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. ^

A case study of the English language teachers’ attitudes toward use of information and communication technology (ICT) in Finland

This qualitative study was aimed at investigating foreign language teachers’ attitudes toward use of information and communication technology (ICT) in their instruction. The insight was gained through the reported experience of ICT implementation by teachers, in what way and for which purpose they refer to use of technology, what kind of support and training they are provided with, and what beliefs they express about the influence of ICT implementation. This case study took place in one of the training schools in Finland. Five teachers participated in semi-structured interviews through a face-to-face approach. The findings demonstrated positive attitudes of teachers toward integration of ICT. The teachers shared their opinions about positive influence that ICT implementation has on both teaching and learning processes. However, they also pointed out the negative sides of ICT use: distraction of the students from usage of technology and technical problems causing frustration to the teachers. In addition, the responses revealed that the teachers are provided with adequate training aimed at enhancing their qualification which is provided with well-timed technology support and colleagues’ collaboration facilitating an efficient and smooth pace of the teaching process. According to the teachers’ opinions ICT integration in education appeared to have changed the role of the teacher. Due to different alterations in the field of ICT development teachers are required to upgrade their skills. The paper concludes with the limitations of the study and the recommendations for conducting further research.

A case study of the English language teachers’ attitudes toward use of information and communication technology (ICT) in Finland

This qualitative study was aimed at investigating foreign language teachers’ attitudes toward use of information and communication technology (ICT) in their instruction. The insight was gained through the reported experience of ICT implementation by teachers, in what way and for which purpose they refer to use of technology, what kind of support and training they are provided with, and what beliefs they express about the influence of ICT implementation. This case study took place in one of the training schools in Finland. Five teachers participated in semi-structured interviews through a face-to-face approach. The findings demonstrated positive attitudes of teachers toward integration of ICT. The teachers shared their opinions about positive influence that ICT implementation has on both teaching and learning processes. However, they also pointed out the negative sides of ICT use: distraction of the students from usage of technology and technical problems causing frustration to the teachers. In addition, the responses revealed that the teachers are provided with adequate training aimed at enhancing their qualification which is provided with well-timed technology support and colleagues’ collaboration facilitating an efficient and smooth pace of the teaching process. According to the teachers’ opinions ICT integration in education appeared to have changed the role of the teacher. Due to different alterations in the field of ICT development teachers are required to upgrade their skills. The paper concludes with the limitations of the study and the recommendations for conducting further research.

Accessibility to general practitioners in rural South Australia - A case study using geographic information system technology

Objective: To demonstrate the potential of GIS (geographic information system) technology and ARIA (Accessibility/Remoteness Index for Australia) as tools for medical workforce and health service planning in Australia. Design: ARIA is an index of remoteness derived by measuring road distance between populated localities and service centres. A continuous variable of remoteness from 0 to 12 is generated for any location in Australia. We created a GIS, with data on location of general practitioner services in non-metropolitan South Australia derived from the database of HUMPS (Rural Undergraduate Medical Placement System), and estimated, for the 1170 populated localities in South Australia, the accessibility/inaccessibility of the 109 identified GP services. Main outcome measures: Distance from populated locality to GP services. Results: Distance from populated locality to GP service ranged from 0 to 677 km (mean, 58 km). In all, 513 localities (43%) had a GP service within 20 km (for the majority this meant located within the town). However, for 173 populated localities (15%), the nearest GP service was more than 80 km away. There was a strong correlation between distance to GP service and ARIA value for each locality (0.69; P<0.05). Conclusions: GP services are relatively inaccessible to many rural South Australian communities. There is potential for GIS and for ARIA to contribute to rational medical workforce and health service planning. Adding measures of health need and more detailed data on types and extent of GP services provided will allow more sophisticated planning.

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.

Information System ProcessInnovation Adoption, Adaptation, Learning, and Unlearning: A Longitudinal Case Study

This thesis examines the history and evolution of information system process innovation (ISPI) processes (adoption, adaptation, and unlearning) within the information system development (ISD) work in an internal information system (IS) department and in two IS software house organisations in Finland over a 43-year time-period. The study offers insights into influential actors and their dependencies in deciding over ISPIs. The research usesa qualitative research approach, and the research methodology involves the description of the ISPI processes, how the actors searched for ISPIs, and how the relationships between the actors changed over time. The existing theories were evaluated using the conceptual models of the ISPI processes based on the innovationliterature in the IS area. The main focus of the study was to observe changes in the main ISPI processes over time. The main contribution of the thesis is a new theory. The term theory should be understood as 1) a new conceptual framework of the ISPI processes, 2) new ISPI concepts and categories, and the relationships between the ISPI concepts inside the ISPI processes. The study gives a comprehensive and systematic study on the history and evolution of the ISPI processes; reveals the factors that affected ISPI adoption; studies ISPI knowledge acquisition, information transfer, and adaptation mechanisms; and reveals the mechanismsaffecting ISPI unlearning; changes in the ISPI processes; and diverse actors involved in the processes. The results show that both the internal IS department and the two IS software houses sought opportunities to improve their technical skills and career paths and this created an innovative culture. When new technology generations come to the market the platform systems need to be renewed, and therefore the organisations invest in ISPIs in cycles. The extent of internal learning and experiments was higher than the external knowledge acquisition. Until the outsourcing event (1984) the decision-making was centralised and the internalIS department was very influential over ISPIs. After outsourcing, decision-making became distributed between the two IS software houses, the IS client, and itsinternal IT department. The IS client wanted to assure that information systemswould serve the business of the company and thus wanted to co-operate closely with the software organisations.

