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.

Semantic service discovery in the service ecosystem

Electronic services are a leitmotif in ‘hot’ topics like Software as a Service, Service Oriented Architecture (SOA), Service oriented Computing, Cloud Computing, application markets and smart devices. We propose to consider these in what has been termed the Service Ecosystem (SES). The SES encompasses all levels of electronic services and their interaction, with human consumption and initiation on its periphery in much the same way the ‘Web’ describes a plethora of technologies that eventuate to connect information and expose it to humans. Presently, the SES is heterogeneous, fragmented and confined to semi-closed systems. A key issue hampering the emergence of an integrated SES is Service Discovery (SD). A SES will be dynamic with areas of structured and unstructured information within which service providers and ‘lay’ human consumers interact; until now the two are disjointed, e.g., SOA-enabled organisations, industries and domains are choreographed by domain experts or ‘hard-wired’ to smart device application markets and web applications. In a SES, services are accessible, comparable and exchangeable to human consumers closing the gap to the providers. This requires a new SD with which humans can discover services transparently and effectively without special knowledge or training. We propose two modes of discovery, directed search following an agenda and explorative search, which speculatively expands knowledge of an area of interest by means of categories. Inspired by conceptual space theory from cognitive science, we propose to implement the modes of discovery using concepts to map a lay consumer’s service need to terminologically sophisticated descriptions of services. To this end, we reframe SD as an information retrieval task on the information attached to services, such as, descriptions, reviews, documentation and web sites - the Service Information Shadow. The Semantic Space model transforms the shadow's unstructured semantic information into a geometric, concept-like representation. We introduce an improved and extended Semantic Space including categorization calling it the Semantic Service Discovery model. We evaluate our model with a highly relevant, service related corpus simulating a Service Information Shadow including manually constructed complex service agendas, as well as manual groupings of services. We compare our model against state-of-the-art information retrieval systems and clustering algorithms. By means of an extensive series of empirical evaluations, we establish optimal parameter settings for the semantic space model. The evaluations demonstrate the model’s effectiveness for SD in terms of retrieval precision over state-of-the-art information retrieval models (directed search) and the meaningful, automatic categorization of service related information, which shows potential to form the basis of a useful, cognitively motivated map of the SES for exploratory search.

Outsourcing and cutting choice in private hospital menus – does it impact on patient foodservice satisfaction?

Patient satisfaction with foodservices is multidimensional. It is well recognised that food and other aspects of foodservice delivery are important elements of patients overall perception of the hospital experience. This study aimed to determine whether menu changes in 2008 at an acute private hospital, considered negative by the dietetic staff, would affect patient satisfaction with the foodservice. Changes to the menu, secondary to the refurbishment of the foodservice facilities decreased the number of choices at breakfast from six to four, and altered the dessert menu to include a larger proportion of commercially produced products. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) was utilised to assess patient satisfaction with the menu changes, as it has proven accuracy and reliability in measuring patient satisfaction. Results of the survey (n=306) were compared to data with previous ACHFPSQ surveys conducted annually since 2003. Data analysed included overall foodservice satisfaction and four dimensions of foodservice satisfaction: food quality, meal service quality, staff/service issues and the physical environment. Satisfaction targets were set at 4 (scale 1–5) for each foodservice dimension. Analysis showed that despite changes to the menu, overall foodservice satisfaction rated high, with a score of 4.3. Eighty-six percent of patients rated the foodservice as either ‘very good’ or ‘good’. The four foodservice dimensions were rated highly (4.2–4.8). Findings were consistent with previous survey results, demonstrating a high level of patient satisfaction across all dimensions of the foodservice, despite changes to the menu. The annual ACHFPSQ was of value to this practice question.

IS service quality as a multi-dimensional formative constuct

This study is motivated by, and proceeds from, a central interest in the importance of evaluating IS service quality and adopts the IS ZOT SERVQUAL instrument (Kettinger & Lee, 2005) as its core theory base. This study conceptualises IS service quality as a multidimensional formative construct and seeks to answer the main research questions: “Is the IS service quality construct valid as a 1st-order formative, 2nd-order formative multidimensional construct?” Additionally, with the aim of validating the IS service quality construct within its nomological net, as in prior service marketing work, Satisfaction was hypothesised as its immediate consequence. With the goal of testing the above research question, IS service quality and Satisfaction were operationalised in a quantitative survey instrument. Partial least squares (PLS), employing 219 valid responses, largely evidenced the validity of IS service quality as a multidimensional formative construct. The nomological validity of the IS service quality construct was also evidenced by demonstrating that 55% of Satisfaction was explained by the multidimensional formative IS service quality construct.

