Examining the post-adoptive infusion of mobile technology in a healthcare domain: determinants and outcomes

The healthcare industry is beginning to appreciate the benefits which can be obtained from using Mobile Health Systems (MHS) at the point-of-care. As a result, healthcare organisations are investing heavily in mobile health initiatives with the expectation that users will employ the system to enhance performance. Despite widespread endorsement and support for the implementation of MHS, empirical evidence surrounding the benefits of MHS remains to be fully established. For MHS to be truly valuable, it is argued that the technological tool be infused within healthcare practitioners work practices and used to its full potential in post-adoptive scenarios. Yet, there is a paucity of research focusing on the infusion of MHS by healthcare practitioners. In order to address this gap in the literature, the objective of this study is to explore the determinants and outcomes of MHS infusion by healthcare practitioners. This research study adopts a post-positivist theory building approach to MHS infusion. Existing literature is utilised to develop a conceptual model by which the research objective is explored. Employing a mixed-method approach, this conceptual model is first advanced through a case study in the UK whereby propositions established from the literature are refined into testable hypotheses. The final phase of this research study involves the collection of empirical data from a Canadian hospital which supports the refined model and its associated hypotheses. The results from both phases of data collection are employed to develop a model of MHS infusion. The study contributes to IS theory and practice by: (1) developing a model with six determinants (Availability, MHS Self-Efficacy, Time-Criticality, Habit, Technology Trust, and Task Behaviour) and individual performance-related outcomes of MHS infusion (Effectiveness, Efficiency, and Learning), (2) examining undocumented determinants and relationships, (3) identifying prerequisite conditions that both healthcare practitioners and organisations can employ to assist with MHS infusion, (4) developing a taxonomy that provides conceptual refinement of IT infusion, and (5) informing healthcare organisations and vendors as to the performance of MHS in post-adoptive scenarios.

Una revisión de la Cadena Datos-Información-Conocimiento desde el Pragmatismo de Peirce

La Cadena Datos-Información-Conocimiento (DIC), denominada “Jerarquía de la Información” o “Pirámide del Conocimiento”, es uno de los modelos más importantes en la Gestión de la Información y la Gestión del Conocimiento. Por lo general, la estructuración de la cadena se ha ido definiendo como una arquitectura en la que cada elemento se levanta sobre el elemento inmediatamente inferior; sin embargo no existe un consenso en la definición de los elementos, ni acerca de los procesos que transforman un elemento de un nivel a uno del siguiente nivel. En este artículo se realiza una revisión de la Cadena Datos-Información-Conocimiento examinando las definiciones más relevantes sobre sus elementos y sobre su articulación en la literatura, para sintetizar las acepciones más comunes. Se analizan los elementos de la Cadena DIC desde la semiótica de Peirce; enfoque que nos permite aclarar los significados e identificar las diferencias, las relaciones y los roles que desempeñan en la cadena desde el punto de vista del pragmatismo. Finalmente se propone una definición de la Cadena DIC apoyada en las categorías triádicas de signos y la semiosis ilimitada de Peirce, los niveles de sistemas de signos de Stamper y las metáforas de Zeleny.

