Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

The role of rules-based compliance systems in the new EU regulatory landscape: perspectives of institutional change and agency

The financial crisis of 2007-2009 and the subsequent reaction of the G20 have created a new global regulatory landscape. Within the EU, change of regulatory institutions is ongoing. The research objective of this study is to understand how institutional changes to the EU regulatory landscape may affect corresponding institutionalized operational practices within financial organizations and to understand the role of agency within this process. Our motivation is to provide insight into these changes from an operational management perspective, as well as to test Thelen and Mahoney?s (2010) modes of institutional change. Consequently, the study researched implementations of an Investment Management System with a rules-based compliance module within financial organizations. The research consulted compliance and risk managers, as well as systems experts. The study suggests that prescriptive regulations are likely to create isomorphic configurations of rules-based compliance systems, which consequently will enable the institutionalization of associated compliance practices. The study reveals the ability of some agents within financial organizations to control the impact of regulatory institutions, not directly, but through the systems and processes they adopt to meet requirements. Furthermore, the research highlights the boundaries and relationships between each mode of change as future avenues of research.

Building post crisis watchtowers: investment management Systems and new institutional logics for regulatory compliance

The financial crisis of 2007-2009 has precipitated large scale regulatory change. Tight deadlines for implementation require organizations to start working on remediation projects before final drafts of regulations are crystalized. Firms are faced with engaging in complex and costly change management programs at a time when profits are diminished. As a consequence of these factors, pre-crisis logics for organizing compliance practices are being questioned and new approaches introduced. Our study explores the use of Investment Management Systems (IMS) in facilitating compliance arrangements. Our motivation is to understand the new logics and the part played by IMS in supporting these approaches. The study adopts an institutional logics perspective to explore the use of such systems at eight financial organizations. The study found new logics for organizing compliance include consolidation, centralization, harmonization and consistency and that the IMS plays an important role in supporting and enabling related activities.

Information architecture for healthcare organizations: the case of a NHS Hospital in UK

Healthcare organizations are known for their complex and intense information environment. Healthcare information is facilitated via heterogeneous information systems or paper-based sources. Access to the right information under increasing time pressure is extremely challenging. This paper proposes an information architecture for healthcare organizations. It facilitates the provision of the right information to the right person in the right place and time tailored to their requirements. It adapts an abductive reasoning research approach. Organizational semiotics serves as its theoretical underpinning, guiding the data collection process through direct observation in the ophthalmology outpatient clinics of a UK hospital. It results the norm and information objects that form the information architecture. This is modeled by Archimate. The contribution of the information architecture can be seen from organizational, social and technical perspective. It clearly shows how information is facilitated within a healthcare organization, reducing duplicated data entry, and guiding the future technological implementation.

Semiotic interoperability- a critical step towards systems integration

Information systems integration becomes critical in enhancing organisational competitiveness through effective use of information resource provided by the whole host of information systems. Information systems integration in its nature is a process of bringing about the capability of communication and information exchange between systems; while interoperability, often as the result of systems integration, is such a capability. However currently there is a lack of theoretical foundation for representation and measure of the interoperability in organisations. Organisational semiotics provides a theoretical foundation for systems interoperability. A notion of ‘semiotic interoperability’ is proposed in this paper as a paradigm, guiding systems integration and measuring degree of interoperability, covering aspects from physical properties, transmission structure of signs, placing emphasis on communicating meaning, intention to social consequence of information.

