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. ^

The role of neighborhood organizations in the production of gentrifiable urban space: The case of Wynwood, Miami's Puerto Rican barrio

Partnerships between government and community-based actors and organizations are considered the hallmark of contemporary governance arrangements for the revitalization and gentrification of economically distressed, inner city areas. This dissertation uses historical, narrative analysis and ethnographic methods to examine the formation, evolution and operation of community-based governance partnerships in the production of gentrifiable urban space in the Wynwood neighborhood of Miami, FL between 1970 and 2010. This research is based on more than four years of participant observation, 60 in-depth interviews with respondents recruited through a purposive snowball sample, review of secondary and archival sources, and descriptive, statistical and GIS analysis. This study examines how different organizations formed in the neighborhood since the 1970s have facilitated the recent gentrification of Wynwood. It reveals specifically how partnerships between neighborhood-based government agencies, nonprofit organizations and real estate developers were constructed to be exclusionary and lead to inequitable economic development outcomes for Wynwood residents. The key factors conditioning these inequalities include both the rationalities of action of the organizations involved and the historical contexts in which their leaders’ thinking and actions were shaped. The historical contexts included the ethnic politics of organizational funding in the 1970s and the “entrepreneurial” turn of community-based economic development and Miami urban politics since the 1980s. Over time neighborhood organizations adopted highly pragmatic rationalities and repertoires of action. By the 2000s when Wynwood experienced unprecedented investment and redevelopment, the pragmatism of community-based organizations led them to become junior partners in governance arrangements and neighborhood activists were unable to directly challenge the inequitable processes and outcomes of gentrification.

Assessing the impact of business group diversification on the internationalization of their affiliates: The case of Latin American firms

This dissertation explored the capacity of business group diversification to generate value to their affiliates in an institutional environment characterized by the adoption of structural pro-market reforms. In particular, the three empirical essays explored the impact of business group diversification on the internationalization process of their affiliates. ^ The first essay examined the direct effect of business group diversification on firm performance and its moderating effect on the multinationality-performance relationship. It further explored whether such moderating effect varies depending upon whether the focal affiliate is a manufacturing or service firm. The findings suggested that the benefits of business group diversification on firm performance have a threshold, that those benefits are significant at earlier stages of internationalization and that these benefits are stronger for service firms. ^ The second essay studied the capacity of business group diversification to ameliorate the negative effects of the added complexity faced by its affiliates when they internationalized. The essay explored this capacity in different dimensions of international complexity. The results indicated that business group diversification effectively ameliorated the effects of the added international complexity. This positive effect is stronger in the institutional voids rather than the societal complexity dimension. In the former dimension, diversified business groups can use both their non-market resources and previous experience to ameliorate the effects of complexity on firm performance. ^ The last essay explored whether the benefits of business group diversification on the scope-performance relationship varies depending on the level of development of the network of subsidiaries and the region of operation of the focal firm. The results suggested that the benefits of business group diversification are location bound within the region but that they are not related to the level of development of the targeted countries. ^ The three essays use longitudinal analyses on a sample of Latin American firms to test the hypotheses. While the first essay used multilevel models and fix effects models, the last two essays used exclusively fix effects models to assess the impact of business group diversification. In conclusion, this dissertation aimed to explain the capacity of business group diversification to generate value under conditions of institutional change.^

The influence of corporate interests on USAID's development agenda: The case of Haiti

This dissertation is an attempt to use the radical political economy approach, which assumes that there is a connection between a state's strategic interests and the interests of dominant multinational corporations (MNCs) located within a state's territory, to explain continuity in the USAID development agenda and lending patterns during the past 30 years of development aid to Haiti. Employing the qualitative method of "process-tracing," my study concludes that the radical political economy approach has an explanatory power when it comes to understanding continuity in the USAID development agenda and lending patterns during the past 30 years of development aid to Haiti. The evidence shows that USAID has implemented in Haiti, from the 1980s through the post-9/11 Washington Consensus period, neoliberal policies that conform to the political economy of US multinational corporations (US MNCs). Contrary to the claim that the USAID-sponsored post-earthquake development paradigm has departed from previous development strategies, the study has shown that USAID has used the occurrence of the January 2010 earthquake tragedy to accelerate in Haiti the implementation of a neoliberal agenda congenial to the business promotion of multinational investors, particularly US multinational corporations. In terms of the way ahead, the study argues for the implementation of a new development approach articulated by a legitimate Haitian state and primarily intended to promote the socioeconomic development of the poorest Haitians.

