Delegation of access in an Information Accountability Framework for eHealth

Shared eHealth records systems offer promising benefits for improving healthcare through high availability of information and improved decision making; however, their uptake has been hindered by concerns over the privacy of patient information. To address these privacy concerns while balancing the requirements of healthcare professionals to have access to the information they need to provide appropriate care, the use of an Information Accountability Framework (IAF) has been proposed. For the IAF and so called Accountable-eHealth systems to become a reality, the framework must provide for a diverse range of users and use cases. The initial IAF model did not provide for more diverse use cases including the need for certain users to delegate access to another user in the system to act on their behalf while maintaining accountability. In this paper, we define the requirements for delegation of access in the IAF, how such access policies would be represented in the Framework, and implement and validate an expanded IAF model.

Chronicling the patient journey: Co-creating value with digital health ecosystems

With the introduction of the PCEHR (Personally Controlled Electronic Health Record), the Australian public is being asked to accept greater responsibility for the management of their health information. However, the implementation of the PCEHR has occasioned poor adoption rates underscored by criticism from stakeholders with concerns about transparency, accountability, privacy, confidentiality, governance, and limited capabilities. This study adopts an ethnographic lens to observe how information is created and used during the patient journey and the social factors impacting on the adoption of the PCEHR at the micro-level in order to develop a conceptual model that will encourage the sharing of patient information within the cycle of care. Objective: This study aims to firstly, establish a basic understanding of healthcare professional attitudes toward a national platform for sharing patient summary information in the form of a PCEHR. Secondly, the studies aims to map the flow of patient related information as it traverses a patient’s personal cycle of care. Thus, an ethnographic approach was used to bring a “real world” lens to information flow in a series of case studies in the Australian healthcare system to discover themes and issues that are important from the patient’s perspective. Design: Qualitative study utilising ethnographic case studies. Setting: Case studies were conducted at primary and allied healthcare professionals located in Brisbane Queensland between October 2013 and July 2014. Results: In the first dimension, it was identified that healthcare professionals’ concerns about trust and medico-legal issues related to patient control and information quality, and the lack of clinical value available with the PCEHR emerged as significant barriers to use. The second dimension of the study which attempted to map patient information flow identified information quality issues, clinical workflow inefficiencies and interoperability misconceptions resulting in duplication of effort, unnecessary manual processes, data quality and integrity issues and an over reliance on the understanding and communication skills of the patient. Conclusion: Opportunities for process efficiencies, improved data quality and increased patient safety emerge with the adoption of an appropriate information sharing platform. More importantly, large scale eHealth initiatives must be aligned with the value proposition of individual stakeholders in order to achieve widespread adoption. Leveraging an Australian national eHealth infrastructure and the PCEHR we offer a practical example of a service driven digital ecosystem suitable for co-creating value in healthcare.

Oppimisen kohteen ja oppijan vastavuoroinen kehitys : Teleyrityksen asiakaspalvelun työyhteisöjen oppimiskäytäntöjen uudistaminen osana teknologis-taloudellista kumousta

