Implications of transforming the Patient Record into a Knowledge Management System

In this paper I theorize about how transforming the interpretative scheme for what a patient record is might restructure a health care setting. The observations presented here were obtained when I during three years followed implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed and interpreted within a framework combining theories about knowledge management with concepts from structuration theory and cognitive theories about schema-use, representations and sense-making. The findings indicate that thinking about the patient record as a knowledge management system might start a horizontal and vertical movement, a movement of coordination and enhancement. I propose that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.interpretative schemes; anesthesia patient record; knowledge management system; knowledge management; structuration theory

Knowledge structuring-Knowledge domination. Two interrelated concepts

“Sociology for me is not only about the big institutions, such as governments, organizations, business firms or societies as a whole. It is very much about the individual and our individual experiences. We come to understand ourselves much better through grasping the wider social forces that influence our lives.” ( Anthony Giddens, published at www.polity.co.uk, a leading social science and humanities publisher. ) This quotation helps identify one reason for integrating ideas about knowledge management with concepts from Anthony Giddens structuration theory in the theoretical framework that I use as an analytical tool in this research. Structuration theory concerns itself with the “social forces that influence our lives” and these forces interest me. In the same article Giddens continuous: ”We live in a world of quite dramatic change…There are three major sets of changes happening in contemporary societies and it is the task of sociology to analyze what they mean for our lives today. First there is globalisation….The second big influence is that of technological change. Information technology is altering many of the ways in which we work and in which we live. The nature of the jobs people do, for example, has been transformed….The third fundamental set of changes is in our everyday lives. Our lives are structured less by the past than by our anticipated future”. In this paper I agure that there is a continous structuring going on in society. I therefore concern myself with a pair of twin concepts that are interrelated. The first one is knowledge structuring; the second is knowledge domination. These two concepts are of vital importance when trying to understand, assess and monitor implications of transformations of work processes and tools at work.Knowledge structuring; knowledge domination; knowledge management; structuration theory; cognitive theories; transformations; information technology; globalisation.

Valuing computer science education research?

This paper critically enquires into the value systems which rule the activities of teaching and research. This critique is intended to demonstrate the application of critical enquiry in Computer Science Education Research and therefore uses critical theory as a method of analysis.A framework of Research as a Discourse is applied to explore how the notions of research as opposed to teaching are presented, and how discipline and research communities are sustained. The concept of a discourse, based upon the work of Foucault, enables critical insight into the processes which regulate forms of thought. This paper positions the field of Computer Science Education Research, as an illustrative case, within the broader discourse of Research, and argues that Computer Science Education Researchers and educators need to understand and engage in this discourse and shape it to their own ends

How to manage people who think. A structural approach.

This is a paper about creativity, diversity and other often used buzzwords. It is also a paper about how to manage people who think. Today we live in a world in which computers and mobile phones have become the key artifacts. Nokia´s slogan ”connecting people” expresses in a brilliant way what it is all about. When we connect people information is transfered and new knowledge hopefully created. And innovations, ideas and individuals are central for everything that takes place. We are all supposed to be flexible, exercising our knowledge in a setting characterized by diversity. This setting is also characterized by paradoxes that I will write more about further down. But transformations such as the globalization and implementing of new information technology race crucial questions about how to deal with a changing economic landscape and new mindsets and changing attitudes. The pages that follow is based on extensive reading of the literature and participating in many conferences and work-shops. In addition to this I have interviewed managers and employees at Electrolux, Ericsson, TeliaSonera and The Confederation of Swedish Enterprise. I have asked people in the above mentioned organizations how they react to concepts such as the knowledge society and the practice of managing knowledge, creativity, diversity and flexibility. This paper is written with a Scandinavian perspective. It is also written with a social constructionist perspective. The theoretical framework includes theories about knowledge management, structuration theory and cognitive theories. The findings are based on interpretative research and I have systematically reflected over the material I have collected. I direct myself towards people in business who think and worry about the future. The purpose is to inspire to further discussions about these very important matters.Knowledge management; structuration theory; knowledge society; globalization; creativity; diversity; flexibility.

