Description and process evaluation of pharmacists’ interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial)

Objective To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. Methods PINCER pharmacists manually recorded patients’ demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded and double entered into SPSS v15, and then summarised using percentages for categorical data (with 95% CI) and, as appropriate, means (SD) or medians (IQR) for continuous data. Key findings Pharmacists spent a median of 20 minutes (IQR 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95%CI 70, 74) (1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95%CI 73, 76) (1516/2038) of cases and 1685 actions were taken in 61% (95%CI 59, 63) (1246/2038) of cases; 66% (95%CI 64, 68) (1383/2105) of interventions recommended by pharmacists were completed and 5% (95%CI 4, 6) (104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists’ placement; the remaining recommendations were rejected or considered not relevant by GPs. Conclusions The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training.

Stage level measurement of information and communication technology in organizations

Na moderna Economia do Conhecimento, na Era do Big Data, entender corretamente o uso e a gestão da Tecnologia de Informação e Comunicação (TIC) tendo como base o campo acadêmico de estudos de Sistemas de Informação (SI), torna-se cada vez mais relevante e estratégico para as organizações que pretendem: permanecer em atividade, estar aptas para atender novas demandas (internas e externas) e enfrentar as complexas mudanças na competição de mercado. Esta pesquisa utiliza a teoria dos estágios de crescimento, fundamentada pelos estudos de Richard L. Nolan nos anos 70. A literatura acadêmica relacionada com modelos de estágios de crescimento e o contexto do campo de estudo de SI, fornecem as bases conceituais deste estudo. A pesquisa identifica um modelo com seus construtos relacionados aos estágios de crescimento das iniciativas da TIC/SI organizacional, partindo das variáveis de benchmark de segundo nível de Nolan, e propõe sua operacionalização com a criação e desenvolvimento de uma escala. De caráter exploratório e descritivo, a pesquisa traz contribuição teórica ao paradigma da teoria dos estágios de crescimento, adicionando um novo processo de crescimento em sua estrutura conceitual. Como resultado, é disponibilizado além de um instrumento de escala bilíngue (português e inglês), recomendações e regras para aplicação de um instrumento de pesquisa do tipo survey, na continuidade deste estudo. Como implicação geral desta pesquisa, é esperado que seu uso e aplicação ao mensurar a avaliação do nível de estágio da TIC/SI em organizações, possam auxiliar dois perfis de indivíduos: acadêmicos que estudam essa temática, assim como, profissionais que buscam respostas de suas ações práticas nas organizações onde trabalham.

Development strategies for the information and communications technology sector in the Caribbean: A global perspective

This occasional paper examines the experiences of three leading global centres of the ICT industry – India, Silicon Valley, and Estonia – to reflect on how the lessons of these models can be applied to the context of countries in the Caribbean region.Several sectors of the technology industry are considered in relation to the suitability for their establishment in the Caribbean. Animation is an area that is showing encouraging signs of development in several countries, and which offers some promise to provide a significant source of employment in the region. However, the global market for animation production is likely to become increasingly competitive, as improved technology has reduced barriers to entry into the industry not only in the Caribbean, but around the world. The region’s animation industry will need to move swiftly up the value chain if it is to avoid the downsides of being caught in an increasingly commoditized market. Mobile applications development has also been widely a heralded industry for the Caribbean. However, the market for consumer-oriented smartphone applications has matured very quickly, and is now a very difficult sector in which to compete. Caribbean mobile developers would be better served to focus on creating applications to suit the needs of regional industries and governments, rather than attempting to gain notice in over-saturated consumer marketplaces such as the iTunes App Store and Google Play. Another sector considered for the Caribbean is “big data” analysis. This area holds significant potential for growth in coming years, but the Caribbean, which is generally considered to be a datapoor region, currently lacks a sufficient base of local customers to form a competitive foundation for such an industry. While a Caribbean big data industry could plausibly be oriented toward outsourcing, that orientation would limit positive externalities from the sector, and benefits from its establishment would largely accrue only to a relatively small number of direct participants in the industry. Instead, development in the big data sector should be twinned with the development of products to build a regional customer base for the industry. The region has pressing needs in areas such as disaster risk reduction, water resource management, and support for agricultural production. Development of big data solutions – and other technology products – to address areas such as these could help to establish niche industries that both support the needs of local populations, and provide viable opportunities for the export of higher-value products and services to regions of the world with similar needs.

