Les effets du partage de connaissances sur la construction de la vision organisante du dossier patient informatise : le cas d’un projet en systeme d’information au sein d’un groupement hospitalier territorial

International audience« While the journey begins with the firm’s consideration of what others in the field are being said to accomplish with the innovation, it ends with its consideration of what it has itself achieved. » (Swanson et Ramiller, 2004). This quote from the creators of the organizing vision suggests the need for structures that are going through an innovation process to introspect on the assets they hold. Swanson and Ramiller's (1997) observation of the organizing vision (OV) around an innovation is defined as follows: "An organizing vision is a community focal idea for the application of information technology in organizations." In 2004, they state that an "organizational vision is usually recognizable by one or a few 'buzzwords' that serve as a thematic label for the discourse of the broader community.". It is therefore primarily a discourse to guide and outline the course of an innovation in an organization. It clarifies the reasons for its existence and gives it meaning in order to mobilize actors in its implementation. However, these discourses mainly analysed journal articles and case studies are fewer. Among them, none proposes to identify knowledge sharing, in the sense of information for coordinating activities and practices, as a founding element of the OV discourse and its "authorized discourse". Our objective is to show the importance of knowledge sharing on the construction of an organizing vision within a health information system (IS) project and to identify it as a source of convergence between actors. It seems interesting to us to extend the exploratory study by Swanson and Ramiller (2003) in order to give concrete organizational keys to IS project managers and to bring the concept of knowledge sharing closer to that of the organizing vision. We believe that there is a practical interest in this. Indeed, we hypothesize that knowledge sharing has an influence on the organizing vision because it is a lever for action to encourage inter-organizational interaction that will allow a better understanding of the practices and expectations of each of the actors in order to achieve the success of a project. Our research was conducted within a Groupement Hospitalier Territorial (GHT) composed of a dozen health establishments, which found itself obliged to change the IT publisher for its Electronic Patient Record (EPR) because the current provider was leaving the French market. This opportunity was seen as a chance to reconcile inter-organizational practices and facilitate the sharing of patient information between institutions. The healthcare sector is particularly interesting for its complexity and technical knowledge with high operational stakes. We will see that in 2010, Morr and Subercaze identified several particularities specific to the healthcare domain for managing knowledge in the context of an information system project. The organizing vision (OV) is composed of 3 elements (interpretation, mobilization and legitimization) that will serve as objects for classifying the discourse. The 4 stratums of the OV (Carton et al., 2016), in turn, will determine the framework of our observation. Our methodology is based on the work of Swanson and Ramiller (2003), and will consist of a qualitative study of the process used to analyse what was said during semi-structured interviews and project scoping meetings by the actors. The main purpose of these scoping meetings is to share knowledge and data between the different institutions. They are also necessary for the work of the external service provider. Thus, after creating a matrix made up of the feelings of the different stakeholders and of the three elements of the organizing vision, we will analyse the discourse of each group of project stakeholders. This classification should make it possible to highlight the predominance of the language elements used and the feelings to which they are attached during the knowledge sharing phase, and then to compare them with the 4 stratums of the organizing vision. Our initial analyses of the project leaders' comments on the referents allow us to draw some initial results in this start-up period of the project. On the aspects of mobilization, the decision-makers are voluntarily positive to encourage the participation of a maximum number of people. However, the legitimization of the service provider is struck by comments that inspire mistrust and this can be explained by the classic mistrust of the client towards his service provider. Finally, the comments about the information system itself are neutral until we see the first tests in situation. Once our study is completed, we would like to extend the work of Swanson and Ramiller to further associate the notion of knowledge sharing with that of the organizing vision. Indeed, their 2003 article mentions knowledge transfer problems in the case studied and the usefulness for information system managers to have certain organizational bases. Also, the study of the actors' feelings during knowledge sharing is a new element in this type of analysis because it can have an influence on the development of the project.« While the journey begins with the firm's consideration of what others in the field are being said to accomplish with the innovation, it ends with its consideration of what it has itself achieved. » (Swanson et Ramiller, 2004). Cette citation des créateurs de la vision organisante avance la nécessaire introspection des structures qui traversent un processus d'innovation sur les atouts qu'elles détiennent. L'observation de la vision organisante (VO) autour d'une innovation de Swanson et Ramiller (1997) est définie ainsi : « Une vision d'organisation est une idée focale de la communauté pour l'application de la technologie de l'information dans les organisations. » En 2004, ils précisent qu'une « vision organisationnelle est généralement reconnaissable par un ou quelques "mots à la mode" (Buzzword) qui servent d'étiquette thématique pour le discours de la communauté au sens large. ». Il s'agit donc principalement d'un discours permettant de guider et d'exposer le cap d'une innovation dans une organisation. Cela éclaircit les raisons de son existence et lui donne un sens afin de mobiliser les acteurs dans sa mise en oeuvre. Cependant, ces discours ont principalement analysé des articles de revue et les études de cas sont plus rares. Parmi elles, aucune ne propose d'identifier le partage de connaissances, au sens des informations de coordination des activités et des pratiques, comme un élément fondateur du discours de la VO et ses « propos autorisés ». Notre objectif est de montrer l'importance du partage de connaissances sur la construction d'une vision organisante au sein d'un projet en système d'information (SI) en santé et de l'identifier comme source de convergence des acteurs. Il nous paraît intéressant de prolonger l'étude exploratoire de Swanson et Ramiller (2003) afin de donner des clés organisationnelles concrètes aux managers de projet SI et de rapprocher davantage le concept de partage de connaissances de celui de la vision organisante. Nous pensons qu'il y a un intérêt pratique à cela. En effet, nous émettons l'hypothèse que le partage de connaissances a une influence sur la vision organisante car c'est un levier d'action pour inciter l'interaction inter-organisationnelle qui permettra une meilleure compréhension des pratiques et des attentes de chacun des acteurs pour aboutir à la réussite d'un projet. Notre recherche s'établit au sein d'un Groupement Hospitalier Territorial (GHT) composé d'une douzaine d'établissements de santé, qui se retrouve dans l'obligation de changer d'éditeur informatique pour son Dossier Patient Informatisé (DPI) car le prestataire actuel quitte le marché français. Cette occasion a été perçue comme une opportunité d'un rapprochement des pratiques inter-organisationnelles et d'une facilitation de partage d'informations patient entre établissements. Le secteur de la santé est particulièrement intéressant pour sa complexité et ses connaissances techniques à forts enjeux opérationnels. Nous verrons qu'en 2010, Morr et Subercaze ont relevé plusieurs particularités propres au domaine de la santé pour gérer la connaissance dans le cadre d'un projet en système d'information. La vision organisante (VO) se compose de 3 éléments (l'interprétation, la mobilisation et la légitimation) qui nous serviront d'objets de classement du discours. Les 4 strates de la VO (Carton et al., 2016), quant à elles, détermineront le cadre de notre observation. Notre méthodologie est basée sur les travaux de Swanson et Ramiller (2003), elle consistera en une étude qualitative du processus utilisé pour analyser les propos tenus lors d'entretiens semidirectifs et des réunions de cadrage du projet par les acteurs. Ces réunions de cadrage ont pour thème principal le partage de connaissances et de données entre les différents établissements. Elles sont également nécessaires au travail du prestataire externe. Ainsi, après avoir créé une matrice constituée du ressenti des différentes parties prenantes et des 3 éléments de la vision organisante, nous allons analyser le discours de chaque groupe d'acteurs du projet. Cette classification doit permettre de faire ressortir la prédominance des éléments de langage utilisés et les sentiments auxquels ils sont rattachés pendant la phase de partage de connaissances, pour ensuite les confronter aux 4 strates de la vision organisante. Nos premières analyses sur les propos des chefs de projets vis-à-vis des référents nous permettent de dessiner de premiers résultats dans cette période de démarrage du projet. Sur les aspects de mobilisation, les décideurs se montrent volontairement positifs pour encourager la participation d'un maximum de personnes. Cependant, la légitimation du prestataire est frappée par des propos inspirant la défiance et cela peut s'expliquer par la méfiance assez classique du client envers son prestataire. Enfin, les propos sur le système d'information en lui-même sont neutres en attendant de voir les premiers tests en situation. Une fois notre étude terminée, nous souhaitons prolonger les travaux de Swanson et Ramiller pour associer davantage la notion de partage de connaissances à celle de la vision organisante. En effet, leur article de 2003 mentionne des problèmes de transfert de connaissances dans le cas étudié et l'utilité pour les managers en système d'information d'avoir certaines bases organisationnelles

