Understanding the dynamics of information technology implementation: The case of clinical information systems

The ultimate intent of this dissertation was to broaden and strengthen our understanding of IT implementation by emphasizing research efforts on the dynamic nature of the implementation process. More specifically, efforts were directed toward opening the "black box" and providing the story that explains how and why contextual conditions and implementation tactics interact to produce project outcomes. In pursuit of this objective, the dissertation was aimed at theory building and adopted a case study methodology combining qualitative and quantitative evidence. Precisely, it examined the implementation process, use and consequences of three clinical information systems at Jackson Memorial Hospital, a large tertiary care teaching hospital.^ As a preliminary step toward the development of a more realistic model of system implementation, the study proposes a new set of research propositions reflecting the dynamic nature of the implementation process.^ Findings clearly reveal that successful implementation projects are likely to be those where key actors envision end goals, anticipate challenges ahead, and recognize the presence of and seize opportunities. It was also found that IT implementation is characterized by the systems theory of equifinality, that is, there are likely several equally effective ways to achieve a given end goal. The selection of a particular implementation strategy appears to be a rational process where actions and decisions are largely influenced by the degree to which key actors recognize the mediating role of each tactic and are motivated to action. The nature of the implementation process is also characterized by the concept of "duality of structure," that is, context and actions mutually influence each other. Another key finding suggests that there is no underlying program that regulates the process of change and moves it form one given point toward a subsequent and already prefigured end. For this reason, the implementation process cannot be thought of as a series of activities performed in a sequential manner such as conceived in stage models. Finally, it was found that IT implementation is punctuated by a certain indeterminacy. Results suggest that only when substantial efforts are focused on what to look for and think about, it is less likely that unfavorable and undesirable consequences will occur. ^

Social construction of Geographic Information Systems. (Volumes I and II)

Geographic Information Systems (GIS) is an emerging information technology (IT) which promises to have large scale influences in how spatially distributed resources are managed. It has had applications in the management of issues as diverse as recovering from the disaster of Hurricane Andrew to aiding military operations in Desert Storm. Implementation of GIS systems is an important issue because there are high cost and time involvement in setting them up. An important component of the implementation problem is the "meaning" different groups of people who are influencing the implementation give to the technology. The research was based on the theory of (theoretical stance to the problem was based on the) "Social Construction of Knowledge" systems which assumes knowledge systems are subject to sociological analysis both in usage and in content. An interpretive research approach was adopted to inductively derive a model which explains how the "meanings" of a GIS are socially constructed. The research design entailed a comparative case analysis over two county sites which were using the same GIS for a variety of purposes. A total of 75 in-depth interviews were conducted to elicit interpretations of GIS. Results indicate that differences in how geographers and data-processors view the technology lead to different implementation patterns in the two sites.

Consequences of interorganizational information systems: An empirical investigation of the effects of EDI use on interorganizational relationships in the retail industry

This dissertation examines the consequences of Electronic Data Interchange (EDI) use on interorganizational relations (IR) in the retail industry. EDI is a type of interorganizational information system that facilitates the exchange of business documents in structured, machine processable form. The research model links EDI use and three IR dimensions--structural, behavioral, and outcome. Based on relevant literature from organizational theory and marketing channels, fourteen hypotheses were proposed for the relationships among EDI use and the three IR dimensions.^ Data were collected through self-administered questionnaires from key informants in 97 retail companies (19% response rate). The hypotheses were tested using multiple regression analysis. The analysis supports the following hypothesis: (a) EDI use is positively related to information intensity and formalization, (b) formalization is positively related to cooperation, (c) information intensity is positively related to cooperation, (d) conflict is negatively related to performance and satisfaction, (e) cooperation is positively related to performance, and (f) performance is positively related to satisfaction. The results support the general premise of the model that the relationship between EDI use and satisfaction among channel members has to be viewed within an interorganizational context.^ Research on EDI is still in a nascent stage. By identifying and testing relevant interorganizational variables, this study offers insights for practitioners managing boundary-spanning activities in organizations using or planning to use EDI. Further, the thesis provides avenues for future research aimed at understanding the consequences of this interorganizational information technology. ^

