Differentiating innovation priorities among stakeholder in hospital care

Background Decisions to adopt a particular innovation may vary between stakeholders because individual stakeholders may disagree on the costs and benefits involved. This may translate to disagreement between stakeholders on priorities in the implementation process, possibly explaining the slow diffusion of innovations in health care. In this study, we explore the differences in stakeholder preferences for innovations, and quantify the difference in stakeholder priorities regarding costs and benefits. Methods The decision support technique called the analytic hierarchy process was used to quantify the preferences of stakeholders for nine information technology (IT) innovations in hospital care. The selection of the innovations was based on a literature review and expert judgments. Decision criteria related to the costs and benefits of the innovations were defined. These criteria were improvement in efficiency, health gains, satisfaction with care process, and investments required. Stakeholders judged the importance of the decision criteria and subsequently prioritized the selected IT innovations according to their expectations of how well the innovations would perform for these decision criteria. Results The stakeholder groups (patients, nurses, physicians, managers, health care insurers, and policy makers) had different preference structures for the innovations selected. For instance, self-tests were one of the innovations most preferred by health care insurers and managers, owing to their expected positive impacts on efficiency and health gains. However, physicians, nurses and patients strongly doubted the health gains of self-tests, and accordingly ranked self-tests as the least-preferred innovation. Conclusions The various stakeholder groups had different expectations of the value of the nine IT innovations. The differences are likely due to perceived stakeholder benefits of each innovation, and less to the costs to individual stakeholder groups. This study provides a first exploratory quantitative insight into stakeholder positions concerning innovation in health care, and presents a novel way to study differences in stakeholder preferences. The results may be taken into account by decision makers involved in the implementation of innovation

Understanding managerial behaviour during initial steps of a clinical information system adoption

Abstract Background While the study of the information technology (IT) implementation process and its outcomes has received considerable attention, the examination of pre-adoption and pre-implementation stages of configurable IT uptake appear largely under-investigated. This paper explores managerial behaviour during the periods prior the effective implementation of a clinical information system (CIS) by two Canadian university multi-hospital centers. Methods Adopting a structurationist theoretical stance and a case study research design, the processes by which CIS managers' patterns of discourse contribute to the configuration of the new technology in their respective organizational contexts were longitudinally examined over 33 months. Results Although managers seemed to be aware of the risks and organizational impact of the adoption of a new clinical information system, their decisions and actions over the periods examined appeared rather to be driven by financial constraints and power struggles between different groups involved in the process. Furthermore, they largely emphasized technological aspects of the implementation, with organizational dimensions being put aside. In view of these results, the notion of 'rhetorical ambivalence' is proposed. Results are further discussed in relation to the significance of initial decisions and actions for the subsequent implementation phases of the technology being configured. Conclusions Theoretical and empirically grounded, the paper contributes to the underdeveloped body of literature on information system pre-implementation processes by revealing the crucial role played by managers during the initial phases of a CIS adoption.</p

Proceedings of the International Conference on Business and Management Dynamics 2016

Cape Town, South Africa, 7 Sept. 2016 – 8 Sept. 2016. Theme: Sustainable economies in the information economy. Purpose: To share the quality academic papers presented at the International Conference on Business and Management Dynamics (ICBMD) held from 7 to 8 September 2016 at African Pride Crystal Hotel and Spa in Cape Town. As grey literature, the proceedings are the contributions made by researchers at the conference and are considered the written record of the work that was presented to fellow conference delegates. Methodology: The methodology used varies from researcher to researcher but are suitable for the studies conducted. Thus, on the one hand, studies that were subjective in nature used the interpretive paradigm, where the qualitative approach adopted made used of the interview method to collect data. On the other hand, studies that were objectively inclined adopted the positivist philosophy and used survey questionnaires to collect data. However, there were some academic papers which used mixed methodology because of the nature of the study. Whatever methodology used adhered to the ethos of the philosophies underpinning the methodology. Contribution made to scholarship: The articles come from individual researchers and each article in the proceedings is unique. Mostly, there is no general argument leading from one contribution to the next. However, it is interesting to note that in the area of economic performance it was evident that real exchange rate and net foreign direct investment contribute more towards innovations in economic growth. With regard to human capital development, papers presented evidence that there exists a definite need to explore the phenomenon of personal branding as limited scientific academic research has been done within the field of personal branding or on elements of the topic. Thus, the outcome argues that personal branding has an influence on leadership style which in turn impacts on organisational performance and related hygiene factors. Furthermore, it was demonstrated that current methods or strategies for enforcing institutionalisation of knowledge sharing within an organisation have not been successful, and, as such, new strategies are needed to reinforce efforts to nurture and invigorate the institutionalisation of knowledge sharing within an organisation. With regard to technology and big data impact on organisational performance, it was evident that system performance, memory consumption and CPU utilisation can be used as criteria to compare and evaluate big data technologies to improve organisational performance. Most of the articles’ contribution reemphasised technology education and training as a means of digitising business and improving effectiveness. Target audience: The target readership is academic researchers and business leaders who require access to the latest developments in the fields of economics, information management, business, education, development studies, social sciences and technology. It is also for policymakers and other stakeholders who need a better understanding of the impact of new developments on existing policies and regulations for their review or amendment