The art of shooting the moving goal - explorative study of EA pilot

Enterprise Architecture (EA) has been recognised as an important tool in modern business management for closing the gap between strategy and its execution. The current literature implies that for EA to be successful, it should have clearly defined goals. However, the goals of different stakeholders are found to be different, even contradictory. In our explorative research, we seek an answer to the questions: What kind of goals are set for the EA implementation? How do the goals evolve during the time? Are the goals different among stakeholders? How do they affect the success of EA? We analysed an EA pilot conducted among eleven Finnish Higher Education Institutions (HEIs) in 2011. The goals of the pilot were gathered from three different stages of the pilot: before the pilot, during the pilot, and after the pilot, by means of a project plan, interviews during the pilot and a questionnaire after the pilot. The data was analysed using qualitative and quantitative methods. Eight distinct goals were recognised by the coding: Adopt EA Method, Build Information Systems, Business Development, Improve Reporting, Process Improvement, Quality Assurance, Reduce Complexity, and Understand the Big Picture. The success of the pilot was analysed statistically using the scale 1-5. Results revealed that goals set before the pilot were very different from those mentioned during the pilot, or after the pilot. Goals before the pilot were mostly related to expected benefits from the pilot, whereas the most important result was to adopt the EA method. Results can be explained by possibly different roles of respondents, which in turn were most likely caused by poor communication. Interestingly, goals mentioned by different stakeholders were not limited to their traditional areas of responsibility. For example, in some cases Chief Information Officers' goals were Quality Assurance and Process Improvement, whereas managers’ goals were Build Information Systems and Adopt EA Method. This could be a result of a good understanding of the meaning of EA, or stakeholders do not regard EA as their concern at all. It is also interesting to notice that regardless of the different perceptions of goals among stakeholders, all HEIs felt the pilot to be successful. Thus the research does not provide support to confirm the link between clear goals and success.

Information sources, ICTs and price information in rural agricultural markets

The spread and rapid uptake of mobile telephony in Sub-Saharan Africa has highlighted the potential role of Information Communication Technologies in improving market participation and welfare outcomes for farm producers in agricultural produce markets. This article explores the influence of different sources of information and transmission technologies on the quantum and reliability of market information flowing to farm producers, based on a survey of farm households in northern Ghana. Our results suggest that the principal role of radio broadcasts and mobile telephony is in providing a broader knowledge of markets by enhancing the quantum of market information flowing to farm producers. They do not, however, appear to have a significant impact on the quality/reliability of price information obtained by farmers for making marketing decisions. Information sources appear to be the chief determinant of the reliability of price information, with price information obtained from extension agents being the most credible. Our results provide some useful insights for the design and implementation of Market Information Systems aimed at encouraging market participation by rural farm producers in agricultural markets.

Rationality of service composition of Workflow Net in a service oriented architecture

Users’ requirements change drives an information system evolution. Consequently, such evolution affects those atomic services which provide functional operations from one state of their composition to another state of composition. A challenging issue associated with such evolution of the state of service composition is to ensure a resultant service composition remaining rational. This paper presents a method of Service Composition Atomic-Operation Set (SCAOS). SCAOS defines 2 classes of atomic operations and 13 kinds of basic service compositions to aid a state change process by using Workflow Net. The workflow net has algorithmic capabilities to compose the required services with rationality and maintain any changes to the services in a different composition also rational. This method can improve the adaptability to the ever changing business requirements of information systems in the dynamic environment.

The agile governance of business IT projects

Organisations typically define and execute their selected strategy by developing and managing a portfolio of projects. The governance of this portfolio has proved to be a major challenge, particularly for large organisations. Executives and managers face even greater pressures when the nature of the strategic landscape is uncertain. This paper explores approaches for dealing with different levels of certainty in business IT projects and provides a contingent governance framework. Historically business IT projects have relied on a structured sequential approach, also referred to as a waterfall method. There is a distinction between the development stages of a solution and the management stages of a project that delivers the solution although these are often integrated in a business IT systems project. Prior research has demonstrated that the level of certainty varies between development projects. There can be uncertainty on what needs to be developed and also on how this solution should be developed. The move to agile development and management reflects a greater level of uncertainty often on both dimensions and this has led the adoption of more iterative approaches. What has been less well researched is the impact of uncertainty on the governance of the change portfolio and the corresponding implications for business executives. This paper poses this research question and proposes a govemance framework to address these aspects. The governance framework has been reviewed in the context of a major anonymous organisation, FinOrg. Findings are reported in this paper with a focus on the need to apply different approaches. In particular, the governance of uncertain business change is contrasted with the management approach for defined IT projects. Practical outputs from the paper include a consideration of some innovative approaches that can be used by executives. It also investigates the role of the business change portfolio group in evaluating and executing the appropriate level of governance. These results lead to recommendations for executives and also proposed further research.