La nécessité du sensemaking sur la construction de la vision organisante : le cas d'un projet SI en santé

International audienceIn this ongoing research, we wish to highlight the contribution of sensemaking (Weick, 1979; Weick et al., 2005) to the construction of an organizing vision (Swanson & Ramiller, 1997; 2004) within health IS project. This convergence of concepts is explained by a desire to deepen the work on the creation of the organizing vision of a project and the construction of an authorized discourse among the members of the organization. Thus, thanks to a qualitative study conducted longitudinally, our initial results tend to confirm the contribution of sensemaking, thanks to the dimensions linked to the environment, enactment, selection and retention of information, in order to give a collective sense to the action with the aim of legitimizing the project and the tool. It also allows for the mobilization of actors around common objectives despite sometimes divergent interests.Dans cette recherche en cours nous souhaitons mettre en lumière l'apport du sensemaking (Weick, 1979 ; Weick et al., 2005) à la construction d'une vision organisante (Swanson & Ramiller, 1997 ; 2004) au sein d'un projet SI en santé. Ce rapprochement de concept s'explique par une volonté d'approfondir les travaux sur la création de la vision organisante d'un projet et la construction d'un discours autorisé parmi les membres de l'organisation. Ainsi, grâce à une étude qualitative menée de manière longitudinale, nos premiers résultats tendent à confirmer l'apport du sensemaking, grâce aux dimensions liées à l'environnement, l'enactment, la sélection et la rétention de l'information, afin de donner un sens collectif à l'action dans un but de légitimation du projet et de l'outil. Il permet également de mobiliser les acteurs autour d'objectifs communs malgré des intérêts parfois divergents