Global practice experience: A useful lens for understanding patient and staff perceptions of successful integration of health information technology in primary care

Making healthcare comprehensive and more efficient remains a complex challenge. Health Information Technology (HIT) is recognized as an important component of this transformation but few studies describe HIT adoption and it's effect on the bedside experience by physicians, staff and patients. This study applied descriptive statistics and correlation analysis to data from the Patient-Centered Medical Home National Demonstration Project (NDP) of the American Academy of Family Physicians. Thirty-six clinics were followed for 26 months by clinician/staff questionnaires and patient surveys. This study characterizes those clinics as well as staff and patient perspectives on HIT usefulness, the doctor-patient relationship, electronic medical record (EMR) implementation, and computer connections in the practice throughout the study. The Global Practice Experience factor, a composite score related to key components of primary care, was then correlated to clinician and patient perspectives. This study found wide adoption of HIT among NDP practices. Patient perspectives on HIT helpfulness on the doctor-patient showed a suggestive trend that approached statistical significance (p = 0.172). Clinicians and staff noted successful integration of EMR into clinic workflow and their perception of helpfulness to the doctor-patient relationship show a suggestive increase also approaching statistical significance (p=0.06). GPE was correlated with clinician/staff assessment of a helpful doctor-patient relationship midway through the study (R 0.460, p = 0.021) with the remaining time points nearing statistical significance. GPE was also correlated to both patient perspectives of EMR helpfulness in the doctor-patient relationship (R 0.601, p = 0.001) and computer connections (R 0.618, p = 0.0001) at the start of the study. ^

Efficiency analysis of information technology and online social networks management : an integrated DEA-Model assessment

This paper analyses the relationship between productive efficiency and online-social-networks (OSN) in Spanish telecommunications firms. A data-envelopment-analysis (DEA) is used and several indicators of business ?social Media? activities are incorporated. A super-efficiency analysis and bootstrapping techniques are performed to increase the model?s robustness and accuracy. Then, a logistic regression model is applied to characterise factors and drivers of good performance in OSN. Results reveal the company?s ability to absorb and utilise OSNs as a key factor in improving the productive efficiency. This paper presents a model for assessing the strategic performance of the presence and activity in OSN.

The causal relationship between information and communication technology and foreign direct investment

This paper investigates the simultaneous causal relationship between investments in information and communication technology (ICT) and flows of foreign direct investment (FDI), with reference to its implications on economic growth. For the empirical analysis we use data from 23 major countries with heterogeneous economic development for the period 1976-99. Our causality test results suggest that there is a causal relationship from ICT to FDI in developed countries, which means that a higher level of ICT investment leads to an increase inflow of FDI. ICT may contribute to economic growth indirectly by attracting more FDI. Contrarily, we could not find significant causality from ICT to FDI in developing countries. Instead, we have partial evidence of opposite causality relationship: the inflow of FDI causes further increases in ICT investment and production capacity. © United Nations University 2006.

Information and Communication Technology (ICT) international spillovers

As information and communications technology (ICT) involves both traditional capital and knowledge capital, potential spillovers through various mechanisms can occur. Having tried to confirm the existence of ICT spillovers across country borders as Park et al. (Inf. Syst. Res., vol. 18, pp. 86-102, 2007), we investigate the patterns and mechanisms of international ICT spillovers. We use panel data on 37 countries from 1996 to 2004. We find that developing countries could reap more benefits from ICT spillovers than developed countries. We also find that the higher the Internet penetration rate in recipient countries, the more international ICT spillovers there might exist. Our findings are important for policy decisions regarding national trade liberalization and economic integration. Developing economies that are more open to foreign trade may have an economic advantage and may develop knowledge-intensive activities, which will lead to economic development in the long run.