Towards Improving the Utilisation of University Teaching Space

There is a perception that teaching space in universities is a rather scarce resource. However, some studies have revealed that in many institutions it is actually chronically under-used. Often, rooms are occupied only half the time, and even when in use they are often only half full. This is usually measured by the ‘utilization’ which is defined as the percentage of available ‘seat-hours’ that are employed. Within real institutions, studies have shown that this utilization can often take values as low as 20–40%. One consequence of such a low level of utilization is that space managers are under pressure to make more efficient use of the available teaching space. However, better management is hampered because there does not appear to be a good understanding within space management (near-term planning) of why this happens. This is accompanied, within space planning (long-term planning) by a lack of experise on how best to accommodate the expected low utilizations. This motivates our two main goals: (i) To understand the factors that drive down utilizations, (ii) To set up methods to provide better space planning. Here, we provide quantitative evidence that constraints arising from timetabling and location requirements easily have the potential to explain the low utilizations seen in reality. Furthermore, on considering the decision question ‘Can this given set of courses all be allocated in the available teaching space?’ we find that the answer depends on the associated utilization in a way that exhibits threshold behaviour: There is a sharp division between regions in which the answer is ‘almost always yes’ and those of ‘almost always no’. Through analysis and understanding of the space of potential solutions, our work suggests that better use of space within universities will come about through an understanding of the effects of timetabling constraints and when it is statistically likely that it will be possible for a set of courses to be allocated to a particular space. The results presented here provide a firm foundation for university managers to take decisions on how space should be managed and planned for more effectively. Our multi-criteria approach and new methodology together provide new insight into the interaction between the course timetabling problem and the crucial issue of space planning.

Reflecting the Public Value of Sport: A game of two halves

This article draws on qualitative research that explores the concept of public value in the delivery of sport services by the organization Sport England. The research took place against a backdrop of shifting priorities following the award of the 2012 Olympic Games to London. It highlights the difficulties that exist in measuring the qualitative nature of the public value of sport and suggests there is a need to understand better the idea. Research with organizations involved alongside Sport England in the delivery of sport is described. This explores the potential to create a public value vision, how to measure it and how to focus public value on delivery beyond the aim of ‘sport for sports sake’ and more towards ‘sport for the greater good’. The article argues that this represents a game of ‘two halves’ in which the first half focuses on 2012 with the second half concerned with its legacy.

The Private Finance Initiative: An Evolving Research Agenda

This article considers the development of the Private Finance Initiative (PFI) and contends that it is now deeply embedded and intertwined in policies to renew and modernize the United Kingdom's public services. After briefly reviewing prior research based upon the themes proposed by Broadbent and Laughlin (1999), this article suggests a new research agenda to reflect how the PFI has matured and developed in recent years.

Using simulation to assess cardiac first-responder schemes exhibiting stochastic and spatial complexities

A Monte-Carlo simulation-based model has been constructed to assess a public health scheme involving mobile-volunteer cardiac First-Responders. The scheme being assessed aims to improve survival of Sudden-Cardiac-Arrest (SCA) patients, through reducing the time until administration of life-saving defibrillation treatment, with volunteers being paged to respond to possible SCA incidents alongside the Emergency Medical Services. The need for a model, for example, to assess the impact of the scheme in different geographical regions, was apparent upon collection of observational trial data (given it exhibited stochastic and spatial complexities). The simulation-based model developed has been validated and then used to assess the scheme's benefits in an alternative rural region (not a part of the original trial). These illustrative results conclude that the scheme may not be the most efficient use of National Health Service resources in this geographical region, thus demonstrating the importance and usefulness of simulation modelling in aiding decision making.

Repurchase intention in B2C e-commerce—A relationship quality perspective

Information systems professionals must pay attention to online customer retention. Drawing on the relationship marketing literature, we formulated and tested a model to explain B2C user repurchase intention from the perspective of relationship quality. The model was empirically tested through a survey conducted in Northern Ireland. Results showed that online relationship quality and perceived website usability positively impacted customer repurchase intention. Moreover, online relationship quality was positively influenced by perceived vendor expertise in order fulfillment, perceived vendor reputation, and perceived website usability, whereas distrust in vendor behavior negatively influenced online relationship quality. Implications of these findings are discussed. © 2011 Elsevier B.V. All rights reserved.

Towards Charity Accountability: Narrowing the gap between provision and needs?

Although charities currently play a rich and varied role in modern society, their continued success is dependent upon the public's trust. With respect to charity accountability, two key questions emerge: to whom is a charity accountable; and what form should that account take? Despite the widespread acceptance that charities should discharge accountability, there is limited knowledge of the relative importance of different stakeholder groups and whether the information currently being disclosed meets their needs. Using extensive document analysis and a survey of stakeholders, this research explores these issues in the context of the top 100 UK fundraising charities. Furthermore, it compares the results with much earlier research to identify changes over time.