Measurement and modelling of solid apparition temperature for the CO2 - H2S - CH4 ternary system

International audienceIn order to develop a new process to eliminate acid gases from natural gas, it is important to consider phase equilibrium properties. New solid-liquid equilibrium data were determined concerning the ternary system CO 2 + H 2 S + CH 4. The experimental technique is based on visual synthetic method. The new experimental data were compared to predictions given by the Predictive Peng-Robinson equation of state (PPR78), PSRK UNIFAC, Peng-Robinson with Huron-Vidal mixing rules and GERG 2008 models coupling with classical approach or Jager and Span for solid phase. The results have shown that the model selected for the fluid phase has more impact that the model considered for the solid phase. New binary interaction parameters of Peng-Robinson equation of state were fitted only on our experimental data and it was found that the obtained values are very different from the value used for Vapor Liquid Equilibrium computation

Study and improvement of sealing solutions for solid oxide cells

International audienceSolid oxide cells (SOC) stacks are by design mechanical complex structures. Ensuring the sealing of this ceramic/metallic multilayer assembly fed with different gases is technically very challenging. The efficient sealing of the stack inner structure and of the mechanical interface between the stack and its inlet/outlet interfaces is however mandatory to allow a proper operation of a SOC stack. The sealing being a critical technical issue for the development of industrial systems analyses of the stack vitroceramic/glass cement were conducted in relevant conditions (high temperature, pressure, SOC standard gases) to qualify and understand their thermomechanical properties and technical limits.The first phase focused on the analysis of vitroceramic seals structures linked to the initial condition and fabrication process. First results, obtained by image analysis show a strong impact of the thermal cycle on the sealing material porosity (Figure 1). These analyses were completed by mechanical tests and leak-rate measurements. This paper presents an overview of this work, the technical means and equipment gathered to address the stack sealing issues and the preliminaries outcomes

Study and improvement of sealing solutions for solid oxide cells

International audienceSolid oxide cells (SOC) stacks are by design mechanical complex structures. Ensuring the sealing of this ceramic/metallic multilayer assembly fed with different gases is technically very challenging. The efficient sealing of the stack inner structure and of the mechanical interface between the stack and its inlet/outlet interfaces is however mandatory to allow a proper operation of a SOC stack. The sealing being a critical technical issue for the development of industrial systems analyses of the stack vitroceramic/glass cement were conducted in relevant conditions (high temperature, pressure, SOC standard gases) to qualify and understand their thermomechanical properties and technical limits.The first phase focused on the analysis of vitroceramic seals structures linked to the initial condition and fabrication process. First results, obtained by image analysis show a strong impact of the thermal cycle on the sealing material porosity (Figure 1). These analyses were completed by mechanical tests and leak-rate measurements. This paper presents an overview of this work, the technical means and equipment gathered to address the stack sealing issues and the preliminaries outcomes

Study and improvement of sealing solutions for solid oxide cells

International audienceSolid oxide cells (SOC) stacks are by design mechanical complex structures. Ensuring the sealing of this ceramic/metallic multilayer assembly fed with different gases is technically very challenging. The efficient sealing of the stack inner structure and of the mechanical interface between the stack and its inlet/outlet interfaces is however mandatory to allow a proper operation of a SOC stack. The sealing being a critical technical issue for the development of industrial systems analyses of the stack vitroceramic/glass cement were conducted in relevant conditions (high temperature, pressure, SOC standard gases) to qualify and understand their thermomechanical properties and technical limits.The first phase focused on the analysis of vitroceramic seals structures linked to the initial condition and fabrication process. First results, obtained by image analysis show a strong impact of the thermal cycle on the sealing material porosity (Figure 1). These analyses were completed by mechanical tests and leak-rate measurements. This paper presents an overview of this work, the technical means and equipment gathered to address the stack sealing issues and the preliminaries outcomes

Introduce grassland in crop rotation, a way to restore microbiodiversity and soil function?

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Introducing Grasslands into Crop Rotations, a Way to Restore Microbiodiversity and Soil Functions

International audienceThe aims of this study were to investigate (i) the influence of aging grassland in the recovery of soil state by the comparison of permanent grassland, two restored grasslands, two temporary grasslands, and a continuous crop in the same pedoclimatic conditions, (ii) the extent and the persistence of the potential changes following a grassland/or cropland phase. We hypothesized that the level of microbial communities and enzyme activities could achieve a profile close to that of permanent grassland after the introduction of grassland for a few years in crop rotations. Soil biophysicochemical properties were studied. Our results indicated that the abundance of microbial communities and enzyme activities were positively correlated to soil C and N contents and negatively correlated to soil pH. The changes in microbial abundance level were strongly linked to the changes in functional level when grasslands are introduced into crop rotations. We also showed that a continuous crop regime had a stronger legacy on the soil biota and functions. By contrast, the legacy of a grassland regime changed quickly when the grassland regime is interrupted by recent culture events. A grassland regime enabled the restoration of functions after more than five cumulative years in the grassland regime