Handbook of service description

With the growth in number and sophistication of services widely available, there is a new urgency for comprehensive service descriptions that take into account both technical and business aspects. The last years have seen a number of efforts for best-of-breed service description focusing on specific aspects of services. The Handbook of Service Description provides the most advanced state of the art insights into these. The main parts of the book provide the most detailed documentation of the Unified Service Description Language (USDL) to date. USDL has been developed across several research institutes and publicly funded projects across Europe and Australia, currently extending to the Americas as part of a standardization push through W3C. The scope of services extends across IT and business, i.e., the socio-technical sense of services scaled to business networks. In this respect, purely human, purely automated and mixed human/automated services were considered, that have a boundary of cognizance that is available through the tasks of service provisioning, discovery, access and delivery. Taken together, the Handbook of Service Description provides a comprehensive reference suitable for a wide-reaching audience including researchers, practitioners, managers, and students who aspire to learn about or to create a deeper scientific foundation for service description and its methodological aspects.

Regional and remote airports under stress in Australia

Australia's airline industry was born on connecting regional communities to major cities, but almost a century later, many regional and remote communities are facing the prospect of losing their air transport services. The focus of this paper is to highlight key issues and concerns surrounding remote, rural and regional airports in Australia using a network governance framework. Contributions are focused towards regional and remote airport managers, decision makers, and policy makers to stimulate further discussion towards retaining regional and remote services to communities.

HRM in professional service firms : engendering commitment to what or whom?

Professional service firms (PSFs) present HR professionals with a number of unique challenges, as they share characteristics of both service and knowledge intensive organizations. While many of these firms are relying on High Commitment Work Practices (HCWPs) to enhance critical employee behaviors such as service quality and turnover, the analysis presented in this paper raises questions about traditional understandings of commitment in professional service environments. In particular, data from three Danish financial investment PSFs suggest that employees are more committed to developing and promoting their own professions than to the organization itself, which has important implications for the way in which HCWPs are designed and utilized. In addition, the focus of HCWP research has favored the use of social exchange theory as an underpinning framework for considering the impact of HR practices on employee commitment. In the context of PSFs, we question the applicability of social exchange theory and instead draw upon the Ability-Motivation-Opportunity (AMO) framework (1982) to analyze how specific HRM practices contribute to the development of commitment, and to successful organizational outcomes in PSFs.

Pervasive technology and public transport : opportunities beyond telematics

The advancements of technology in the field of public transport have been considerable. Information Technology (IT) has made the dissemination of information effortless, contributing to reduced perceived waiting time, increased sense of security, and value for money. Nevertheless, and in light of the ever more obvious widespread presence of powerful mobile devices, it seems that the use of technology may be geared towards supplementary services other than telematics. Looking at it from a passenger’s perspective, this article provides an overview of what IT-based services are currently offered in public transport and what is their assessed impact. We finalise by putting forward possible directions that future services might follow, and stress out the necessity to come up with frameworks that enable for the impact assessment on service quality and customer satisfaction.

The relationship between unsafe working conditions and workers’ behavior and their impacts on injury severity in the U.S.

Unsafe acts of workers (e.g. misjudgment, inappropriate operation) become the major root causes of construction accidents when they are combined with unsafe working conditions (e.g. working surface conditions, weather) on a construction site. The overarching goal of the research presented in this paper is to explore ways to prevent unsafe acts of workers and reduce the likelihood of construction accidents occurring. The study specifically aims to (1) understand the relationships between human behavior related and working condition related risk factors, (2) identify the significant behavior and condition factors and their impacts on accident types (e.g. struck by/against, caught in/between, falling, shock, inhalation/ingestion/absorption, respiratory failure) and injury severity (e.g. fatality, hospitalized, non-hospitalized), and (3) analyze the fundamental accident-injury relationship on how each accident type contributes to the injury severity. The study reviewed 9,358 accidents which occurred in the U.S. construction industry between 2002 and 2011. The large number of accident samples supported reliable statistical analyses. The analysis identified a total of 17 significant correlations between behavior and condition factors and distinguished key risk factors that highly impacted on the determination of accident types and injury severity. The research outcomes will assist safety managers to control specific unsafe acts of workers by eliminating the associated unsafe working conditions and vice versa. They also can prioritize risk factors and pay more attention to controlling them in order to achieve a safer working environment.

