Information Quality in Secondary Use of EHR Data : A Case Study of Quality Management in a Norwegian Hospital

The motivation for undertaking this study relates to my experiences from practice in a public hospital, where I have observed variations in reaching organizational goals of quality management informed by electronic health records (EHR) data. For example, while some departments and units have long-time traditions in meeting the quality goals that are set locally, regionally, or nationally, other departments and units struggle to meet the same quality goals. Thus, generating actionable information by reusing routinely collected EHR data does not necessary lead to action in response to the information. This process of generating information from existing EHR data, and communicating and using such information for organizational purposes, may be challenging in a highly complex environment such as health care organizations. Within this process, information quality (IQ) may influence actors’ perceptions of action possibilities the information offers, thus influencing the actual use of the information required to reach organizational goals. EHR data can be used for clinical purposes at the point-of-care (i.e., primary use) and reused for purposes that do not involve patient treatment directly (i.e., secondary use). Examples of such secondary use includes quality management, research, and policy development. Though it is widely accepted that IQ influences the use of EHR systems and the information generated by EHR systems, research on the implications of IQ on health care processes is limited: the focus of the current literature is concerned with defining and assessing IQ in primary use of EHR data, whereas the role of IQ in secondary use of EHR data remains unclear. Thus, this dissertation investigates the role of IQ in secondary use of EHR data in an organizational context. This dissertation addresses this practical and theoretical challenge by focusing on the overall research objective of understanding the role of IQ in secondary use of EHR data. To address this research objective, this dissertation explores the following research questions: RQ1. How do human actors influence in transformation of IQ while generating, communicating, and using information in secondary use of EHR data? RQ2. What are the underlying generative mechanisms through which IQ transforms in the process of secondary use of EHR data?publishedVersio

The Role of Information Quality in Healthcare Organizations: A Multi-Disciplinary Literature Review

The volume of data in healthcare repositories is growing exponentially, giving increased concerns on its organizational implications. The quality of data and information represents a considerable risk for organizations, particularly in healthcare, where consequences of poor quality may be fatal for patients. This research seeks to investigate the role of information quality in organizations, by reviewing multi-disciplinary research literature and provide a framework of the relations between IQ and its organizational implications. Findings suggest that research on information quality has focused on different aspects of organizational impact: organizational performance, process performance, process improvement, and decision-making. However, since the research is fragmented and scarce, this paper suggests a shift in research focus from defining, measuring and improving information quality, to understanding the implications and applications of information quality towards better and safer health services

Digital Innovation of Healthcare Services in Times of Crisis and Beyond

The COVID-19 pandemic has created a worldwide state of emergency, triggering extensive digital innovation within healthcare institutions to recover from the disrupted services caused by the pandemic. The purpose of this research is to explore the phenomena of digital innovation during these extraordinary conditions and to understand the impacts during the pandemic and beyond. To do so, we conducted a systematic literature review by analyzing 130 research articles across research disciplines that were published during the pandemic. We found that the innovation processes were highly iterative and focused on rapid diffusion to address the urgent need for stabilizing and recovering disrupted services. This short-term perspective may result in adverse impacts beyond the pandemic, such as increased inequity. Moreover, we found that some environmental factors were highly adaptive to the pandemic, whereas others were less so. We suggest that organizations should focus on the latter when building resilience to future pandemics

Smartphone usage among older adults

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BEYOND CRISIS RESPONSE: LEVERAGING SOCIOTECH-NICAL TRANSFORMABILITY

We investigate the organizational capacities required to leverage digital infrastructures both (1) in re-sponse to crisis and external threats, and (2) in realizing the transformative potential associated with the digital infrastructures. Thus, our research question is: What is required for organizations to be able to transform in the face of disruptions and breakdowns? We report from an empirical study of a digital infrastructure innovation process in the context of the COVID-19 pandemic, which involved extensions and novel development of both the technology and the former service model. While the literature on organizational resilience offers us a conceptual framework to identify organizational capabilities, we lean on literature that foregrounds transformability as a crucial aspect of resilience. We discuss organ-izational capacities which are considered vital in realizing the potential for transformative crisis learn-ing in sociotechnical systems that builds adaptive capacity and influences the enactment of future or-ganisational routines

Information quality life cycle in secondary use of EHR data

The paper argues that existing research on information quality (IQ) mainly focuses on the primary use of electronic health record (EHR) data, whereas IQ in secondary use of EHR data needs further deliberation. The current view of IQ in a healthcare context is static. It assumes that once the EHR system generates the infor- mation product, individual users may act on the information based on their subjective perception of its quality. However, this view ignores the complexities of secondary use of EHR data, in which users are actively involved in (re)generating and communicating the information product. Thus, IQ does not remain static but keeps on transforming through active engagement and interpersonal communication. To contribute to this debate, we conducted a qualitative case study in a Norwegian healthcare context by employing an IQ life cycle model. In conclusion, we enhanced the existing IQ model by (1) adding interpersonal communication, (2) showing the interrelations of the IQ dimensions, and (3) integrating the mechanisms of the transformation process for IQ in secondary use of EHR data. In doing so, we unfold the dynamics of IQ in the secondary use of EHR data.publishedVersio

The Role of Mediators in Transforming and Translating Information Quality: A Case of Quality Assurance in a Norwegian Hospital Trust

The existing literature on information quality (IQ) provides limited understanding of how roles influence IQ in healthcare. The traditional way of understanding roles such as collectors, custodians, and consumers assumes that data are simply transformed into information and subsequently used by consumers. However, this does not explain how interpersonal communication influences IQ. In reality, the actors involved can actively change the quality of healthcare information through transformation, translation, or distortion. Latour’s idea of intermediaries and mediators can be an appropriate lens for understanding these roles. Latour defined intermediaries as socio-technical actors who simply transport information, whereas mediators can transform, translate, distort, and change the meaning of information. Following Latour’s idea, we conducted a qualitative case study of quality assurance in a Norwegian healthcare organization. In doing so, we illustrated how IQ mediators can distort or create shared understanding of quality assurance information, which further influences enactment

A Boundary Spanning Perspective of Practical Impact: The Case of IS Practitioner Doctorates

IS research often seeks to deliver practical impact, in addition to the traditional requirement for theoretical contribution. While an admirable goal, it is nevertheless a challenging prospect, as key questions remain around how to best facilitate a relationship between IS academic and practitioner communities. To explore this question, our paper investigates boundary spanning by ‘practitioner doctorates’ - PhD students with professional experience who seek to span the fields of academia and practice during their research. Drawing on in-depth interviews with practitioner doctorates, our findings point towards several factors for practical impact such as researcher legitimacy, expectation management, and adapting to changes in industry requirements. In doing so, we contribute towards an understanding of engaged scholarship in IS and take steps towards addressing the dearth of research on doctoral studies in the IS field to date

Information Quality in Healthcare Delivery Improvement: A Critical Realist Approach

Electronic health record systems (EHS) are the primary source of information for improving healthcare delivery processes. Research on adoption and use of this technology is now spanning more than four decades, but how to transform data in EHS into improved delivery processes is a persistent challenge for healthcare organizations. Insufficient quality of EHS data has previously been suggested as one possible impediment, but the role of information quality throughout the improvement process remains unclear. Thus, this article is investigating the role of information quality in a public hospital improvement intervention. Based on a critical realist analysis, an underlying mechanism for succeeding with improvement is proposed; for commitment to improvement to take place, production and communication of improvement information must incorporate certain information quality elements, and facilitated by management involvement and improvement culture. This mechanism must be triggered on different organizational levels until improvement commitment is achieved among clinicians

App for forebygging og håndtering av kriser

På Verdensdagen for selvmordsforebygging den 10. september 2014, lanserte Sørlandet sykehus HF mobilappen MinPlan Norge. MinPlan Norge er en elektronisk plan for forebygging og håndtering av kriser, hvor målsettingen er å forhindre selvmord, overdose og selvskading