Computational learning of the conditional phase-type (C-Ph) distribution: Learning C-Ph distributions

This paper presents a new algorithm for learning the structure of a special type of Bayesian network. The conditional phase-type (C-Ph) distribution is a Bayesian network that models the probabilistic causal relationships between a skewed continuous variable, modelled by the Coxian phase-type distribution, a special type of Markov model, and a set of interacting discrete variables. The algorithm takes a dataset as input and produces the structure, parameters and graphical representations of the fit of the C-Ph distribution as output.The algorithm, which uses a greedy-search technique and has been implemented in MATLAB, is evaluated using a simulated data set consisting of 20,000 cases. The results show that the original C-Ph distribution is recaptured and the fit of the network to the data is discussed.

Investigating the efficiency of fitting Coxian phase-type distributions to health care data

Coxian phase-type distributions are becoming a popular means of representing survival times within a health care environment. They are favoured as they show a distribution as a system of phases and can allow for an easy visual representation of the rate of flow of patients through a system. Difficulties arise, however, in determining the parameter estimates of the Coxian phase-type distribution. This paper examines ways of making the fitting of the Coxian phase-type distribution less cumbersome by outlining different software packages and algorithms available to perform the fit and assessing their capabilities through a number of performance measures. The performance measures rate each of the methods and help in identifying the more efficient. Conclusions drawn from these performance measures suggest SAS to be the most robust package. It has a high rate of convergence in each of the four example model fits considered, short computational times, detailed output, convergence criteria options, along with a succinct ability to switch between different algorithms.

Is Use of Optional Attributes and Associations in Conceptual Modeling Always Problematic? Theory and Empirical Tests

Prior research has argued that use of optional properties in conceptual models results in loss of information about the semantics of the domains represented by the models. Empirical research undertaken to date supports this argument. Nevertheless, no systematic analysis has been done of whether use of optional properties is always problematic. Furthermore, prior empirical research might have deliberately or unwittingly employed models where use of optionality always causes problems. Accordingly, we examine analytically whether use of optional properties is always problematic. We employ our analytical results to inform the design of an experiment where we systematically examined the impact of optionality on users’ ability to understand domains represented by different types of conceptual models. We found evidence that use of optionality undermines users’ ability to understand the domain represented by a model but that this effect weakens when use of mandatory properties to replace optional properties leads to more-complex models.

Improving the Semantics of Conceptual-Modeling Grammars:A New Perspective on an Old Problem

A core activity in information systems development involves understanding the
conceptual model of the domain that the information system supports. Any conceptual model is ultimately created using a conceptual-modeling (CM) grammar. Accordingly, just as high quality conceptual models facilitate high quality systems development, high quality CM grammars facilitate high quality conceptual modeling. This paper seeks to provide a new perspective on improving the quality of CM grammar semantics. For the past twenty years, the leading approach to this topic has drawn on ontological theory. However, the ontological approach captures just half of the story. It needs to be coupled with a logical approach. We show how ontological quality and logical quality interrelate and we outline three contributions of a logical approach: the ability to see familiar conceptualmodeling problems in simpler ways, the illumination of new problems, and the ability to prove the benefit of modifying CM grammars.

On the Ontological Quality and Logical Quality of Conceptual-Modeling Grammars: The Need for a Dual Perspective

A core activity in information systems development involves building a conceptual model of the domain that an information system is intended to support. Such models are created using a conceptual-modeling (CM) grammar. Just as high-quality conceptual models facilitate high-quality systems development, high-quality CM grammars facilitate high-quality conceptual modeling. This paper provides a new perspective on ways to improve the quality of the semantics of CM grammars. For many years, the leading approach to this topic has relied on ontological theory. We show, however, that the ontological approach captures only half the story. It needs to be coupled with a logical approach. We explain how the ontological quality and logical quality of CM grammars interrelate. Furthermore, we outline three contributions that a logical approach can make to evaluating the quality of CM grammars: a means of seeing some familiar conceptual-modeling problems in simpler ways; the illumination of new problems; and the ability to prove the benefit of modifying existing CM grammars in particular ways. We demonstrate these benefits in the context of the Entity-Relationship grammar. More generally, our paper opens up a new area of research with many opportunities for future research and practice.