Reciprocal development of the object and subject of learning. The renewal of the learning practices of front-line communities in a telecommunications company as part of the techno-economical paradigm change. Current changes in production have been seen as an indication of a shift from the techno-economical paradigm of a mass-production era to a new paradigm of the information and communication technological era. The rise of knowledge management in the late 1990s can be seen as one aspect of this paradigm shift, as knowledge creation and customer responsiveness were recognized as the prime factors in business competition. However, paradoxical conceptions concerning learning and agency have been presented in the discussion of knowledge management. One prevalent notion in the literature is that learning is based on individuals’ voluntary actions and this has now become incompatible with the growing interest in knowledge-management systems. Furthermore, commonly held view of learning as a general process that is independent of the object of learning contradicts the observation that the current need for new knowledge and new competences are caused by ongoing techno-economic changes. Even though the current view acknowledges that individuals and communities have key roles in knowledge creation, this conception defies the idea of the individuals’ and communities’ agency in developing the practices through which they learn. This research therefore presents a new theoretical interpretation of learning and agency based on Cultural-Historical Activity Theory. This approach overcomes the paradoxes in knowledge-management theory and offers means for understanding and analyzing changes in the ways of learning within work communities. This research is also an evaluation of the Competence-Laboratory method which was developed as part of the study as a special application of Developmental Work Research methodology. The research data comprises the videotaped competence-laboratory processes of four front-line work communities in a telecommunications company. The findings reported in the five articles included in this thesis are based on the analyses of this data. The new theoretical interpretation offered here is based on the assessment that the findings reported in the articles represent one of the front lines of the ongoing historical transformation of work-related learning since the research site represents one of the key industries of the new “knowledge society”. The research can be characterized as elaboration of a hypothesis concerning the development of work related learning. According to the new theoretical interpretation, the object of activity is also the object of distributed learning in work communities. The historical socialization of production has increased the number of actors involved in an activity, which has also increased the number of mutual interdependencies as well as the need for communication. Learning practices and organizational systems of learning are historically developed forms of distributed learning mediated by specific forms of division of labor, specific tools, and specific rules. However, the learning practices of the mass production era become increasingly inadequate to accommodate the conditions in the new economy. This was manifested in the front-line work communities in the research site as an aggravating contradiction between the new objects of learning and the prevailing learning practices. The constituent element of this new theoretical interpretation is the idea of a work community’s learning as part of its collaborative mastery of the developing business activity. The development of the business activity is at the same time a practical and an epistemic object for the community. This kind of changing object cannot be mastered by using learning practices designed for the stable conditions of mass production, because learning has to change along the changes in business. According to the model introduced in this thesis, the transformation of learning proceeds through specific stages: predefined learning tasks are first transformed into learning through re-conceptualizing the object of the activity and of the joint learning and then, as the new object becomes stabilized, into the creation of new kinds of learning practices to master the re-defined object of the activity. This transformation of the form of learning is realized through a stepwise expansion of the work community’s agency. To summarize, the conceptual model developed in this study sets the tool-mediated co-development of the subject and the object of learning as the theoretical starting point for developing new, second-generation knowledge management methods. Key words: knowledge management, learning practice, organizational system of learning, agency

Työlähtöiset menetelmät työterveyshuollossa : Oppimisen johtaminen uuden toimintakonseptin käyttöönotto- ja vakiinnuttamisvaiheessa

Working life is changing. The core of the change is change in the production and service concepts of organizations. Changes at work are connected to problems in the well-being of employees. To respond to this challenge, occupational health care must develop a course of action. A group of occupational health care units has developed new activity theory-based methods, the object of which is to change the service concept of occupational health care. The focus is on the changes and disturbances in work activity. My aim was to study this development from the perspective of knowledge management; to clarify directors'/ managers' conceptions of the content and object of their managerial work and the tensions included in these conceptions; to examine the learning process involved in these methods and to bring to light the problems, developmental needs and challenges during the implementation and consolidation phases of the process. This was a case study which included 10 occupational health care units using or being trained to use activity theory-based methods. My data consisted of interviews with directors/managers and recordings of the meetings; 20 directors/ managers are represented; I interviewed seven directors/ managers who represented four units. Directors'/ managers' conceptions of the content and object of managerial work were divided into eight categories of description, which I connected to the historical forms of organizations and types of management. Intuitive and rational management are historically older forms of management. The categories of description representing intuitive and rational management contained many internal tensions, i.e. they do not satisfy the demands of the environment. On the other hand, the categories of description which represented management by results and the control of the development process contained very few or no tensions at all; they are effective in the present environment of occupational health care. The learning process of activity theory-based methods has been expansive in nature. The occupational health care units studied are in different phases of the learning process, and these processes have been different. In three units the focus was on work development; in one unit the focus was on development of the service concept. The most central problems, challenges and developmental needs during the implementation phase were related to learning and spreading of methods inside one's own unit, and during the consolidation phase to working with partners.

