158,587 research outputs found

    Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.

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    BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested

    Leveraging Open-standard Interorganizational Information Systems for Process Adaptability and Alignment: An Empirical Analysis

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    PurposeThe purpose of this paper is to understand the value creation mechanisms of open-standard inter-organizational information system (OSIOS), which is a key technology to achieve Industry 4.0. Specifically, this study investigates how the internal assimilation and external diffusion of OSIOS help manufactures facilitate process adaptability and alignment in supply chain network.Design/methodology/approachA survey instrument was designed and administrated to collect data for this research. Using three-stage least squares estimation, the authors empirically tested a number of hypothesized relationships based on a sample of 308 manufacturing firms in China.FindingsThe results of the study show that OSIOS can perform as value creation mechanisms to enable process adaptability and alignment. In addition, the impact of OSIOS internal assimilation is inversely U-shaped where the positive effect on process adaptability will become negative after an extremum point is reached.Originality/valueThis study contributes to the existing literature by providing insights on how OSIOS can improve supply chain integration and thus promote the achievement of industry 4.0. By revealing a U-shaped relationship between OSIOS assimilation and process adaptability, this study fills previous research gap by advancing the understanding on the value creation mechanisms of information systems deployment

    Determinants of innovativeness in SMEs. disentangling core innovation and technology adoption capabilities

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    This paper studies innovativeness in SMEs from a set of innovation indicators at the firm level, capturing various types of innovation (product, process, organisational, and marketing innovations) and the level of innovativeness in these firm’s developments. The article identifies two separate dimensions in the innovativeness of Spanish SMEs, using factor analysis techniques. One dimension is associated with the capabilities for core/internal innovation and the other with the capabilities for the adoption of technology. The paper shows that significant differences exist in the personal and organisational factors that favour these two dimensions. The entrepreneur’s motivation, business planning, and cooperation in R&D activities constitute significant factors when considering the core dimension of a firm’s innovativeness, but have no effect on the firm’s capabilities for technology adoption. However, the use of external consultancy services seems to have no significant effect on the core dimension of the innovativeness of anSME, whereas it is a relevant factor for its technology adoption. Furthermore, it is shown that the entrepreneur’s education plays a more significant role in the core dimension of a firm’s innovativeness than in its capabilities for technology adoption. Depending on the policy objectives, these differences should lead to the application of specific policy approaches when an attempt to stimulate innovation in SMEs is made

    Decision Support Tools for Cloud Migration in the Enterprise

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    This paper describes two tools that aim to support decision making during the migration of IT systems to the cloud. The first is a modeling tool that produces cost estimates of using public IaaS clouds. The tool enables IT architects to model their applications, data and infrastructure requirements in addition to their computational resource usage patterns. The tool can be used to compare the cost of different cloud providers, deployment options and usage scenarios. The second tool is a spreadsheet that outlines the benefits and risks of using IaaS clouds from an enterprise perspective; this tool provides a starting point for risk assessment. Two case studies were used to evaluate the tools. The tools were useful as they informed decision makers about the costs, benefits and risks of using the cloud.Comment: To appear in IEEE CLOUD 201

    Organizational energy: A behavioral analysis of human and organizational factors in manufacturing

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    This paper seeks to explore the behavior and embodied energy involved in the decision-making of information technology/information systems (IT/IS) investments using a case within a small- to medium-sized manufacturing firm. By analyzing decision making within a given case context, this paper describes the nature of the investment through the lens of behavioral economics, causality, input-output (IO) equilibrium, and the general notion of depletion of executive energy function. To explore the interplay between these elements, the authors structure the case context via a morphological field in order to construct a fuzzy cognitive map of decision-making relationships relating to the multidimensional and nonquantifiable problems of IT/IS investment evaluation. Noting the significance of inputs and outputs relating to the investment decision within the case, the authors assess these cognitive interrelationships through the lens of the Leontief IO energy equilibrium model. Subsequently, the authors suggest, through an embodied energy audit, that all such management decisions are susceptible to decision fatigue (so-called 'ego depletion'). The findings of this paper highlight pertinent cognitive and IO paths of the investment decision-making process that will allow others making similar types of investments to learn from and draw parallels from such processes

    EDI and intelligent agents integration to manage food chains

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    Electronic Data Interchange (EDI) is a type of inter-organizational information system, which permits the automatic and structured communication of data between organizations. Although EDI is used for internal communication, its main application is in facilitating closer collaboration between organizational entities, e.g. suppliers, credit institutions, and transportation carriers. This study illustrates how agent technology can be used to solve real food supply chain inefficiencies and optimise the logistics network. For instance, we explain how agribusiness companies can use agent technology in association with EDI to collect data from retailers, group them into meaningful categories, and then perform different functions. As a result, the distribution chain can be managed more efficiently. Intelligent agents also make available timely data to inventory management resulting in reducing stocks and tied capital. Intelligent agents are adoptive to changes so they are valuable in a dynamic environment where new products or partners have entered into the supply chain. This flexibility gives agent technology a relative advantage which, for pioneer companies, can be a competitive advantage. The study concludes with recommendations and directions for further research

    Reflexivity and flexibility: Complementary routes to innovation?

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    Flexibility and reflexivity are essential processes for organisational innovation. The aim of the paper is to investigate their concurrent and interactive contribution in enhancing two innovation outcomes (the organisational openness towards innovation and the actual innovation adoption). Participants were 357 Italian employees. Results of a hierarchical regression model showed the role of both factors in fostering the two innovation outcomes under study. In addition, results showed the complementary interaction of reflexivity and flexibility, outlining two possible routes to innovation. Specifically, reflexivity appears to be a generative learning process capable of encouraging innovation in low-flexibility conditions, whereas flexibility tends to encourage innovation in low-reflexivity conditions. The findings provide empirical support of their roles as complementary resources for innovation, which has been under-examined in the literature

    EXTENDED ENTERPRISE AND INFORMATION SYSTEMS GOVERNANCE IN AN INTER-ORGANIZATIONAL CONTEXT

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    Flexibility, openness, and cooperation are fundamental tendencies that positively mark the ensemble of private and public sector organizations. For a sustainable development in a more and more complex globalized and competitive business environment, the ee-business, extended enterprise, inter-enterprise cooperative information systems, workflow, corporate governance, IS governance
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