Managing conflict in user-oriented development environments: Effects on information systems success

Today, many organizations are turning to new approaches to building and maintaining information systems (I/S) to cope with a highly competitive business environment. Current anecdotal evidence indicates that the approaches being used improve the effectiveness of software development by encouraging active user participation throughout the development process. Unfortunately, very little is known about how the use of such approaches enhances the ability of team members to develop I/S that are responsive to changing business conditions.^ Drawing from predominant theories of organizational conflict, this study develops and tests a model of conflict among members of a development team. The model proposes that development approaches provide the relevant context conditioning the management and resolution of conflict in software development which, in turn, are crucial for the success of the development process.^ Empirical testing of the model was conducted using data collected through a combination of interviews with I/S executives and surveys of team members and business users at nine organizations. Results of path analysis provide support for the model's main prediction that integrative conflict management and distributive conflict management can contribute to I/S success by influencing differently the manifestation and resolution of conflict in software development. Further, analyses of variance indicate that object-oriented development, when compared to rapid and structured development, appears to produce the lowest levels of conflict management, conflict resolution, and I/S success.^ The proposed model and findings suggest academic implications for understanding the effects of different conflict management behaviors on software development outcomes, and practical implications for better managing the software development process, especially in user-oriented development environments. ^

Hospitality Information Systems: Intuitive, Object-Oriented, and Wireless Technology

Automated information system design and implementation is one of the fastest changing aspects of the hospitality industry. During the past several years nothing has increased the professionalism or improved the productivity within the industry more than the application of computer technology. Intuitive software applications, deemed the first step toward making computers more people-literate, object-oriented programming, intended to more accurately model reality, and wireless communications are expected to play a significant role in future technological advancement.

Information systems to support decision-making in *construction owner organizations: A data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, non-integrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. ^ A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. ^ One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects. ^

Analysis of fractured terrain using remote sensing and geographic information systems : establishing a correlation between fracture network properties and vegetation

This research analyzed the spatial relationship between a mega-scale fracture network and the occurrence of vegetation in an arid region. High-resolution aerial photographs of Arches National Park, Utah were used for digital image processing. Four sets of large-scale joints were digitized from the rectified color photograph in order to characterize the geospatial properties of the fracture network with the aid of a Geographic Information System. An unsupervised landcover classification was carried out to identify the spatial distribution of vegetation on the fractured outcrop. Results of this study confirm that the WNW-ESE alignment of vegetation is dominantly controlled by the spatial distribution of the systematic joint set, which in turn parallels the regional fold axis. This research provides insight into the spatial heterogeneity inherent to fracture networks, as well as the effects of jointing on the distribution of surface vegetation in desert environments.

Information systems to support decision-making in construction owner organizations : a data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, nonintegrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects.

Information Discovery on Electronic Health Records Using Authority Flow Techniques

Background As the use of electronic health records (EHRs) becomes more widespread, so does the need to search and provide effective information discovery within them. Querying by keyword has emerged as one of the most effective paradigms for searching. Most work in this area is based on traditional Information Retrieval (IR) techniques, where each document is compared individually against the query. We compare the effectiveness of two fundamentally different techniques for keyword search of EHRs. Methods We built two ranking systems. The traditional BM25 system exploits the EHRs' content without regard to association among entities within. The Clinical ObjectRank (CO) system exploits the entities' associations in EHRs using an authority-flow algorithm to discover the most relevant entities. BM25 and CO were deployed on an EHR dataset of the cardiovascular division of Miami Children's Hospital. Using sequences of keywords as queries, sensitivity and specificity were measured by two physicians for a set of 11 queries related to congenital cardiac disease. Results Our pilot evaluation showed that CO outperforms BM25 in terms of sensitivity (65% vs. 38%) by 71% on average, while maintaining the specificity (64% vs. 61%). The evaluation was done by two physicians. Conclusions Authority-flow techniques can greatly improve the detection of relevant information in EHRs and hence deserve further study.