Big Data Health Care Innovations:Performance Dashboarding as a Process of Collective Sensemaking

Big data is poised to revolutionize health care, and performance dashboards can be an important tool to manage big data innovations. Dashboards show the progress being made and provide critical management information about effectiveness and efficiency. However, performance dashboards are more than just a clear and straightforward representation of performance in the health care context. Instead, the development and maintenance of informative dashboards can be more productively viewed as an interactive and iterative process involving all stakeholders. We refer to this process as dashboarding and reflect on our learnings within a large European Union–funded project. Within this project, multiple big data applications in health care are being developed, piloted, and scaled up. In this paper, we discuss the ways in which we cope with the inherent sensitivities and tensions surrounding dashboarding in such a dynamic environment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/1677

The long and winding road towards payment for healthcare innovation with high societal value but limited commercial value:A comparative case study of devices and health information technologies

Innovation is widely recognized as an important means of tackling challenges that face healthcare systems. But innovation can only succeed in this role if financial conditions allow innovations with high societal value to be developed and implemented. This study is an in-depth examination of the role of payment mechanisms throughout the innovation process, from the perspective of innovators. We conducted a comparative case study of four innovation projects, two involving medical devices and two involving health information technologies, all of which originated from academic settings. Although financial factors were found to have impeded the progress of innovative products at every step in the innovation process, this effect appears to have been strongest during the implementation phase. The perceived commercial value of an innovative product was a key factor in obtaining sufficient payment. Innovative products with potentially significant societal value but limited commercial value are unlikely to become structurally embedded in practice, or to be scaled up beyond the local level. The study reveals four additional factors that affect progress through the healthcare innovation process: compatibility of the innovation with existing practice, and commitment, competences, and social capital of the innovator. We identify a number of lessons for policy and practice that we believe would increase the likelihood of innovations with potentially significant societal value to achieve widespread implementation. These lessons reflect three key issues identified in our research: 1) shift the focus from commercial value towards societal value; 2) support dissemination of innovations beyond the local level; 3) help innovators to convey their valuable ideas.<br/

Financial risk allocation and provider incentives in hospital–insurer contracts in The Netherlands

In healthcare systems with a purchaser–provider split, contracts are an important tool to define the conditions for the provision of healthcare services. Financial risk allocation can be used in contracts as a mechanism to influence provider behavior and stimulate providers to provide efficient and high-quality care. In this paper, we provide new insights into financial risk allocation between insurers and hospitals in a changing contracting environment. We used unique nationwide data from 901 hospital–insurer contracts in The Netherlands over the years 2013, 2016, and 2018. Based on descriptive and regression analyses, we find that hospitals were exposed to more financial risk over time, although this increase was somewhat counteracted by an increasing use of risk-mitigating measures between 2016 and 2018. It is likely that this trend was heavily influenced by national cost control agreements. In addition, alternative payment models to incentivize value-based health care were rarely used and thus seemingly of lower priority, despite national policies being explicitly directed at this goal. Finally, our analysis shows that hospital and insurer market power were both negatively associated with financial risk for hospitals. This effect becomes stronger if both hospital and insurer have strong market power, which in this case may indicate a greater need to reduce (financial) uncertainties and to create more cooperative relationships.</p

Go configure: the mix of purchasing practices to choose for your supply base

Purchasing and supply management professionals recognize the value of aggressive transactional sourcing, as well as of having cooperative relationships with suppliers. But what mix of transactional and relational purchasing are organizations using, and which should they use? A novel instrument is developed to measure organizations’ use of transaction purchasing, electronic purchasing, interactive purchasing, and network purchasing. Four mixes of practices are identified and labeled “transactional,” “interpersonal dyadic,” “interpersonal network,” and “integrative relational” configurations. Organizations using an integrative relational configuration generally outperform others. Irrespective of configuration, organizations use more interactive and network purchasing with suppliers of direct inputs but more transaction purchasing with suppliers of indirect inputs

Comprehensive routine diagnostic screening to identify predictive mutations, gene amplifications, and microsatellite instability in FFPE tumor material