Meaning or measurement? Researching the social contexts of health and settlement among newly-arrived refugee youth in Melbourne, Australia

What are the most appropriate methodological approaches for researching the psychosocial determinants of health and wellbeing among young people from refugee backgrounds over the resettlement period? What kinds of research models can involve young people in meaningful reflections on their lives and futures while simultaneously yielding valid data to inform services and policy? This paper reports on the methods developed for a longitudinal study of health and wellbeing among young people from refugee backgrounds in Melbourne, Australia. The study involves 100 newly-arrived young people 12 to 18 years of age, and employs a combination of qualitative and quantitative methods implemented as a series of activities carried out by participants in personalized settlement journals. This paper highlights the need to think outside the box of traditional qualitative and/or quantitative approaches for social research into refugee youth health and illustrates how integrated approaches can produce information that is meaningful to policy makers, service providers and to the young people themselves.

Satisfiers and dissatisfiers for international students of higher education : an exploratory study in Australia

This paper explores the main satisfiers and dissatisfiers for international students in Australia’s higher educational sector. Using a critical incident technique, this study is conducted with international students of higher education in Australia. Four categories of satisfiers and dissatisfiers emerge from the data which are related to individual performance, quality of the educational service, socialisation, and living conditions.

Weight stigma in maternity care : women's experiences and care providers' attitudes

Background: Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods: Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results: Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal weight pregnant women. Even care providers who reported few weight-stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions: Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

Analysis of multilateral service conversations in global business networks

The rapid growth of services available on the Internet and exploited through ever globalizing business networks poses new challenges for service interoperability. New services, from consumer “apps”, enterprise suites, platform and infrastructure resources, are vying for demand with quickly evolving and overlapping capabilities, and shorter cycles of extending service access from user interfaces to software interfaces. Services, drawn from a wider global setting, are subject to greater change and heterogeneity, demanding new requirements for structural and behavioral interface adaptation. In this paper, we analyze service interoperability scenarios in global business networks, and propose new patterns for service interactions, above those proposed over the last 10 years through the development of Web service standards and process choreography languages. By contrast, we reduce assumptions of design-time knowledge required to adapt services, giving way to run-time mismatch resolutions, extend the focus from bilateral to multilateral messaging interactions, and propose declarative ways in which services and interactions take part in long-running conversations via the explicit use of state.

Bus and car travel time on urban networks : integrating Bluetooth and bus vehicle identification data

Travel time in an important transport performance indicator. Different modes of transport (buses and cars) have different mechanical and operational characteristics, resulting in significantly different travel behaviours and complexities in multimodal travel time estimation on urban networks. This paper explores the relationship between bus and car travel time on urban networks by utilising the empirical Bluetooth and Bus Vehicle Identification data from Brisbane. The technologies and issues behind the two datasets are studied. After cleaning the data to remove outliers, the relationship between not-in-service bus and car travel time and the relationship between in-service bus and car travel time are discussed. The travel time estimation models reveal that the not-in-service bus travel time are similar to the car travel time and the in-service bus travel time could be used to estimate car travel time during off-peak hours

Riding a mile in their shoes : understanding Australian metropolitan rail passenger perceptions and experiences of crowdedness using mixed-methods research

Metrics such as passengers per square metre have been developed to define optimum or crowded rail passenger density. Whilst such metrics are important to operational procedures, service evaluation and reporting, they fail to fully capture and convey the ways in which passengers experience crowded situations. This paper reports findings from a two year study of rail passenger crowding in five Australian capital cities which involved a novel mixed-methodology including ethnography, focus groups and an online stated preference choice experiment. The resulting data address the following four fundamental research questions: 1) to what extent are Australian rail passengers concerned by crowding, 2) what conditions exacerbate feelings of crowdedness, 3) what conditions mitigate feelings of crowdedness, and 4) how can we usefully understand passengers’ experiences of crowdedness? It concludes with some observations on the significance and implications of these findings for customer service provision. The findings outlined in this paper demonstrate that the experience of crowdedness (including its tolerance) cannot be understood in isolation from other customer services issues such as interior design, quality of environment, safety and public health concerns. It is hypothesised that tolerance of crowding will increase alongside improvements to overall customer service. This was the first comprehensive study of crowding in the Australian rail industry.