SHADOW IT SYSTEMS: DISCERNING THE GOOD AND THE EVIL

Shadow IT is becoming increasingly important as digital work practices make it easier than ever for business units crafting their own IT solutions. Prior research on shadow IT systems has often used fixed accounts of good or evil: They have been celebrated as powerful drivers of innovation or demonized as lacking central governance. We introduce a method to IT managers and architects enabling a more nuanced understanding of shadow IT systems with respect to their architectural embeddedness. Drawing on centrality measures from network analysis, the method portrays shadow IT systems as most critical if they hold a central position in a network of applications and information flows. We use enterprise architecture data from a recycling company to demonstrate and evaluate the method in a real project context. In the example, several critical and yet disregarded shadow IT systems have been identified and measures were taken to govern them decently

Shared decision-making: A vehicle for participation and individualized clinical care pathways? A Scoping review on patients’ and physicians’ perceived facilitators and barriers for shared decision-making for frail and elderly patients in the clinical sett

Introduction: Shared decision-making (SDM) is considered to be a promising approach to enable person-centredness and tailored treatment pathways, according to persons’ individual needs. Foremost, this concerns frail and elderly patients, who suffer from multiple health issues and increased vulnerability, requiring individualized healthcare. SDM and person-centred projects are being conducted and policy and regulatory settings are being implemented worldwide. However, little is known about facilitators and barriers for implementing SDM into clinical practice for the specific needs of frail and elderly patients. Objective And Method: We aim to gain a comprehensive overview over original studies on perceived facilitators and barriers for the adoption of shared decision-making within the clinical setting by elderly and frail patients and clinical physicians. Our objective is twofold: First, we aim at collecting and understanding facilitators and barriers addressed by elderly and frail patients and clinical physicians. Second, we aim at understanding the underlying approaches and methods employed in respective studies. We conducted a scoping review, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). Based on the databases PubMed, Medline and CINAHL, we identified and reviewed 11 articles. Results: For the first research question, the articles indicate that patients want to participate in decision-making, fostering autonomy; while communication barriers, asymmetric power relationships between patients and clinical physicians and a lack of patients’ health literacy remain crucial barriers. For the second research question, quantitative and qualitative studies are equally applied. Second, research on perceived facilitators and barriers for the adoption of shared decision-making within the clinical setting by elderly and frail patients and clinical physicians are almost exclusively conducted after participation in a SDM consultation. Third, the evaluation of the conceptual approaches demonstrates that the selected articles are primarily concerned with the collection of determinants that enable or impede the implementation and adoption SDM, without employing a distinct theoretical framework for explaining these determinants and assessing underlying relationships. Forth, the selected studies mainly used surveys and interviews. Conclusion: Overall, we identified only a limited number of articles addressing patient and clinical physician perceptions on facilitators and barriers for SDM. These findings further imply that SDM research concerning elderly and frail patients should become more encompassing by employing research that incorporate theory-based qualitative analysis, patient and clinician development of SDM perceptions (before and after SDM consultation), and observations of SDM consultations. Observations are particularly relevant as these remain as a black box. Implications: We suggest conducting a qualitative study that examines facilitators and barriers of clinical physicians and patients both prior to and post to SDM consultation, in combination with a non-participatory observation of actual SDM consultations. The observation of practice is indispensable to enable a thorough understanding of SDM and its’ application

Exploring Enterprise Transformation from a Path Dependence Perspective: A Recycling Case and Conceptual Model

In dispersed, multinational enterprises, complex integrations of information systems are a commonly hated threat as they render difficult fundamental changes of IT structures and standards embedded therein. This paper explores how integrations can turn into a burden and how thereby a company\u27s technology platform can lock-in to a local optimum. We conceptualize information system architectures - a company\u27s set of information systems and integrations - as networks. Based thereupon, we suggest a network model of path building that formalizes architectural growth processes and on-top technology adoptions, as when new systems attach preferentially to important hubs. Agent-based simulations give insights into how different growth parameters, i.e. new systems\u27 degree of integration and preferentiality, increase the architecture\u27s complexity and can reinforce predominant architectural patterns, such as islands of shared technologies . We contrast the simulation results to empirical data that show the emergence of a fragmented IT landscape in a regionally-dispersed recycling company