L'adoption d'une innovation technopédagogique par une communauté enseignante universitaire

Résumé: L'adoption d'une innovation technopédagogique par une communauté enseignante universitaire La thèse traite de l'adoption d'une innovation technopédagogique par une communauté enseignante universitaire. Cette étude longitudinale, réalisée dans le cadre d'une recherche-action, vise à comprendre la dynamique globale du processus d'adoption d'une innovation. Le cadre de réflexion théorique de l'étude provient de la recherche en management, en systèmes d'information et en éducation. Il tient à la fois compte des motivations et des besoins des individus (dimension individuelle), de la compatibilité des technologies de l'information selon les théories usuelles de l'apprentissage (dimension pédagogique) et du type de soutien à offrir aux utilisatrices-utilisateurs (dimension organisationnelle). Le modèle d'accompagnement émergeant de cette recherche se compose de cycles itératifs au cours desquels un groupe définit et résout un problème, puis réfléchit successivement aux enjeux émergents d'un cycle à l'autre. Le modèle tient explicitement compte des trois éléments clés suivants: l'individu, la pédagogie et l'organisation qui forment une dynamique systémique indissociable et en interaction les unes les autres pendant toute la durée du processus d'adoption de l'innovation. Il met aussi en lumière la nécessité de stimuler une réflexion critique grâce au concours de ressources externes crédibles pour déterminer la compatibilité des technologies à partir d'expériences concrètes. Une telle démarche participative systématique permet d'accroître la cohésion des idées du groupe par le dialogue et les débats d'opinions_ Par ailleurs, la proximité avec notre milieu de recherche sur une période de deux ans offre la possibilité de saisir plusieurs facettes de la dynamique organisationnelle. Lorsque l'on réalise une étude longitudinale qui met en évidence l'incidence d'événements concomitants, on constate la fragilité du processus et la réversibilité de la décision d'adoption. L'intention d'adoption évolue constamment au gré des expériences des individus et du contexte qui évolue lui-même. L'établissement de relations partenariales avec les groupes intéressés représente une activité essentielle pour pallier ou neutraliser les effets indésirables d'événements concomitants.||Abstract: This thesis deals with a university teaching community adopting a technological/pedagogical innovation. This longitudinal study--part of an action-research study--aims at gaining understanding of the overall dynamics involved in adopting an innovation. The study's conceptual framework derives from management, information-systems, and teaching research. It takes into account the motivations and needs of individuals (individual dimension), the compatibility of information technologies according to current learning theories (pedagogical dimension), and the type of support to be offered to users (organizational dimension). The companion model issuing from this research work comprises iterative cycles during which a group defines and solves a problem and then successively reflects on the issues emerging from one cycle to the next. The model takes explicit account of three key elements: the individual, pedagogical approach, and organization form an indissociable system dynamic in which all dimensions interact during the entire process of adopting innovation. It also sheds light on the need to stimulate critical reflection about the combination of credible external resources so that tangible experiences can be used to determine technology compatibility. This kind of systematic participative process yields greater cohesiveness of group ideas through dialogue and discussion. Moreover, the proximity to our research setting over two years provides the opportunity to seize the many facets of organizational dynamics. During the course of a longitudinal study that highlights the incidence of concomitant events, the fragility of the process and reversibility of the adoption decision become apparent. The adoption intention constantly fluctuates through the experiences of individuals and the context, which also changes. Establishing partnership relations with interested groups stands out as an essential activity in attenuating or counteracting the undesirable effects produced by concomitant events.