476 resultados para Integrated Information Systems


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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.

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Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

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There have been powerful incentives for Tasmanian Small and Medium-sized Enterprises (SMEs) to adopt information technology to enable them to remain competitive and to comply with legislative regulations. This research study was undertaken to establish whether SMEs implementing computerised accounting systems have a subsequent change in their external accountancy fees. The research study employed a quantitative methodology using survey questionnaires. The study found that in less than 3% of cases SMEs reported a decrease in accountancy fees, in almost 45% of cases the organisation actually experienced a slight to substantial fee increase while 52% reported no change in accountancy fees.

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Evidence-based practice is increasingly being recognised as an important issue in a range of professional contexts including education, nursing, occupational therapy and librarianship. Many of these professions have observed a relationship or interface between evidence-based practice and information literacy. Using a phenomenographic approach this research explores variation in the how library and information professionals are experiencing evidence-based practice as part of their professional work. The findings of the research provide a basis for arguing that evidence-based practice represents the professional's enactment of information literacy in the workplace.

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The field of collaborative health planning faces significant challenges created by the narrow focus of the available information, the absence of a framework to organise that information and the lack of systems to make information accessible and guide decision-making. These challenges have been magnified by the rise of the ‘healthy communities movement’, as a result of which, there have been more frequent calls for localised, collaborative and evidence-driven health related decision-making. This paper discusses the role of decision support systems as a mechanism to facilitate collaborative health decision-making. The paper presents a potential information management framework to underpin a health decision support system and describes the participatory process that is currently being used to create an online tool for health planners using geographic information systems. The need for a comprehensive information management framework to guide the process of planning for healthy communities has been emphasised. The paper also underlines the critical importance of the proposed framework not only in forcing planners to engage with the entire range of health determinants, but also in providing sufficient flexibility to allow exploration of the local setting-based determinants of health.

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A graduate destination survey can provide a snap shot in time of a graduate’s career progression and outcome. This paper will present the results of a Queensland University of Technology study exploring the employment outcomes of students who had completed a library and information science course from the Faculty of Information Technology between 2000 and 2008. Seventy-four graduates completed an online questionnaire administered in July 2009. The study found that 90% of the graduates surveyed were working and living in Queensland, with over three quarters living and working in Brisbane. Nearly 70% were working full-time, while only 1.4% indicating that they were unemployed and looking for work. Over 80% of the graduates identified themselves as working in “librarianship”. This study is the first step in understanding the progression and destination of QUT’s library and information science graduates. It is recommended that this survey becomes an ongoing initiative so that the results can be analysed and compared over time.

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Jordan is adopting Enterprise Resource Planning (ERP) systems in both its public and private sectors. Jordan's emerging private sector has historically close ties to the public sector; though a global market orientation requires a shift in its organizational culture. ERPs however embed business processes which do not necessarily fit with traditional cultural practices, and implementation success is not assured. This study looks at the perceptions of both public and private sector ERP implementations in Jordan and assesses these on various measures of success. There were few differences between public and private sectors, but the benefits actually realized in Jordanian ERPs fell short of claims made for the technology in other cultures.

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This paper proposes a security architecture for the basic cross indexing systems emerging as foundational structures in current health information systems. In these systems unique identifiers are issued to healthcare providers and consumers. In most cases, such numbering schemes are national in scope and must therefore necessarily be used via an indexing system to identify records contained in pre-existing local, regional or national health information systems. Most large scale electronic health record systems envisage that such correlation between national healthcare identifiers and pre-existing identifiers will be performed by some centrally administered cross referencing, or index system. This paper is concerned with the security architecture for such indexing servers and the manner in which they interface with pre-existing health systems (including both workstations and servers). The paper proposes two required structures to achieve the goal of a national scale, and secure exchange of electronic health information, including: (a) the employment of high trust computer systems to perform an indexing function, and (b) the development and deployment of an appropriate high trust interface module, a Healthcare Interface Processor (HIP), to be integrated into the connected workstations or servers of healthcare service providers. This proposed architecture is specifically oriented toward requirements identified in the Connectivity Architecture for Australia’s e-health scheme as outlined by NEHTA and the national e-health strategy released by the Australian Health Ministers.