Building Regional Security: Cooperation in the 21st Century: The Case of the Caribbean Regional Security System [RSS]

Small states that lack capacity and act on their own may fall victim to international and domestic terrorism, transnational organized crime or criminal gangs. The critical issue is not whether small Caribbean states should cooperate in meeting security challenges, but it is rather in what manner, and by which mechanisms can they overcome obstacles in the way of cooperation. The remit of the Regional Security System (RSS) has expanded dramatically, but its capabilities have improved very slowly. The member governments of the RSS are reluctant to develop military capacity beyond current levels since they see economic and social development and disaster relief as priorities, requiring little investment in military hardware. The RSS depends on international donors such as the USA, Canada, Great Britain, and increasingly China to fund training programs, maintain equipment and acquire material. In the view of most analysts, an expanded regional arrangement based on an RSS nucleus is not likely in the foreseeable future. Regional political consensus remains elusive and the predominance of national interests over regional considerations continues to serve as an obstacle to any CARICOM wide regional defense mechanism. Countries in the Caribbean, including the members of the RSS, have to become more responsible for their own security from their own resources. While larger CARICOM economies can do this, it would be difficult for most OECS members of the RSS to do the same. The CARICOM region including the RSS member countries, have undertaken direct regional initiatives in security collaboration. Implementation of the recommendations of the Regional Task Force on Crime and Security (RTFCS) and the structure and mechanisms created for the staging of the Cricket World Cup (CWC 2007) resulted in unprecedented levels of cooperation and permanent legacy institutions for the regional security toolbox. The most important tier of security relationships for the region is the United States and particularly USSOUTHCOM. The Caribbean Basin Security Initiative [CBSI] in which the countries of the RSS participate is a useful U.S. sponsored tool to strengthen the capabilities of the Caribbean countries and promote regional ownership of security initiatives. Future developments under discussion by policy makers in the Caribbean security environment include the granting of law enforcement authority to the military, the formation of a single OECS Police Force, and the creation of a single judicial and law enforcement space. The RSS must continue to work with its CARICOM partners, as well as with the traditional “Atlantic Powers” particularly Canada, the United States and the United Kingdom to implement a general framework for regional security collaboration. Regional security cooperation should embrace wider traditional and non-traditional elements of security appropriate to the 21st century. Security cooperation must utilize to the maximum the best available institutions, mechanisms, techniques and procedures already available in the region. The objective should not be the creation of new agencies but rather the generation of new resources to take effective operations to higher cumulative levels. Security and non-security tools should be combined for both strategic and operational purposes. Regional, hemispheric, and global implications of tactical and operational actions must be understood and appreciated by the forces of the RSS member states. The structure and mechanisms, created for the staging of Cricket World Cup 2007 should remain as legacy institutions and a toolbox for improving regional security cooperation in the Caribbean. RSS collaboration should build on the process of operational level synergies with traditional military partners. In this context, the United States must be a true partner with shared interests, and with the ability to work unobtrusively in a nationalistic environment. Withdrawal of U.S. support for the RSS is not an option.

The Council on Foreign Relations and the Grand Area: Case Studies on the Origins of the IMF and the Vietnam War

This article examines the role of corporate elites within the Council on Foreign Relations (CFR) in establishing the framework for the IMF and the rationale for the Vietnam War. Drawing on the CFR's War-Peace Study Groups, established in World War II as a conduit between corporate elites and the U.S. government, the author first analyzes the role of corporate power networks in grand area planning. He shows that such planning provided a framework for postwar foreign and economic policymaking. He then documents the relationship between corporate grand area planning and the creation of the IMF. The analysis concludes with an examination of the relationship between grand area planning and the Vietnam War.