Information and communication technology (ICT) and human development

Using panel data for 41 developed and developing countries over the period 1998-2004, this paper examines the links between ICT diffusion and human development. We conducted a panel regression analysis of the investments in healthcare, education and information and communication technology (ICT) against human development index (HDI). The results show that these variables can be used to predict HDI scores. In agreement with findings of previous research, it is clear from our analysis that the central focus on ICT as a solution for development will not bring the results that the promoters of ICT as an ‘engine of growth’ are expecting. It is unwise to disaggregate the issues of education and healthcare infrastructure from ICT infrastructure development. ICT policies should be integrated with other national policies in order to find a holistic and structural solution to development.

The impact of information and communication technology (ICT), education and regulation on economic freedom in Islamic Middle Eastern countries

Our study investigated the impact of ICT expansion on economic freedom in the Middle East (Bahrain, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen). Our empirical analysis used archival data from 1995 to 2005; it showed that ICT expansion in the Middle East has been effective both in bridging the digital divide and also in promoting economic freedom in a region that was vulnerable to political, social, and global conflict. However, differences between countries, such as the educational attainment of their citizens and institutional resistance to technology acceptance, both enhanced and restricted the relationship between ICT and economic freedom.

Information and communication technology demands at work : the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata

PURPOSE: The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata. METHODS: This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates. RESULTS: ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p < 0.01) and effort (r = 0.51; p < 0.01) dimensions. ICT demands were associated with suboptimal self-rated health, also after adjustment for age, sex, SES, lifestyle and BMI (OR 1.49 [95 % CI 1.36-1.63]), but job strain (OR 1.93 [95 % CI 1.74-2.14) and ERI (OR 2.15 [95 % CI 1.95-2.35]) showed somewhat stronger associations with suboptimal self-rated health. CONCLUSION: ICT demands are common among people with intermediate and high SES and associated with job strain, ERI and suboptimal self-rated health. ICT demands should thus be acknowledged as a potential stressor of work-related stress in modern working life.

p-BioSPRE-an information and communication technology framework for transnational biomaterial sharing and access

Biobanks represent key resources for clinico-genomic research and are needed to pave the way to personalised medicine. To achieve this goal, it is crucial that scientists can securely access and share high-quality biomaterial and related data. Therefore, there is a growing interest in integrating biobanks into larger biomedical information and communication technology (ICT) infrastructures. The European project p-medicine is currently building an innovative ICT infrastructure to meet this need. This platform provides tools and services for conducting research and clinical trials in personalised medicine. In this paper, we describe one of its main components, the biobank access framework p-BioSPRE (p-medicine Biospecimen Search and Project Request Engine). This generic framework enables and simplifies access to existing biobanks, but also to offer own biomaterial collections to research communities, and to manage biobank specimens and related clinical data over the ObTiMA Trial Biomaterial Manager. p-BioSPRE takes into consideration all relevant ethical and legal standards, e.g., safeguarding donors’ personal rights and enabling biobanks to keep control over the donated material and related data. The framework thus enables secure sharing of biomaterial within open and closed research communities, while flexibly integrating related clinical and omics data. Although the development of the framework is mainly driven by user scenarios from the cancer domain, in this case, acute lymphoblastic leukaemia and Wilms tumour, it can be extended to further disease entities.

Variable Demand and Profitability in Service Companies: a case study in the information technology sector

Managing a variable demand scenario is particularly challenging on services organizations because services companies usually have a major part of fixed costs. The article studies how a services organization manages its demand variability and its relation with the organization`s profitability. Moreover, the study searched for alternatives used to reduce the demand variability`s impact on the profitability of the company. The research was based on a case study with a Brazilian services provider on information technology business. The study suggests that alternatives like using outsourced employees to cover demand peaks may bring benefits only on short term, reducing the profitability of the company on long term: Some options are revealed, like the internationalization of employees and the investment on developing its own workforce.