An integrative semiotic methodology for IS research

Semiotics studies the production, transmission and interpretation of meaning represented symbolically in signs and messages, primarily but not exclusively in language. For information systems (IS) the domain of semiosis consists of human and non-human interactions based on technologically-mediated communication in the social, material and personal worlds. The paper argues that semiosis has immense bearing on processes of communication central to the advanced information and communications technologies studied by IS scholars. Its use separately, or in mixed methods approaches, enriches areas of central concern to the IS field, and is particularly apt when researching internet-based development and applications, for example virtual worlds and social media. This paper presents a four step structured methodology, informed by a central theoretical semiotic framework to provide practical guidelines for operationalizing semiotics in IS research. Thus, using illustrative examples, the paper provides a step-by-step semiotics approach to research based on distinctive semiotic concepts and their relationships – producer, consumer, medium, code, message and content – and how, at an integrating level, the personal, social and material worlds relate through sociation, embodiment and socio-materiality

Environmental protection through e-regulation: critical and empirical perspectives using a rule of law analysis

Sometimes the most commonplace and uninteresting tools demand close attention because their mundane nature means that their role is misunderstood. The use of computer technology by government – specifically, by environmental regulators – is one such instance. Information and communications technology (ICT) is increasingly deployed in bureaucratic and regulatory processes throughout the developed world; as in commerce and industry, software code and databases are becoming the invisible ‘glue’ that interconnects the various actors in the regulatory system and weaves an invisible web of control between decision-makers, regulated entities and ordinary citizens. Nonetheless, this topic has received only disconnected academic attention, perhaps because there is little that seems intrinsically interesting about a database. The issues which ICT raises are not always obvious but nonetheless significant if we are to make the best use of these new tools without unwittingly sacrificing important principles. There is now a substantial body of literature on regulation and ICT. However, this focuses on either ‘information’ or ‘communications’, rarely on both together or on the use of ICT for regulation rather than something to be regulated. There are few theoretical or practical perspectives on the role of ICT in environmental regulation. This thesis applies both in combination, developing a values-based, analytical and empirically grounded framework in order to contextualise the use of ICT as a regulatory tool. The ever-increasing deployment of ICT in homes and offices, the built environment and the world at large creates significant opportunities for achieving better environmental outcomes but this new and poorly-understood development also raises questions about the proper operation of the rule of law by an increasingly computerised state. This research explores how the widespread implementation of ICT is altering power relationships in the system of environmental regulation. It asks to what extent this new capability of large-scale information capture leads to more or less control on the part of regulators, whether existing balances and imbalances of power are altered by these new tools (even when they are seen as neutral) and what happens when the ‘glue’ hardens and installed technology makes policy change difficult. The thesis critically reviews the operation of the rule of law in digitised government, the development of ICT in environmental regulation, the role of scientific information in environmental regulation and the use of disclosure as a regulatory tool. It combines theoretical perspectives from sociology, chiefly actor-network theory, with insights from semi-structured interviews with staff in regulatory agencies, non-governmental agencies and regulated entities, to build a thematic network model of how the use of ICT for information-gathering, as a means of control and as a conduit for communications is perceived by practitioners of environmental regulation. It uses this to sketch the contours of a new field of study, ‘e-regulation’, centred around the core values of the rule of law. It places this discussion in the context of a dynamic, networked and globalised social and economic environment. It concludes by discussing how to protect the rule of law in e-government, highlighting current best practice

ICT Development and Organizational Change in the Thai Public Sector.

