An empirical investigation of health information system failure in regional Sri Lanka

Public health decision making is critically dependant on accurate, timely and reliable information. There is a widespread belief that most of the national and sub-national health information systems fail in providing much needed information support for evidence based health planning and interventions. This situation is more acute in developing nations where resources are either stagnant or decreasing, coupled with the situations of demographic transition and double burden of diseases. Literature abounds with publications, which provide information on misguided health interventions in developing nations, leading to failure and waste of resources. Health information system failure is widely blamed for this situation. Nevertheless, there is a dearth of comprehensive evaluations of existing national or sub-national health information systems, especially in the region of South-East Asia. This study makes an attempt to bridge this knowledge gap by evaluating a regional health information system in Sri Lanka. It explores the strengths and weaknesses of the current health information system and related causative factors in a decentralised health system and then proposes strategic recommendations for reform measures. A mix methodological and phased approach was adopted to reach the objectives. An initial self administered questionnaire survey was conducted among health managers to study their perceptions in relation to the regional health information system and its management support. The survey findings were used to establish the presence of health information system failure in the region and also as a precursor to the more in-depth case study which was followed. The sources of data for the case study were literature review, document analysis and key stake holder interviews. Health information system resources, health indicators, data sources, data management, data quality, and information dissemination were the six major components investigated. The study findings reveal that accurate, timely and reliable health information is unavailable and therefore evidence based health planning is lacking in the studied health region. Strengths and weaknesses of the current health information system were identified and strategic recommendations were formulated accordingly. It is anticipated that this research will make a significant and multi-fold contribution for health information management in developing countries. First, it will attempt to bridge an existing knowledge gap by presenting the findings of a comprehensive case study to reveal the strengths and weaknesses of a decentralised health information system in a developing country. Second, it will enrich the literature by providing an assessment tool and a research method for the evaluation of regional health information systems. Third, it will make a rewarding practical contribution by presenting valuable guidelines for improving health information systems in regional Sri Lanka.

Multi-level information fusion for environment aware robotic navigation

This thesis develops the hardware and software framework for an integrated navigation system. Dynamic data fusion algorithms are used to develop a system with a high level of resistance to the typical problems that affect standard navigation systems.

A hybrid of modified PSO and local search on a multi-robot search system

Particle swarm optimization (PSO), a new population based algorithm, has recently been used on multi-robot systems. Although this algorithm is applied to solve many optimization problems as well as multi-robot systems, it has some drawbacks when it is applied on multi-robot search systems to find a target in a search space containing big static obstacles. One of these defects is premature convergence. This means that one of the properties of basic PSO is that when particles are spread in a search space, as time increases they tend to converge in a small area. This shortcoming is also evident on a multi-robot search system, particularly when there are big static obstacles in the search space that prevent the robots from finding the target easily; therefore, as time increases, based on this property they converge to a small area that may not contain the target and become entrapped in that area.Another shortcoming is that basic PSO cannot guarantee the global convergence of the algorithm. In other words, initially particles explore different areas, but in some cases they are not good at exploiting promising areas, which will increase the search time.This study proposes a method based on the particle swarm optimization (PSO) technique on a multi-robot system to find a target in a search space containing big static obstacles. This method is not only able to overcome the premature convergence problem but also establishes an efficient balance between exploration and exploitation and guarantees global convergence, reducing the search time by combining with a local search method, such as A-star.To validate the effectiveness and usefulness of algorithms,a simulation environment has been developed for conducting simulation-based experiments in different scenarios and for reporting experimental results. These experimental results have demonstrated that the proposed method is able to overcome the premature convergence problem and guarantee global convergence.

An online urban information system initiative for the Shibuya city, Tokyo

The computing tools and technologies with urban information systems are designed to enhance planners’ capability to deal with complex urban environments and to plan for prosperous and liveable communities. This paper examines the role of Online Urban Information Systems or in another words Internet based Geographic Information Systems as spatial decision support systems to aid local planning process. This paper introduces a prototype Internet GIS model that aims to integrate a public oriented interactive decision support system for urban planning process. This model, referred as a ‘Community based Internet GIS’, incorporates advanced information technologies and community involvement in decision making processes on the web environment. This innovative model has been recently applied to a pilot case in Tokyo and this paper concludes with the preliminary results of this project.