The influence of pre-processing on the estimation of readability of web documents

This paper investigates the effect that text pre-processing approaches have on the estimation of the readability of web pages. Readability has been highlighted as an important aspect of web search result personalisation in previous work. The most widely used text readability measures rely on surface level characteristics of text, such as the length of words and sentences. We demonstrate that different tools for extracting text from web pages lead to very different estimations of readability. This has an important implication for search engines because search result personalisation strategies that consider users reading ability may fail if incorrect text readability estimations are computed.

Tiedon jakaminen tiimityössä

Knowledge-sharing in a teamwork The study examines the link between knowledge-sharing that takes place in a team and the dimensions and objectives of the team s activities. The question the study poses is: How does knowledge-sharing in a team relate to the team s activities? The exchange of knowledge is examined using knowledge-sharing networks and the conversion model, which describes the process of knowledge formation. The answer to the question is sought through four empirical articles describing the activities of a team from the viewpoint of quality, fairness, power related to knowledge management, and performance. One of the articles used in the study describes the role of networks in work life more generally. It attempts to shed light on the manner in which team-related networks operate as part of a more extensive structure of organizational networks. Finland is one of the most eager users of teamwork, if numbers are used as a yardstick. About half of all Finnish wage earners worked in teams in 2009, and comparisons show that the use of teams in Finland is above the EU average. This study focuses on so-called semi-autonomous teams, which carry out permanent work tasks. In such teams, tasks are interdependent, and teams are jointly responsible for ensuring that the work is done. Team members may also, at least to some extent, agree between themselves on how the tasks are carried out and are able to take part in the decision-making process. Such teamwork makes knowledge-sharing an important element for the team s activities. Knowledge and knowledge-sharing have become a major resource, allowing organizations to operate and even compete in today s increasingly competitive markets. A single team or a single organization cannot, however, possess all the knowledge required for carrying out the tasks assigned to it. Although it is difficult to copy the knowledge generated in an organization, it is important to share the knowledge within and between organizations. External links supply teams and organizations with important knowledge that allows them to keep their operations up-to-date and their structures well-functioning. In fact, knowledge provides teams and organizations with an intangible resource that improves their capacity to interact with their environment and to adjust to it. For this reason, it is important to examine both the internal and external knowledge-sharing taking place in a team. The findings of the study show that in terms of quality, fairness, performance and the knowledge management issues concerning a team, its social network structure is both internally and externally connected with its activities. A team structure that is internally coherent and at the same time open to external contacts, is, with certain restrictions, connected with the quality, fairness, and performance of the team. The restrictions concern differences between procedural and interactional justice, public and private sectors, and the team leaders and ordinary team members. The role of the team leader is closely connected with the management of networks that are considered valuable. The results of the study indicate that teamwork is supervisor-dominated. Thus, teamwork does not substantially strengthen the influence of individual employees as players in knowledge-transfer networks. However, ordinary team members possess important peer contacts inside the organization. Teamwork clearly allows employees to interact in a democratic manner, and here the transfer of tacit knowledge plays an important role. Keywords: teamwork, knowledge-sharing, social networks, organization

