Explaining the Health Information Technology Paradox

Excerpt] The substantial gap between the promise inherent in upgrading information systems in health care and the documented reality has baffled health care scholars. Why is a technology so clearly capable of creating efficiencies, increasing safety, and promoting greater information sharing and coordination across professionals failing to live up to expectations

Measurement Error in Performance Studies of Health Information Technology: Lessons from the Management Literature

Just as researchers and clinicians struggle to pin down the benefits attendant to health information technology (IT), management scholars have long labored to identify the performance effects arising from new technologies and from other organizational innovations, namely the reorganization of work and the devolution of decision-making authority. This paper applies lessons from that literature to theorize the likely sources of measurement error that yield the weak statistical relationship between measures of health IT and various performance outcomes. In so doing, it complements the evaluation literature’s more conceptual examination of health IT’s limited performance impact. The paper focuses on seven issues, in particular, that likely bias downward the estimated performance effects of health IT. They are 1.) negative self-selection, 2.) omitted or unobserved variables, 3.) mis-measured contextual variables, 4.) mismeasured health IT variables, 5.) lack of attention to the specific stage of the adoption-to-use continuum being examined, 6.) too short of a time horizon, and 7.) inappropriate units-of-analysis. The authors offer ways to counter these challenges. Looking forward more broadly, they suggest that researchers take an organizationally-grounded approach that privileges internal validity over generalizability. This focus on statistical and empirical issues in health IT-performance studies should be complemented by a focus on theoretical issues, in particular, the ways that health IT creates value and apportions it to various stakeholders

Editorial Essay: Introduction to a Special Issue on Work and Employment Relations in Health Care

[Excerpt] This special issue of the ILR Review is designed to showcase the central role that work organization and employment relations play in shaping important outcomes such as the quality of care and organizational performance. Each of the articles included in this special issue makes an important contribution to our understanding of the large and rapidly changing health care sector. Specifically, these articles provide novel empirical evidence about the relationship between organizations, institutions, and work practices and a wide array of central outcomes across different levels of analysis. This breadth is especially important because the health care literature has largely neglected employment-related factors in explaining organizational and worker outcomes in this industry. Individually, these articles shed new light on the role that health information technologies play in affecting patient care and productivity (see Hitt and Tambe; Meyerhoefer et al.); the relationship between work practices and organizational reliability (Vogus and Iacobucci); staffing practices, processes, and outcomes (Kramer and son; Hockenberry and Becker; Kossek et al.); health care unions’ effects on the quality of patient care (Arindrajit, Kaplan, and Thompson); and the relationship between the quality of jobs and the quality of care (Burns, Hyde, and Killet). Below, we position the articles in this special issue against the backdrop of the pressures and challenges facing the industry and the organizations operating within it. We highlight the implications that organizational responses to industry pressures have had for organizations, the patients they care for, and the employees who deliver this care

PERLINDUNGAN HUKUM INVESTOR SELAKU KONSUMEN SEHUBUNGAN DENGAN INVESTASI BERBASIS IKLAN DI MEMILES

Perkembangan ekonomi di era digital memunculkan banyak jenis investasi baru. Dengan banyaknya jenis investasi yang bermunculan, menjadikan sarana bagi masyarakat sehingga banyak yang tertarik untuk melakukan investasi online secara legal maupun ilegal karena keuntungan besar yang dijanjikan. Dalam hal ini salah satunya adalah investasi berbasis iklan yang menyebabkan sejumlah kerugian bagi investornya.  Investasi berbasis iklan ini dilakukan oleh PT KAM AND KAM melalui aplikasinya yang bernama MeMiles dan berhasil meraup dana kurang lebih sebesar 750 (tujuh ratus lima puluh) miliar rupiah tanpa mengantongi izin dari Otoritas Jasa Keuangan dan menggunakan skema ponzi. Tujuan dari dilakukannya penelitian ini yaitu mengetahui pengaturan mengenai perlindungan hukum investor selaku konsumen dalam perusahaan investasi berbasis iklan berdasarkan Undang-Undang Nomor 8 Tahun 1999 tentang Perlindungan Konsumen. Adapun hasil dari penelitian ini, pemerintah sudah memberi upaya untuk mencegah terjadinya praktik investasi ilegal melalui sosialiasi dan membentuk beberapa Lembaga Perlindungan Konsumen Swadaya Masyarakat sebagai cara untuk melindungi dan mengayomi investor selaku konsumen yang sudah dirugikan dan menerima masukan dari LPKSM mengenai Undang-Undang Perlindungan Konsumen

