IT in Healthcare: an Integrative Study of Organizational Change

Research on Healthcare IT is a highly multidisciplinary field. Each stream of research brings a certain focus and contributionsto our understanding of the role of technology in healthcare. However, this high multidisciplinary can be confusing as theresults and implications of the different streams may look incommensurable. This paper looks at various streams of researchon health IT and presents an integrative framework that utilizes organizational change to understand how different researchstreams on health IT interrelate and contradict in terms of their focus, contributions and implications. We argue that such anintegrative understanding is the key to capture the complexity of health IT projects and ensure their success

Legitimate Peripheral Participation and Value Creation in Online Knowledge Sharing Communities

Online knowledge sharing communities require contributions and active participation to thrive, yet all participation is not equal. Community members well-socialized in the community are more likely to make stronger contributions. In this paper, we theorize about how legitimate peripheral participation of new online knowledge sharing community members can drive different types of contributions and potentially generate value for the community. We conduct an agent-based simulation analysis of different configurations of legitimate peripheral participation to explore our theoretical arguments. We find, in general, that increased requirements for legitimate peripheral participation of new members drive quality contributions and generates value for the community. However, we also find that there is an inflection point where too many such demands may stifle contributions and impede value creation in these communities

THE ROLE OF WORKAROUNDS DURING AN OPENSOURCE ELECTRONIC MEDICAL RECORD SYSTEM IMPLEMENTATION

A significant degree of customization of medical information technology is required to effectively integrate the promise of IT with the diversity and complexity of medical work. In the absence of such customizations, dissatisfaction and resistance toward the system arise. Indeed, the complexity of the medical work and the inability of software to tailor to the diverse medical practices may explain the limited diffusion of health information systems especially in North America. We study the role of workarounds during an open-source Electronic Medical Record System (EMR) implementation at a medium-size urgent care clinic in a major Canadian city. We found that the technology appropriation process involved the evolving of number of non-trivial workarounds in order to match the EMR to medical work. The emergence of workarounds is conceptualized as a knowledge creation and integration process. This perspective allows us to look at the antecedents and the change dynamics of workarounds in the clinic. Furthermore diverging from the negative view toward workarounds, we discuss the importance of incorporating workarounds during and following system development. The workaround perspective shed the light on how users’ behavior can be channeled into a constructive development effort. This paper contributes by examining the workaround of medical practitioners using an open-source electronic medical record system as well as offering a knowledge perspective for the study of EMR appropriation

Organizations and Communities: A Symbiosis View

How can organizations and communities engage in mutually beneficial relationships? We develop a framework that explains how an open community’s engagement with an organization can be mutually beneficial to both in the long-term. We theorize how a symbiotic relationship between organizations and communities can be achieved by nurturing various forms of capital flow between organizations and communities as well as creating virtuous feedback loops within each other’s capital creation systems

Stakeholders’ Use of Microblogging to Engage in Emotion Strategies During a Crisis

The rise of microblogging has drastically transformed the ways in which people become aware of, talk about, experience, and respond to crises. Microblogging allows for multiple stakeholders to express and manage emotions that a crisis may trigger. This research examines how multiple stakeholders engage in emotion strategies through microblogging over the course of a crisis. Relying upon and extending emerging literatures on crisis management and the psycho-sociology of emotions, we propose the concept of emotion strategies to explore and elaborate upon the different uses of emotions and their crucial importance in a crisis context. We examine how microblogging features and affordances might enable and shape the emotion strategies of various stakeholders involved in a crisis. We outline the details of an ongoing investigation in the context of the 2010 Gulf of Mexico oil spill and provide illustrative insights. We conclude by highlighting future steps in this research and expected contributions

a cross-sectional study

Funding Information: The data supporting the findings of this study are available upon request from the Gaza NCD study dataset, in accordance with data sharing policies established by the UK\u2019s Department for International Development (DFID), the Medical Research Council (MRC), the Economic and Social Research Council (ESRC), and Welcome Trust\u2019s Health Systems Research Initiative (HSRI) (Grant Number: MR/S012877/1). Funding Information: We would like to thank the tremendous efforts of the data collectors and field supervisors in the Gaza Strip who showed courage, resilience, and dedication to conducting this survey in the most challenging circumstances. The original study was funded by the UK\u2019s Department for International Development (DFID), the Medical Research Council (MRC), the Economic and Social Research Council (ESRC) and Welcome Trust\u2019s Health Systems Research Initiative (HSRI) (MR/S012877/1). AI, LH, HD, MK, and IS would like to acknowledge the training received under the Scholars in HeAlth Research Program (SHARP) that was in part supported by the Fogarty International Center and Office of Dietary Supplements of the National Institutes of Health (Award Number D43 TW009118). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The publication of this article was funded by the Weill Cornell Medicine \u2013 Qatar Health Sciences Library. Publisher Copyright: © The Author(s) 2024.Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases (NCDs) and preventable deaths, with pronounced impacts in conflict zones like Gaza. A cross-sectional study, conducted in 2020, in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease (CAD), chronic lung disease (CLD), and stroke using regression analysis. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. After adjusting for various factors, the study identified significant associations between cigarette smoking in men and adverse health outcomes, such as CAD and CLD, with adjusted odds ratios (OR) of 1.67, 95% CI (1.22–2.29) and 1.68, 95% CI (1.21–2.33) respectively. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. The findings of this study could assist other researchers in designing interventions aimed at reducing smoking prevalence by utilizing the associated factors identified in our analysis, such as age, education level, physical activity, and body mass index among men in Gaza.publishersversionpublishe

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Learning in Online Environments: Balancing Cooperation and Competition

Learning environments, such as classrooms, can be designed to combine elements of cooperation and competition. Assessing these novel settings is not easy as it requires prolonged observational or experimental data. Today, many online environments are virtual providing transparent settings for assessing the effectiveness of learning strategies. We benefit from Dota 2, an online video game in which players join competing teams fighting in battles. Leveraging data about 3.5 million matches, we operationalize learning using objective data and perform conceptual clustering to uncover the best strategies for learning with cooperation, competition, or both elements. This work contributes to a better understanding of learning and informs the design of virtual learning environments