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This teaching case aims to contribute to understanding the phenomenon of Enterprise Systems (ES) implementations in universities. Through this case, students will gain understanding of the importance of ‘contextual elements’ for large scale information systems (IS) implementations, in particular ES. This teaching case illustrates how these contextual factors contribute to the success or failure of such implementations, and how they can influence the decisions that dictate the lifecycle of such systems. The case describes ES implementations at a leading Australian university, and presents a rich account of the institutional, national and industry-sector contexts that have influenced the directions and decisions taken. The journey encountered with the main Enterprise Systems that support Financials, Human Resources and Facilities are described suggesting the lifecycle phases, critical success factors and lessons learnt.

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The impact of government policy can become a strong enabler for the use of e-portfolios to support learning and employability. E-portfolio policy and practice seeks to draw together the different elements of integrated education and learning, graduate attributes, employability skills, professional competencies and lifelong learning, ultimately to support an engaged and productive workforce. Drawing on and updating the research findings from a nationwide research study conducted as part of the Australian ePortfolio Project, the present chapter discusses two important areas of the e-portfolio environment, government policy and academic policy. The focus is on those jurisdictions where government and academic policy issues have had a significant impact on e-portfolio practice, such as the European Union, the Netherlands, Scandinavian countries and the United Kingdom, as well as in Australia and New Zealand. These jurisdictions are of interest as government policy discussions are currently focusing on the need for closer integration between the different education and employment sectors. Finally, issues to be considered as well as strategies for driving policy decision making are presented.

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In a resource constrained business world, strategic choices must be made on process improvement and service delivery. There are calls for more agile forms of enterprises and much effort is being directed at moving organizations from a complex landscape of disparate application systems to that of an integrated and flexible enterprise accessing complex systems landscapes through service oriented architecture (SOA). This paper describes the deconstruction of an enterprise into business services using value chain analysis as each element in the value chain can be rendered as a business service in the SOA. These business services are explicitly linked to the attainment of specific organizational strategies and their contribution to the attainment of strategy is assessed and recorded. This contribution is then used to provide a rank order of business service to strategy. This information facilitates executive decision making on which business service to develop into the SOA. The paper describes an application of this Critical Service Identification Methodology (CSIM) to a case study.

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Introduction - The planning for healthy cities faces significant challenges due to lack of effective information, systems and a framework to organise that information. Such a framework is critical in order to make accessible and informed decisions for planning healthy cities. The challenges for planning healthy cities have been magnified by the rise of the healthy cities movement, as a result of which, there have been more frequent calls for localised, collaborative and knowledge-based decisions. Some studies have suggested that the use of a ‘knowledge-based’ approach to planning will enhance the accuracy and quality decision-making by improving the availability of data and information for health service planners and may also lead to increased collaboration between stakeholders and the community. A knowledge-based or evidence-based approach to decision-making can provide an ‘out-of-the-box’ thinking through the use of technology during decision-making processes. Minimal research has been conducted in this area to date, especially in terms of evaluating the impact of adopting knowledge-based approach on stakeholders, policy-makers and decision-makers within health planning initiatives. Purpose – The purpose of the paper is to present an integrated method that has been developed to facilitate a knowledge-based decision-making process to assist health planning Methodology – Specifically, the paper describes the participatory process that has been adopted to develop an online Geographic Information System (GIS)-based Decision Support System (DSS) for health planners. Value – Conceptually, it is an application of Healthy Cities and Knowledge Cities approaches which are linked together. Specifically, it is a unique settings-based initiative designed to plan for and improve the health capacity of Logan-Beaudesert area, Australia. This setting-based initiative is named as the Logan-Beaudesert Health Coalition (LBHC). Practical implications - The paper outlines the application of a knowledge-based approach to the development of a healthy city. Also, it focuses on the need for widespread use of this approach as a tool for enhancing community-based health coalition decision making processes.