Service Dog Ramp

This project involves designing a device to help a service dog easily get into and out of a truck. It details the design and manufacturing process. The project was interrupted due to the COVID-19 pandemic, so detailed instructions are provided for whoever takes on the project in the future

Karakteristik Fisik dan Mekanik Bangunan Rumah Tinggal Satu Lantai dalam Memenuhi persyaratan Tahan Gempa

Indonesia merupakan salah satu negara yang hampir setiap wilayahnya memiliki tingkat resiko gempa bumi yang tinggi. Setiap tahunnya dapat dipastikan terjadi gempa bumi yang mengakibatkan kerusakan yang cukup parah. Sebagai salah satu wilayah rawan terhadap gempa, perencanaan struktur bangunan rumah tahan gempa di Kota Malang merupakan suatu hal yang mutlak. Sebagian besar rumah tinggal di kota Malang merupakan bangunan yang menggunakan struktur beton dan bata merah sebagai dinding. Oleh karena itu penting untuk dilakukan kajian untuk menganalisis rumah tinggal dengan dinding bata sebagai elemen struktural. Pada penelitian ini dilakukan proses analisis pada rumah dengan material dinding bata dari Turen, Godanglegi dan Wajak. Dilakukan perhitungan untuk mengetahui tegangan yang terjadi pada bangunan akibat beban gempa dan beban gravitasi. Data bangunan rumah dan beban gempa yang digunakan mengikuti data yang telah di atur oleh PPURG 1987 dan SNI 1726-2012 serta perhitungan dilakukan secara manual dengan menggunakan aplikasi Autocad, Microsoft Word dan Microsoft Excel. Pengaruh fisik dari bata khususnya massa jenis merupakan salah satu faktor yang menentukan besaran gaya geser dasar seismik (V). Nilai berat pasangan bata yang didapat dari PPURG 1987 sebesar 250 kg/m2 lebih besar dari nilai ketiga sampel yang ada. Sehingga gaya geser dasar seismik yang terjadi lebih kecil dari perhitungan di penelitian ini. Dari hasil perhitungan didapat tegangan tekan maksimal yang terjadi (30,56 kg/cm2) lebih kecil dari nilai kuat tekan sampel yang paling kecil (32,25 kg/cm2). Tegangan geser maksimal yang terjadi (0,64511 kg/cm2) lebih kecil dari nilai kuat geser sampel yang paling kecil (2,56 kg/cm2). Namun, tegangan tarik lentur maksimal yang terjadi adalah sebesar (30,56 kg/cm2) lebih besar daripada nilai kuat tarik lentur dari ketiga sampel (kekuatan maksimum sampel sebesar 2,13 kg/cm2). Pada penilitian ini, kolom beton bertulang dianggap sebagai dinding bata. Untuk penelitian selanjutnya, disarankan perhitungan dilakukan dengan menganggap dinding bata dan kolom bekerja sebagai struktur komposit

Superbugs Versus Outsourced Cleaners: Employment Arrangements and the Spread of Health Care-Associated Infections

On any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. The authors demonstrate this relationship empirically, finding support for their theory by using a self-constructed data set that marries infection data to structural, organizational, and workforce features of California’s general acute care hospitals. The study thus advances the literature on nonstandard work arrangements—outsourcing in particular—while sounding a cautionary note to hospital administrators and health care policymakers

Tentative detection of the gravitational magnification of type Ia supernovae

The flux from distant type Ia supernovae (SN) is likely to be amplified or de-amplified by gravitational lensing due to matter distributions along the line-of-sight. A gravitationally lensed SN would appear brighter or fainter than the average SN at a particular redshift. We estimate the magnification of 26 SNe in the GOODS fields and search for a correlation with the residual magnitudes of the SNe. The residual magnitude, i.e. the difference between observed and average magnitude predicted by the "concordance model" of the Universe, indicates the deviation in flux from the average SN. The linear correlation coefficient for this sample is r=0.29. For a similar, but uncorrelated sample, the probability of obtaining a correlation coefficient equal to or higher than this value is ~10%, i.e. a tentative detection of lensing at ~90% confidence level. Although the evidence for a correlation is weak, our result is in accordance with what could be expected given the small size of the sample.Comment: 7 pages, 2 figure