Groupware and Workflow Tools - A Case study of SAP Business Workflow Supporting System Integration in a Global Telecommunication Company

Workflow management systems aim at the controlled execution of complex application processes in distributed and heterogeneous environments. These systems will shape the structure of information systems in business and non-business environments. E business and system integration is a fertile soil for WF and groupware tools. This thesis aims to study WF and groupware tools in order to gather in house knowledge of WF to better utilize WF solutions in future, and to focus on SAP Business Workflow in order to find a global solution for Application Link Enabling support for system integration. Piloting this solution in Nokia collects the experience of SAP R/3 WF tool for other development projects in future. The literary part of this study will guide to the world of business process automation providing a general description of the history, use and potentials of WF & groupware software. The empirical part of this study begins with the background of the case study describing the IT environment initiating the case by introducing SAP R/3 in Nokia, the communication technique in use and WF tool. Case study is focused in one solution with SAP Business Workflow. This study provides a concept to monitor communication between ERP systems and to increase the quality of system integration. Case study describes a way create support model for ALE/EDI interfaces. Support model includes monitoring organization and the workflow processes to solve the most common IDoc related errors.

Exploring the value creation in service ecosystem context: the case of the information technology sector

This thesis examines customer value creation in a service ecosystem context. The objective of this thesis is to develop a comprehensive view of value creation processes in a service ecosystem context and an understanding on the roles of the stakeholders involved in these processes, focusing on the information technology industry. The novelty of the two central concepts of this thesis, systemic customer value and service ecosystem, as well as the gap in the literature of empirical research on value creation in an ecosystem-level, opened an interesting research topic. The empirical study is conducted as a single case analysis, utilizing Group Decision Support System (GDSS) and also Analytic Hierarchy Process (AHP). The findings suggest that customer value is created by a complex combination of interactions among different actors of the ecosystem. Thus, value is not created by a single offering directed to the customer, but by an integration of services from different parts of the ecosystem as well as the active participation of customer in this process.

Implementation of hospital-wide computer information system :a case study of this change process

This case study examines the impact of a computer information system as it was being implemented in one Ontario hospital. The attitudes of a cross section of the hospital staff acted as a barometer to measure their perceptions of the implementation process. With The Mississauga Hospital in the early stages of an extensive computer implementation project, the opportunity existed to identify staff attitudes about the computer system, overall knowledge and compare the findings with the literature. The goal of the study was to develop a greater base about the affective domain in the relationship between people and the computer system. Eight exploratory questions shaped the focus of the investigation. Data were collected from three sources: a survey questionnaire, focused interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. Instrumentation in the study consisted of a survey distributed at two points in time to randomly selected hospital employees who represented all staff levels.Other sources of data included hospital documents, and twenty-five focused interviews with staff who replied to both surveys. Leavitt's socio-technical system, with its four subsystems: task, structure, technology, and people was used to classify staff responses to the research questions. The study findings revealed that the majority of respondents felt positive about using the computer as part of their jobs. No apparent correlations were found between sex, age, or staff group and feelings about using the computer. Differences in attitudes, and attitude changes were found in potential relationship to the element of time. Another difference was found in staff group and perception of being involved in the decision making process. These findings and other evidence about the role of change agents in this change process help to emphasize that planning change is one thing, managing the transition is another.

Accounting information systems as institutional carriers: a case study of regulatory compliance in UK asset management houses

Previously, governments have responded to the impacts of economic failures and consequently have developed more regulations to protect employees, customers, shareholders and the economic wellbeing of the state. Our research addresses how Accounting Information Systems (AIS) may act as carriers for institutionalised practices associated with maintaining regulatory compliance within the context of UK Asset Management Houses. The AIS was found to be a strong conduit for institutionalized compliance related practices, utilising symbolic systems, relational systems, routines and artefacts to carry approaches relating to regulative, normative and cultural-cognitive strands of institutionalism. Thus, AIS are integral to the development and dissipation of best practice for the management of regulatory compliance. As institutional elements are clearly present we argue that AIS and regulatory compliance provide a rich context to further institutionalism. Since AIS may act as conduits for regulatory approaches, both systems adopters and clients may benefit from actively seeking to codify and abstract best practices into AIS. However, the application of generic institutionalized approaches, which may be applied across similar organizations, must be tempered with each firm’s business environment and associated regulatory exposure. A balance should be sought between approaches specific enough to be useful but generic enough to be universally applied.

Case study on the maintenance of a construction monitoring using USN-based data acquisition

In recent years, there has been an increasing interest in the adoption of emerging ubiquitous sensor network (USN) technologies for instrumentation within a variety of sustainability systems. USN is emerging as a sensing paradigm that is being newly considered by the sustainability management field as an alternative to traditional tethered monitoring systems. Researchers have been discovering that USN is an exciting technology that should not be viewed simply as a substitute for traditional tethered monitoring systems. In this study, we investigate how a movement monitoring measurement system of a complex building is developed as a research environment for USN and related decision-supportive technologies. To address the apparent danger of building movement, agent-mediated communication concepts have been designed to autonomously manage large volumes of exchanged information. In this study, we additionally detail the design of the proposed system, including its principles, data processing algorithms, system architecture, and user interface specifics. Results of the test and case study demonstrate the effectiveness of the USN-based data acquisition system for real-time monitoring of movement operations.