Hur höra tyst kunskap? Utveckling av en metod för studier av tyst kunnande

Det tysta kunnandet utgör en stor del av kunskapsresursen både hos oss som individer och i arbetsorganisationerna. Trots att vi omger oss med böcker, manualer och databaser, som alla är exempel på explicit kunskap, så är det ”den rätta känslan”, erfarenheten och våra färdigheter som avgör om och hur vi klarar av våra uppgifter. Dessa begrepp är alla relaterade till den tysta dimensionen av kunskap. En dimension som traditionellt karaktäriserats som abstrakt, individuell, omedveten, praktisk, erfarenhetsbaserad och framför allt svår att uttrycka. Alla dessa är karaktärsdrag som ställt speciella krav inom kunskapsforskning och -ledning. Resultatet av detta är att både forskning och ledning av det tysta kunnandet har åsidosatts till förmån för forskning och ledning av explicit kunskap. Ett bidragande problem har varit bristen på lämpliga metoder för att ur ett företagsekonomiskt perspektiv studera och leda tyst kunnande. Ett annat problem har varit oklarhet i begreppet tyst kunskap. Detta har lett till brist på förståelse och/eller missförstånd. För att råda bot på svårigheten att uttrycka vårt tysta kunnande har människan utvecklat olika begrepp som i vår vardagskommunikation symboliserar tyst kunnande. Begrepp som intuition, människokännedom, förhandlingsförmåga och kultur används vanligt och med dem uttrycker vi den tysta dimensionen av kunnande. Dessa begrepp utgör även grunden för den intervjumetod som utvecklats för att empiriskt studera eller i ledningssyfte kartlägga tyst kunnande. Metoden använder dessa ”Epitet för Tyst Kunskap” (ETK) som bas för stimuluskort-intervjuer. Intervjuer som visat sig öka möjligheten att utforska och kartlägga tyst kunnande i organisationer oberoende av om man är forskare eller företagsledare.

A Relationship Mediated Theory of Internal Marketing (summary section only)

This report presents a new theory of internal marketing. The thesis has developed as a case study in retrospective action research. This began with the personal involvement of the author in an action research project for customer service improvement at a large Australian retail bank. In other words, much of the theory generating ‘research’ took place after the original project ‘action’ had wound down. The key theoretical proposition is that internal marketing is a relationship development strategy for the purpose of knowledge renewal. In the banking case, exchanges of value between employee participants emerged as the basis for relationship development, with synergistic benefits for customers, employees and the bank. Relationship development turned out to be the mediating variable between the learning activity of employee participants at the project level and success in knowledge renewal at the organisational level. Relationship development was also a pivotal factor in the motivation and customer consciousness of employees. The conclusion reached is that the strength of relationship-mediated internal marketing is in combining a market focused commitment and employee freedom in project work to achieve knowledge renewal. The forgotten truth is that organisational knowledge can be renewed through dialogue and learning, through being trustworthy, and by gaining the trust of employees in return.

Druvan - Den personalekonomiska nyttan av mångdimensionell företagshälsovårds- och personalutvecklingsverksamhet baserad på Metal Age-konceptet i Dragsfjärds kommun (2002-2005)

Under åren 2002-2005 förverkligades Druvan-projektet i Dragsfjärds kommun, vilket innebar en dramatisk ökning av företagshälsovårdsinsatserna. Företagshälsovårdsutgifterna ökade från 20 € per anställd till över 400 €. Den totala satsningen på personalens hälsa ökade ännu mer. Innehållet i Druvan baserade sig på den s.k. Metal Age-metoden. Metoden går ut på att arbetsgemenskapen tillsammans identifierar utvecklingsbehov och –åtgärder. Projektet ledde till en stor mängd utvecklingsåtgärder och därpå följande effekter på personalens hälsa, trivsel och samarbete. Som en del av åtgärderna utarbetade kommunen en personalrapport för de aktuella åren. Under projekttiden utvecklades personalens arbetsförmåga betydligt gynnsammare än förväntat. Den ekonomiska analysen visade att det investerade kapitalet gav en avkastning på 46%. Nyttan uppkom som resultat av minskad sjukfrånvaro och färre förtidspensioneringar. Druvan-projektet stöder de tidigare bedömningarna, enligt vilka det finns ett klart utrymme för att öka satsningarna på företagshälsovård i vårt land. Detta gäller speciellt arbetsplatser vars satsningar på företagshälsovård är betydligt under genomsnittet. Dragsfjärds kommun har beslutat göra Druvan till en bestående struktur inom kommunen. Guy Ahonen är professor i Knowledge Management, speciellt personalekonomi vid institutionen för företagsledning och organisation vid Hanken. Ove Näsman är ledande företagsläkare vid Dalmed OyAb i Dalsbruk i sydvästra Finland. Båda har forskat i årtionden kring effekterna av ökat välbefinnande i arbetet.