A gestalt generated from grounded theory concerning intuition in IS research

Intuition is an important and under-researched concept in information systems. Prior exploratory research has shown that that there is potential to characterize the use of intuition in academic information systems research. This paper extends this research to all of the available issues of two leading IS journals with the aim of reaching an approximation of theoretical saturation. Specifically, the entire text of MISQ and ISR was reviewed for the years 1990 through 2009 using searchable PDF versions of these publications. All references to intuition were coded on a basis consistent with Grounded Theory, interpreted as a gestalt and represented as a mind-map. In the period 1990-2009, 681 incidents of the use of "intuition", and related terms were found in the articles reviewed, representing a greater range of codes than prior research. In addition, codes were assigned to all issues of MIS Quarterly from commencement of publication to the end of the 2012 publication year to support the conjecture that coding saturation has been approximated. The most prominent use of the term of "intuition" was coded as "Intuition as Authority" in which intuition was used to validate a statement, research objective or a finding; representing approximately 34 per cent of codes assigned. In research articles where mathematical analysis was presented, researchers not infrequently commented on the degree to which a mathematical formulation was "intuitive"; this was the second most common coding representing approximately 16 per cent of the codes. The possibly most impactful use of the term "intuition" was "Intuition as Outcome", representing approximately 7 per cent of all coding, which characterized research results as adding to the intuitive understanding of a research topic or phenomena.This research aims to contribute to a greater theoretical understanding of the use of intuition in academic IS research publications. It provides potential benefits to practitioners by providing insight into the use of intuition in IS management, for example, emphasizing the emerging importance of "intuitive technology". Research directions include the creation of reflective and/or formative constructs for intuition in information systems research and the expansion of this novel research method to additional IS academic publications and topics.

Modelling the resistance of Enterprise Architecture adoption: linking strategic level of Enterprise Architecture to organisational changes and change resistance

During the last few years Enterprise Architecture (EA) has received increasing attention among industry and academia. By adopting EA, organisations may gain a number of benefits such as better decision making,increased revenues and cost reduction, and alignment of business and IT. However, EA adoption has been found to be difficult. In this paper a model to explain resistance during EA adoption process (REAP) is introduced and validated. The model reveals relationships between strategic level of EA, resulting organisational changes, and sources of resistance. By utilising REAP model, organisations may anticipate and prepare for the organisational change resistance during EA adoption.

Formal validation of automated policy refinement in the management of network security systems

Policy hierarchies and automated policy refinement are powerful approaches to simplify administration of security services in complex network environments. A crucial issue for the practical use of these approaches is to ensure the validity of the policy hierarchy, i.e. since the policy sets for the lower levels are automatically derived from the abstract policies (defined by the modeller), we must be sure that the derived policies uphold the high-level ones. This paper builds upon previous work on Model-based Management, particularly on the Diagram of Abstract Subsystems approach, and goes further to propose a formal validation approach for the policy hierarchies yielded by the automated policy refinement process. We establish general validation conditions for a multi-layered policy model, i.e. necessary and sufficient conditions that a policy hierarchy must satisfy so that the lower-level policy sets are valid refinements of the higher-level policies according to the criteria of consistency and completeness. Relying upon the validation conditions and upon axioms about the model representativeness, two theorems are proved to ensure compliance between the resulting system behaviour and the abstract policies that are modelled.

Informationssäkerhet inom grafiska företag

The study shows the current need for security solutions concerning work with information in different areas.Investigations will show important solutions for printers’ needs to meet the increasingly harder demands forfast and safe digital communications. Important factors to be analyzed in the investigations are: access todifferent types of information, workers authority of information, access to the data base register internallyand externally, production solutions for an effective fault detection and data base solutions fororders and distribution.Planned and unplanned stops result in a standard of value in interruptions. Internal data bases areprotected by so-called “Fire Walls”, “Watch Dogs” and Virtual Private Networks. Offset plates are locked infor a definitive range of time. Subsequent destruction and remaining sheets are shredded and recycled. Alldocumentation is digital, in business control systems, which guarantees that no important documents arelying around in working places. Fault detection work is facilitated by the ability to fully track the order numberson incoming orders.