Background: Sensitive and reliable molecular diagnostics is needed to guide therapeutic decisions for cancer patients. Although less material becomes available for testing, genetic markers are rapidly expanding. Simultaneous detection of predictive markers, including mutations, gene amplifications and MSI, will save valuable material, time and costs. Methods: Using a single-molecule molecular inversion probe (smMIP)-based targeted next-generation sequencing (NGS) approach, we developed an NGS panel allowing detection of predictive mutations in 33 genes, gene amplifications of 13 genes and microsatellite instability (MSI) by the evaluation of 55 microsatellite markers. The panel was designed to target all clinically relevant single and multiple nucleotide mutations in routinely available lung cancer, colorectal cancer, melanoma, and gastro-intestinal stromal tumor samples, but is useful for a broader set of tumor types. Results: The smMIP-based NGS panel was successfully validated and cut-off values were established for reliable gene amplification analysis (i.e. relative coverage ≥3) and MSI detection (≥30% unstable loci). After validation, 728 routine diagnostic tumor samples including a broad range of tumor types were sequenced with sufficient sensitivity (2.4% drop-out), including samples with low DNA input (< 10 ng; 88% successful), low tumor purity (5-10%; 77% successful), and cytological material (90% successful). 75% of these tumor samples showed ≥1 (likely) pathogenic mutation, including targetable mutations (e.g. EGFR, BRAF, MET, ERBB2, KIT, PDGFRA). Amplifications were observed in 5.5% of the samples, comprising clinically relevant amplifications (e.g. MET, ERBB2, FGFR1). 1.5% of the tumor samples were classified as MSI-high, including both MSI-prone and non-MSI-prone tumors. Conclusions: We developed a comprehensive workflow for predictive analysis of diagnostic tumor samples. The smMIP-based NGS analysis was shown suitable for limited amounts of histological and cytological material. As smMIP technology allows easy adaptation of panels, this approach can comply with the rapidly expanding molecular markers

Contacts and contracts: Cross-level network dynamics in the development of an aircraft material

In this paper, we investigate how interorganizational networks and interpersonal networks interact over time. We present a retrospective longitudinal case study of the network system that developed a novel aircraft material and analyze changeepisodes from a structurationist perspective. We identify five types of episodes in which interpersonal and interorganizational networks interact (persistence, prospecting, consolidation, reconfiguration, and dissolution) and analyze conditionsfor these episodes and sequences among them. Our findings advance a cross-level perspective on embeddedness and show how individuals may draw on relational and structural embeddedness as distributed resources. The multiple levels of embeddedness impact network dynamics by introducing converging and diverging dialectics, thereby limiting path dependence and proactive network orchestration

Proactive environmental strategy in a supply chain context: The mediating role of investments

Abstract: There is a growing body of knowledge on the link between environmental management and supply chain management, but there is contradicting evidence on the impact of a proactive environmental strategy on environmental performance. Therefore, this paper investigates the impact of proactive environmental strategy on environmental performance as mediated by environmental investments. We also consider the antecedents of the adoption of proactive environmental strategy. We develop and test hypotheses, using data collected from 96 Turkish manufacturers through an online questionnaire. The model was tested using Partial Least Squares (PLS), a structural equation modelling method. The results show that a proactive environmental strategy leads to higher environmental investments; both internally and externally in collaboration with suppliers. Our findings support our hypothesis that environmental investments acts as a mediating variable between proactive environmental strategy and environmental performance. The results also show that customer pressure and, particularly, organizational commitment positively impact the extent to which firms adopt a proactive environmental strategy

The impact of customer-specific marketing expenses on customer retention and customer profitability

We study the effects of customer-specific marketing expenses on customer retention and customer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a hitherto unstudied type of expense targeted at individual customer relationships: the offering of free equipment to customers. The data allow tracking the activities performed in more than 4,500 customer relationships over a period of 4 years. Retention rates are higher for customers targeted with free equipment, but this effect results from an interaction with customer size. First-order dynamic panel data analyses show that the impact of targeted marketing expenses on customer dollar profit is positive for large customers, but there is no effect for smaller customers. Thus, targeted marketing expenses seem to be a tool for relationship maintenance rather than customer development: they help in retaining large customers that generate more profit, but they do not seem to work in developing new customers into larger, more profitable ones

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe