Electronic Health Records: Cure-all or Chronic Condition?

Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential

Business Models for e-Health: Evidence from Ten Case Studies

An increasingly aging population and spiraling healthcare costs have made the search for financially viable healthcare models an imperative of this century. The careful and creative application of information technology can play a significant role in meeting that challenge. Valuable lessons can be learned from an analysis of ten innovative telemedicine and e-health initiatives. Having proven their effectiveness in addressing a variety of medical needs, they have progressed beyond small-scale implementations to become an established part of healthcare delivery systems around the world

Born to be Wild: Using Communities of Practice as a Tool for Knowledge Management

This paper looks at what happens when Communities of Practice are used as a tool for Knowledge Management. The original concept of a Community of Practice appears to have very little in common with the knowledge sharing communities found in Knowledge Management, which are based on a revised view of 'cultivated' communities. We examine the risks and benefits of cultivating Communities of Practice rather than leaving them 'in the wild'. The paper presents the findings from two years of research in a small microelectronics firm to provide some insights into the wild vs domesticated dichotomy and discusses the implications of attempting to tame Communities of Practice in this way.Comment: Paper presented at the Ethicomp 2010: The 'Backwards, Forwards and Sideways' changes of ICT, Tarragona, Spain, April, 2010, pp. 71 - 80

An Analysis of Key Factors for the Success of the Communal Management of Knowledge.

This paper explores the links between Knowledge Management and new community-based models of the organization from both a theoretical and an empirical perspective. From a theoretical standpoint, we look at Communities of Practice (CoPs) and Knowledge Management (KM) and explore the links between the two as they relate to the use of information systems to manage knowledge. We begin by reviewing technologically supported approaches to KM and introduce the idea of Systèmes d'Aide à la Gestion des Connaissances SAGC (Systems to aid the Management of Knowledge). Following this we examine the contribution that communal structures such as CoPs can make to intraorganizational KM and highlight some of 'success factors' for this approach to KM that are found in the literature. From an empirical standpoint, we present the results of a survey involving the Chief Knowledge Officers (CKOs) of twelve large French businesses; the objective of this study was to identify the factors that might influence the success of such approaches. The survey was analysed using thematic content analysis and the results are presented here with some short illustrative quotes from the CKOs. Finally, the paper concludes with some brief reflections on what can be learnt from looking at this problem from these two perspectives.Knowledge Management; Community-based; Communities of Practice; Gestion des Connaissances; Chief Knowledge Officers; Success Factors; KM

Born to be Wild: Using Communities of Practice as a Tool for Knowledge Management

This paper looks at what happens when Communities of Practice are used as a tool for Knowledge Management. The original concept of a Community of Practice appears to have very little in common with the knowledge sharing communities found in Knowledge Management, which are based on a revised view of 'cultivated' communities. We examine the risks and benefits of cultivating Communities of Practice rather than leaving them 'in the wild'. The paper presents the findings from two years of research in a small microelectronics firm to provide some insights into the wild vs domesticated dichotomy and discusses the implications of attempting to tame Communities of Practice in this way.Communities of Practice, Knowledge Management

Communities of Practice: Going One Step Too Far?.

In the late 1990s, Knowledge Management (KM) and Communities of Practice (CoPs) seemed inseparable. CoPs appeared to offer the key to reversing the failure of some of the earlier technologically based attempts to manage knowledge. However, the original CoP concept was built around a very different set of principles to those put forward by the proponents of KM. This paper presents a critical review of some of the claims made for CoPs. It will address questions such as "Are CoPs really suitable for use in a business setting?" and "Can a CoP ever be truly virtual?"Communities of Practice, Knowledge Management, Business Environment, Virtual Environment, Social Networks.

An interdisciplinary study of information systems: Christopher Alexander and IS failure.

This paper describes work carried out at the University of York; its contents do not represent the views or opinions of BT. It provides an example of how insights into the field of IS can be gained by looking at it from the perspective of other academic disciplines. Based on the idea that physical and virtual office spaces exist to serve parallel organisational requirements, it is argued that designers of information systems (IS) should be able to learn from the experience of architects in order to improve their methods and redefine their objectives. Firstly, the work of Christopher Alexander is reviewed to show how his work on architectural patterns has been of value to the designers object-oriented systems. Secondly, similarities in the literature between notions of failure in architecture and IS design are identified. These are then examined through interviews with practitioners to establish the relevance of the approach. Finally, the area that Alexander described as ‘the quality without a name’ is highlighted as a topic for further research.Information Systems, Patterns, Virtual Office, Christopher Alexander

The Concept of Appropriation as a Heuristic for Conceptualising the Relationship between Technology, People and Organisations.

The stated aim of this conference is to debate the continuing evolution of IS in businesses and other organisations. This paper seeks to contribute to this debate by exploring the concept of appropriation from a number of different epistemological, cultural and linguistic viewpoints to allow us to explore 'the black box' of appropriation and to gain a fuller understanding of the term. At the conceptual level, it will examine some of the different ways in which people have attempted to explain the relationship between the objective and concrete features of technology and the subjective and shifting nature of the people and organisation within which that technology is deployed. At the cultural and linguistic level the paper will examine the notion as it is found in the Francophone literature, where the term has a long and rich history, and the Anglophone literature where appropriation is seen as a rather more specialist term. The paper will conclude with some observations on the ongoing nature of the debate, the value of reading beyond the literature with which one is familiar and the rewards that come from exploring different historical (and linguistic) viewpoints.Appropriation; Heuristic; Technology; People; Organisations