IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study

BACKGROUND: Factors of IT adoption have largely been discussed in the literature. However, existing frameworks (such as TAM or TTF) are failing to include one important aspect, the interaction between user and task. METHOD: Based on a literature study and a case study, we developed the FITT framework to help analyse the socio-organisational-technical factors that influence IT adoption in a health care setting. RESULTS: Our FITT framework ("Fit between Individuals, Task and Technology") is based on the idea that IT adoption in a clinical environment depends on the fit between the attributes of the individual users (e.g. computer anxiety, motivation), attributes of the technology (e.g. usability, functionality, performance), and attributes of the clinical tasks and processes (e.g. organisation, task complexity). We used this framework in the retrospective analysis of a three-year case study, describing the adoption of a nursing documentation system in various departments in a German University Hospital. We will show how the FITT framework helped analyzing the process of IT adoption during an IT implementation: we were able to describe every found IT adoption problem with regard to the three fit dimensions, and any intervention on the fit can be described with regard to the three objects of the FITT framework (individual, task, technology). We also derive facilitators and barriers to IT adoption of clinical information systems. CONCLUSION: This work should support a better understanding of the reasons for IT adoption failures and therefore enable better prepared and more successful IT introduction projects. We will discuss, however, that from a more epistemological point of view, it may be difficult or even impossible to analyse the complex and interacting factors that predict success or failure of IT projects in a socio-technical environment

Radioisotopes for medical and industrial use during the 50-year history of the Institute of Nuclear Research

The paper summarises the 50-years long history of the development of research programmes related to the practical applications of radionuclides in various fields of the Polish economy. The changing trends of interest of the potential users are reflected in the research and development activities of the Radioisotope Centre POLATOM. In the 1960's and 1970's the main areas of activity were focused on the sealed sources and radiolabelled compounds for the investigation of industrial processes. The introduction to the routine practice of the RIA and the IRMA kits for hormonal in vitro diagnostics in the 70-ties and 80-ties resulted in the general availability of this diagnostic technique in Poland. The number of radioisotopes having the required radiation type, energy and half-life is steadily increasing due to the progress in irradiation facilities and in chemical separation processes. The need for modern radiopharmaceuticals, more specific and providing higher diagnostic and therapeutic potential as an alternative to other medical modalities is reflected in the research programmes carried out and implemented currently at the Radioisotope Centre POLATOM

Reflectivity Studies of Lattice Vibrations and Free Electrons in MBE Grown GaN Epitaxial Layers

We have observed a sharp structure with a peak at the frequency of the E$\text{}_{1}$-TO phonon in the reflectivity of GaN epitaxial layers grown by molecular beam epitaxy on Si substrates. The simulations of the reflection performed show that the observed shape can be explained by assuming both collective lattice vibrations and free carriers contributions to the dielectric function. We assumed the Lorentz oscillator to describe the contribution of the collective lattice vibrations and the Drude-Lorentz model for that of free carriers. Fitting the calculated reflectivity to the spectrum obtained experimentally allowed us to evaluate lattice and free carrier parameters

Allied Health Manpower Strategies: Estimates of the Potential Gains from Efficient Task Delegation

This study analyzes the potential impact of physician extenders on the productivity of primary care practices and considers the consequent implica tion for future health manpower requirements. A number of previous inves tigations have evaluated a variety of extenders in experimental settings. This study, in contrast, constructs and operates a simulation model of the repre sentative practice permitting one to synthesize the experiences and insights of earlier demonstration projects. The model requires the practice to delegate tasks to paramedical personnel including the physician extender in such a way as to minimize the total cost of delivering a list of required medical services. The alternative acceptable techniques for delivering care are defined by the number of minutes of each type of medical personnel that must be employed in producing each service. Primary care is characterized by distinct medical services. The model reveals that physician extenders could increase the productivity of a representative primary care practice by up to 74 per cent Alternatively, the commitment of physician time required to serve a patient load of 100 visits a week might be reduced by 14.2 hours through effective use of an extender. The article concludes with observations on the implications of physician extenders for future health manpower requirements. O rig in a l A rticles The demand for medical services is in creasing dramatically. As public and private insurance schemes develop to cover the costs of care, the demands on the health care system will expand further. These ex panded demands have prompted experts to propose that additional resources b e allo cated towards existing programs of physi cian training. Such proposals are premised on the the assumption that th e current organization of the health care system will continue indefinitely. However, in view of the extraordinary cost of medical education and the great length of time required to develop new training programs, it seems appropriate to explore alternative strate gies for the expansion of medical services. Considerable i n t e r e s t h a s developed within the medical profession in task dele gation and in the training of new classes of 45

Factors Affecting and Affected by User Acceptance of Computer-based Nursing Documentation: Results of a Two-year Study

Objectives: The documentation of the nursing process is an important but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems such as low quality of documentation are reported. It is unclear whether computer-based documentation systems can reduce these problems and which factors influence their acceptance by users. Design: We introduced a computer-based nursing documentation system on four wards of the University Hospitals of Heidelberg and systematically evaluated its preconditions and its effects in a pretest–posttest intervention study. For the analysis of user acceptance, we concentrated on subjective data drawn from questionnaires and interviews. Measurements: A questionnaire was developed using items from published questionnaires and items that had to be developed for the special purpose of this study. Results: The quantitative results point to two factors influencing the acceptance of a new computer-based documentation system: the previous acceptance of the nursing process and the previous amount of self-confidence when using computers. On one ward, the diverse acceptance scores heavily declined after the introduction of the nursing documentation system. Explorative qualitative analysis on this ward points to further success factors of computer-based nursing documentation systems. Conclusion: Our results can be used to assist the planning and introduction of computer-based nursing documentation systems. They demonstrate the importance of computer experience and acceptance of the nursing process on a ward but also point to other factors such as the fit between nursing workflow and the functionality of a nursing documentation system