Reconceptualising the information system as a service

The study will cross-fertilise Information Systems (IS) and Services Marketing ideas through reconceptualising the information system as a service (ISaaS). The study addresses known limitations of arguably the two most significant dependent variables in these disciplines - Information System Success or IS-Impact, and Service Quality. Planned efforts to synthesise analogous conceptions across these disciplines, are expected to force a deeper theoretical understanding of the broad notions of success, quality, value and satisfaction and their interrelations. The aims of this research are to: (1) yield a conceptually superior and more extensively validated IS success measurement model, and (2) develop and operationalise a more rigorously validated Service Quality measurement model, while extending the ‘service’ notion to ‘operational computer-based information systems in organisations’. In the development of the new models the study will address contemporary validation issues.

The impact of usability on clinician acceptance of a health information system

The two longitudinal case studies that make up this dissertation sought to explain and predict the relationship between usability and clinician acceptance of a health information system. The overall aim of the research study was to determine what role usability plays in the acceptance or rejection of systems used by clinicians in a healthcare context. The focus was on the end users (the clinicians) rather than the views of the system designers and managers responsible for implementation and the clients of the clinicians. A mixed methods approach was adopted that drew on both qualitative and quantitative research methods. This study followed the implementation of a community health information system from early beginnings to its established practice. Users were drawn from different health service departments with distinctly different organisational cultures and attitudes to information and communication technology used in this context. This study provided evidence that a usability analysis in this context would not necessarily be valid when the users have prior reservations on acceptance. Investigation was made on the initial training and post-implementation support together with a study on the nature of the clinicians to determine factors that may influence their attitude. This research identified that acceptance of a system is not necessarily a measure of its quality, capability and usability, is influenced by the user’s attitude which is determined by outside factors, and the nature and quality of training. The need to recognise the limitations of the current methodologies for analysing usability and acceptance was explored to lay the foundations for further research.

TCSC control design for transient stability improvement of a multi-machine power system using trajectory sensitivity

This paper discusses the effects of thyristor controlled series compensator (TCSC), a series FACTS controller, on the transient stability of a power system. Trajectory sensitivity analysis (TSA) has been used to measure the transient stability condition of the system. The TCSC is modeled by a variable capacitor, the value of which changes with the firing angle. It is shown that TSA can be used in the design of the controller. The optimal locations of the TCSC-controller for different fault conditions can also be identified with the help of TSA. The paper depicts the advantage of the use of TCSC with a suitable controller over fixed capacitor operation.

The measurement of information system use: preliminary considerations

The concept of system use has suffered from a "too simplistic definition" (DeLone and McLean [9], p. 16). This paper reviews various attempts at conceptualization and measurement of system use and then proposes a re-conceptualization of it as "the level of incorporation of an information system within a user's processes." We then go on to develop the concept of a Functional Interface Point and four dimensions of system usage: automation level, the proportion of the business process encoded by the information system; extent, the proportion of the FIPs used by the business process; frequency, the rate at which FIPs are used by the participants in the process; and thoroughness, the level of use of information/functionality provided by the system at an FIP. The article concludes with a discussion of some implications of this re-conceptualization and areas for follow on research.

The Measurement of Information System Use: Preliminary Considerations

DeLone and McLean (1992, p. 16) argue that the concept of “system use” has suffered from a “too simplistic definition.” Despite decades of substantial research on system use, the concept is yet to receive strong theoretical scrutiny. Many measures of system use and the development of measures have been often idiosyncratic and lack credibility or comparability. This paper reviews various attempts at conceptualization and measurement of system use and then proposes a re-conceptualization of it as “the level of incorporation of an information system within a user’s processes.” The definition is supported with the theory of work systems, system, and Key-User-Group considerations. We then go on to develop the concept of a Functional- Interface-Point (FIP) and four dimensions of system usage: extent, the proportion of the FIPs used by the business process; frequency, the rate at which FIPs are used by the participants in the process; thoroughness, the level of use of information/functionality provided by the system at an FIP; and attitude towards use, a set of measures that assess the level of comfort, degree of respect and the challenges set forth by the system. The paper argues that the automation level, the proportion of the business process encoded by the information system has a mediating impact on system use. The article concludes with a discussion of some implications of this re-conceptualization and areas for follow on research.

United we stand, divided we fall: the failure of an accounting information system in a major radiology provider

This article explores the way in which a major Australian radiology organization implemented a complex accounting information system and how workers in the 72 radiology practises that had to use it resisted the change. The study reports on the issues that led to the circumvention of the system by individuals and, after only three years, complete withdrawal of the accounting information system by the parent organization. This article has implications for firms in the health care and other sectors considering implementing new accounting information systems. Organizations need to incorporate change management techniques and provide open communication to all stakeholders to minimize disruption and potential problems.