Information and communication technology (ICT) has long been central to modernization in the public sector. Socio-political factors within which the technology is developed and used play an important role in informing the design of the technology, and determine how it is used in public sector organizations. Thai bureaucracy has been constrained by long-established bureaucratic culture, strict social status, and hierarchical control, which give rise to distinctive public administration styles, organizational arrangements, and work practices. This dissertation examines how these socio-political characteristics result in distinctive patterns of ICT development and adoption in the Thai public sector. By analyzing ethnographic fieldnotes, interview transcripts, and government artifacts collected from a 12-month period of fieldwork, this dissertation explores three key aspects of ICT development efforts in the Thai public sector: (1) relations between ICT and managerial control in the public sector; (2) processes of standardization in government information infrastructure development; and (3) the importance and complexities of boundary work in digital government development efforts. Beyond its effects on public administration and service provision processes, the development of computerized technology is associated with a series of organizational changes that often produce challenges and tensions attending ICT development efforts. The dissertation offers lessons for digital government scholarship and the wider field of information science by specifically exploring changes in power structures, work practices, and the roles and relationships of government officials within and across agencies resulting from the implementation and use of new technologies. Following selected findings extend the understanding of technology development and organizational change in the public sector. First, information systems are used to reinforce existing hierarchical control power and authority, leading to tensions and resistance to the systems and control. Second, infrastructure development and standardization are a politically loaded process provoking conflict among agencies competing for power and autonomy over information resources. Third, the effects of technology adoption on work practices and relationships among officials are concentrated among lower- to middle-ranking officials, with relatively little impact on the practices of higher-ranking officials. Fourth, computerization does not necessarily increase the speed and efficiency of public administration as paper-based practices are still dominantly in effect.PHDInformationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/97970/1/radaphat_1.pd

Interaction between information systems and organizational change: Case study of Petroleos Mexicanos.

This research investigates the impact of local conditions on the use of information technology in a public organization, and how the use of that technology affects the organization. It focuses on a case study of the state-owned oil corporation of Mexico, Petroleos Mexicanos (Pemex). Since its foundation in 1940 as an integrated national oil company, Pemex has been in a continuing process of modernization. In recent years, this process has involved substantial use of information technology and organizational restructuring, based on models imported from industrialized countries. This has been done without always explicitly considering local conditions, although information systems research has widely emphasized the need to consider the social aspects when implementing information technology. Such research has argued the need to explore how the local conditions shape information systems, as they are constructed and enacted by actors when making sense of their use of systems in their daily work environment. The research uses institutional theory and a contextualist framework to examine both how local social values and historical conditions shape the use of information technology and what impact its use has on the social environment and the organization changes that take place. Although the research highlights the local context, it deals more broadly with processes that are occurring in many organizations in various developing countries because of the global transformations linked to the widely pervasive diffusion of information technology. It therefore also provides an understanding of the generic process of information technology utilization in developing countries, with the aim of guiding practice

The impact of corporate versus professional control mechanisms on the adoption of health informatics in Australia

This study is grounded in a desire to describe and understand the positioning of eHealth within the health policy process. Policies and politics are intertwined (Corbitt, 1995). The current literature on health policy analysis suggested the problem of how to conceptualize power and relate power to notions like discourse and how to integrate these ideas of power into a conceptual framework for policy analysis. The current literature on power and politics in Information Systems (IS) deployments have drawn on limited conceptual resources to understand IS as artifacts, and power as a definable (and often manageable) entity, in ascribing IS a political role. This thesis questions the power relations that constitute the health policy process and those that are constituted by the health policy process. The research interprets health policy initiatives within the broader political and ideological context in which it is occurring. This study focuses on the discursive nature of health policy, and how various practices and techniques are implicated in governing the interpretation of policy intentions and behaviors to act in relation to policy. Of particular interest in this study are the discursive spaces for action within which acts of power and resistance can unfold. This study aims to illustrate that the critical interpretive perspective (Doolin and McLeod 2005) applied to an understanding of health policy as a process constituent of power relations, a process involved in governance and advocacy tied to polity, knowledge and intervention can contribute to an understanding of the mobilization of authority and the impact this has on interpretation of policy intentions. This thesis argues that policy contexts create new discursive spaces for action, spaces which provide opportunities to maneuver allowing for framing of issues or resisting practice change. It suggests that the political landscape of action is made apparent within these spaces, and further that information systems become the medium through which the legitimacy of professional and corporate control mechanisms are contested. This thesis argues that renegotiated health information systems illuminate the reform ideas which have diffused into practice and those that have been delayed at a point in time