Pilot Implementation of Health Information Systems: Issues and Challenges

Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare information system. Based on the findings from this study, we identify three main challenges: (1) defining an appropriate scope for pilot implementation, (2) managing the implementation process, and (3) ensuring commitment to the pilot. Finally, recommendations for future research and implications for practice are provided

When Systems Lose Their Identity

This paper reports a longitudinal study of the design and implementation of a Web-based groupware application. We studied the development of three versions of the application, and the preliminary discussions of the forth. We adopt a sensemaking perspective to analyze the dynamics of this process and show that improvisational action and bricolage (make do with the materials at hand) played a vital role in the development process, successfully within a small group of people, but less so when more, distributed people became involved. The paper introduces the problem of distributed sensemaking in IS development

Augmenting the Human Capital Earnings Equation with Measures of Where People Work

We augment standard log earnings equations for workers in US manufacturing with variables reflecting measured and unmeasured attributes of their employer. Using panel employee-establishment data, we find that establishment-level employment, education of coworkers, capital equipment per worker, and firm-level R&D intensity affects earnings substantially. Unobserved characteristics of employers captured by employer fixed effects also contribute to the variance of log earnings, although less than unobserved characteristics of individuals captured by individual fixed effects. The observed and unobserved measures of employers mediate the effects of individual characteristics on earnings and increase earnings inequality through sorting of workers among establishments

It’s where you work: increases in the dispersion of earnings across establishments and individuals in the United States

This paper analyzes the role of establishments in the upward trend in dispersion of earnings that has become a central topic in economic analysis and policy debate. It decomposes changes in the variance of log earnings among individuals into the part due to changes in earnings among establishments and the part due to changes in earnings within establishments. The main finding is that much of the 1970s–2010s increase in earnings inequality results from increased dispersion of the earnings among the establishments where individuals work. Our results direct attention to the role of establishment-level pay setting and economic adjustments in earnings inequality

It’s where you work: increases in earnings dispersion across establishments and individuals in the US

This paper links data on establishments and individuals to analyze the role of establishments in the increase in inequality that has become a central topic in economic analysis and policy debate. It decomposes changes in the variance of ln earnings among individuals into the part due to changes in earnings among establishments and the part due to changes in earnings within-establishments and finds that much of the 1970s-2010s increase in earnings inequality results from increased dispersion of the earnings among the establishments where individuals work. It also shows that the divergence of establishment earnings occurred within and across industries and was associated with increased variance of revenues per worker. Our results direct attention to the fundamental role of establishment-level pay setting and economic adjustments in earnings inequality

Changing Patterns of Land Access, Inheritance and Emerging Female Village Headpersons in a Patriarchal Society among the Tumbuka in Northern Malawi

The Tumbuka are normally described as patrilineal where inheritance of property including land, cattle and village headmanship is from father to son. There is evidence that initially the Tumbuka were matrilineal. In this society, village heads are normally men, and land and other property are owned and inherited by men. However, there is an emergence of female village headpersons in this patrilineal society. This paper, using data from the Malawi Land Tenure and Social Capital (MLTSC) project, examines the factors that have led to this change and implications for residence at marriage. The study found that female village headpersons are largely single and that they are also chosen because there is no son or eligible male in the lineage to inherit the village headmanship. In terms of land inheritance, although land is largely inherited by sons, there is evidence from the data that in cases where there are no sons land can be inherited by daughters. Daughters also have access to land if they are divorced and they return to their natal villages. While inheritance rules exist, this paper shows that they are not as rigid