Patent intelligence and its implications for patent productivity

The prevailing hypercompetitive environment has made it essential for organizations to gather competitive intelligence from environmental scanning. The knowledge gained leads to organizational learning, which stimulates increased patent productivity. This paper highlights five practices that aid in developing patenting intelligence and empirically verifies to what extent this organizational learning leads to knowledge gains and financial gains realized from consequent higher patent productivity. The model is validated based on the perceptions of professionals with patenting experience from two of the most aggressively patenting sectors in today’s economy, viz., IT and pharmaceutical sectors (n=119). The key finding of our study suggests that although organizational learning from environmental scanning exists, the application of this knowledge for increasing patent productivity lacks due appreciation. This missing link in strategic analysis and strategy implementation has serious implications for managers which are briefly discussed in this paper.

Supervised matching of comments with news article segments

Comments constitute an important part of Web 2.0. In this paper, we consider comments on news articles. To simplify the task of relating the comment content to the article content the comments are about, we propose the idea of showing comments alongside article segments and explore automatic mapping of comments to article segments. This task is challenging because of the vocabulary mismatch between the articles and the comments. We present supervised and unsupervised techniques for aligning comments to segments the of article the comments are about. More specifically, we provide a novel formulation of supervised alignment problem using the framework of structured classification. Our experimental results show that structured classification model performs better than unsupervised matching and binary classification model.

Semi-supervised SVMs for classification with unknown class proportions and a small labeled dataset

In the design of practical web page classification systems one often encounters a situation in which the labeled training set is created by choosing some examples from each class; but, the class proportions in this set are not the same as those in the test distribution to which the classifier will be actually applied. The problem is made worse when the amount of training data is also small. In this paper we explore and adapt binary SVM methods that make use of unlabeled data from the test distribution, viz., Transductive SVMs (TSVMs) and expectation regularization/constraint (ER/EC) methods to deal with this situation. We empirically show that when the labeled training data is small, TSVM designed using the class ratio tuned by minimizing the loss on the labeled set yields the best performance; its performance is good even when the deviation between the class ratios of the labeled training set and the test set is quite large. When the labeled training data is sufficiently large, an unsupervised Gaussian mixture model can be used to get a very good estimate of the class ratio in the test set; also, when this estimate is used, both TSVM and EC/ER give their best possible performance, with TSVM coming out superior. The ideas in the paper can be easily extended to multi-class SVMs and MaxEnt models.

Sufficient conditions for formation of a network topology by self-interested agents

Networks such as organizational network of a global company play an important role in a variety of knowledge management and information diffusion tasks. The nodes in these networks correspond to individuals who are self-interested. The topology of these networks often plays a crucial role in deciding the ease and speed with which certain tasks can be accomplished using these networks. Consequently, growing a stable network having a certain topology is of interest. Motivated by this, we study the following important problem: given a certain desired network topology, under what conditions would best response (link addition/deletion) strategies played by self-interested agents lead to formation of a pairwise stable network with only that topology. We study this interesting reverse engineering problem by proposing a natural model of recursive network formation. In this model, nodes enter the network sequentially and the utility of a node captures principal determinants of network formation, namely (1) benefits from immediate neighbors, (2) costs of maintaining links with immediate neighbors, (3) benefits from indirect neighbors, (4) bridging benefits, and (5) network entry fee. Based on this model, we analyze relevant network topologies such as star graph, complete graph, bipartite Turan graph, and multiple stars with interconnected centers, and derive a set of sufficient conditions under which these topologies emerge as pairwise stable networks. We also study the social welfare properties of the above topologies.