die Ergebnisse dieser Arbeit können dazu betragen, dass eine verbesserte Risiko- und Krisenkommunikation das Management von Infektionskrankheiten der politischen Entscheidungsträger erleichtert