The impact of health information technology on the quality of medical and health care : a systematic review

Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

Making the processes of designing explicit within an information technology environment

In this paper, technology is described as involving processes whereby resources are utilised to satisfy human needs or to take advantage of opportunities, to develop practical solutions to problems. This study, set within one type of technology context, information technology, investigated how, through a one semester undergraduate university course, elements of technological processes were made explicit to students. While it was acknowledged in the development and implementation of this course that students needed to learn technical skills, technological skills and knowledge, including design, were seen as vital also, to enable students to think about information technology from a perspective that was not confined and limited to `technology as hardware and software'. This paper describes how the course, set within a three year program of study, was aimed at helping students to develop their thinking and their knowledge about design processes in an explicit way. An interpretive research approach was used and data sources included a repertory grid `survey'; student interviews; video recordings of classroom interactions, audio recordings of lectures, observations of classroom interactions made by researchers; and artefacts which included students' journals and portfolios. The development of students' knowledge about design practices is discussed and reflections upon student knowledge development in conjunction with their learning experiences are made. Implications for ensuring explicitness of design practice within information technology contexts are presented, and the need to identify what constitutes design knowledge is argued.

Validation of the impact of Health Information Technology (I-HIT) scale : an international collaborative

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the IHIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the IHIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative’s validation of the IHIT Scale completed to date.

The new middle class meets the creative class : the Master of Business Administration (MBA) and creative innovation in 21st-century China

‘MBA fever’ in China needs to be understood in the wider context of forces driving structural change in China’s relation to the global knowledge economy. The rise of a ‘new middle class’ in China is connected to the new claims for cultural leadership of an emergent ‘creative class’, which generates new issues about the relevance of the MBA in China, in terms of its relevance to Chinese economic circumstances, and its flexibility and capacity to respond to accumulation strategies that emphasise innovation, creativity and entrepreneurship.

Assessment of the influence of cultural barriers to HDR supervision of non-English speaking background (NESD) students in engineering and information technology (IT) disciplines

The paper details the results of the first phase of an on-going research into the sociocultural factors that influence the supervision of higher degrees research (HDR) engineering students in the Faculty of Built Environment and Engineering (BEE) and Faculty of Science and Technology (FaST) at Queensland University of Technology. A quantitative analysis was performed on the results from an online survey that was administered to 179 engineering students. The study reveals that cultural barriers impact their progression and developing confidence in their research programs. We argue that in order to assist international and non-English speaking background (NESB) research students to triumph over such culturally embedded challenges in engineering research, it is important for supervisors to understand this cohort's unique pedagogical needs and develop intercultural sensitivity in their pedagogical practice in postgraduate research supervision. To facilitate this, the governing body (Office of Research) can play a vital role in not only creating the required support structures but also their uniform implementation across the board.

An example of developing a business model for information and communication technologies (ICT) adoption on construction projects – the National Museum of Australia project

Effective use of information and communication technologies (ICT) is necessary for delivering efficiency and improved project delivery in the construction industry. Convincing clients or contracting organisations to embrace ICT is a difficult task, there are few templates of an ICT business model for the industry to use. ICT application in the construction industry is relatively low compared to automotive and aerospace industries. The National Museum of Australia project provides a unique opportunity for investigating and reporting on this deficiency in publicly available knowledge. Concentrates on the business model content and objectives, briefly indicates the evaluation framework that was used to evaluate ICT effectiveness.

Enhancing business continuity management capacities in the insurance industry : a Southeast Asian perspective

As a resilience enhancing practice, business continuity management (BCM) can play an important role in aiding preparation of the insurance industry for coping with the losses incurred by major discontinuity incidents: regardless of cause. Acknowledging the increasing frequency of unpredictable man-made disasters and natural catastrophes, the insurance industry would benefit from examining and implementing, where suitable, key elements of BCM. Such strategic decisions would assist insurers and re-insurers collectively to enhance mutual capability to respond to, and recover from, the impact of significant losses. This paper presents a comparison of opinions about BCM practitioners in both retail and re-insurance companies on the importance of generic continuity practices with actual levels of BCM practice across the two industry groups in Southeast Asia. It suggests means by which multi-lateral cooperation across Asian economies and between retail and re-insurance market segments might enhance the viability of the insurance industry in the face of increased stress from major natural and socio-technical hazards.

Exploring the role of the governing body (board) in information technology governance : a study of Australian universities

In this thesis, I advance the understanding of information technology (IT) governance research and corporate governance research by considering the question “How do boards govern IT?” The importance of IT to business has increased over the last decade, but there has been little academic research which has focused on boards and their role in the governance of IT (Van Grembergen, De Haes and Guldentops, 2004). Most of the research on information technology governance (ITG) has focused on advancing the understanding and measurement of the components of the ITG model (Buckby, Best & Stewart, 2008; Wilkin & Chenhall, 2010), a model recommended by the IT Governance Institute (2003) as ‘best practice’ for boards to use in governing IT. IT governance is considered to be the responsibility of the board and is said to form an important subset of an organisation’s corporate governance processes (Borth & Bradley, 2008). Boards need to govern IT as a result of the large capital investment in IT resources and high dependency on IT by organisations. Van Grembergen, De Haes and Guldentops (2004) and De Haes & Van Grembergen (2009) indicate that corporate governance matters are not able to be effectively discharged unless IT is being governed properly, and call for further specific research on the role of the board in ITG. Researchers also indicate that the link between corporate governance and IT governance has been neglected (Borth & Bradley, 2008; Musson & Jordan, 2005; Bhattacharjya & Chang, 2008). This thesis will address this gap in the ITG literature by providing the bridge between the ITG and corporate governance literatures. My thesis uses a critical realist epistemology and a mixed method approach to gather insights into my research question. In the first phase of my research I develop a survey instrument to assess whether boards consider the components of the ITG model in governing IT. The results of this first study indicated that directors do not conceptualise their role in governing IT using the elements of the ITG model. Thus, I moved to focus on whether prominent corporate governance theories might elucidate how boards govern IT. In the second phase of the research, I used a qualitative inductive case based study to assess whether agency, stewardship and resource dependence theories explain how boards govern IT in Australian universities. As the first in-depth study of university IT governance processes, my research contributes to the ITG research field by revealing that Australian university board governance of IT is characterized by a combination of agency theory and stewardship theory behaviours and processes. The study also identified strong links between a university’s IT structure and evidence of agency and stewardship theories. This link provides insight into the structures element of the emerging enterprise governance of IT framework (Van Grembergen, De Haes & Guldentops, 2004; De Haes & Van Grembergen, 2009; Van Grembergen & De Haes, 2009b; Ko & Fink, 2010). My research makes an important contribution to governance research by identifying a key link between corporate and ITG literatures and providing insight into board IT governance processes. The research conducted in my thesis should encourage future researchers to continue to explore the links between corporate and IT governance research.

Business process management : theory on progression and maturity

Business Process Management (BPM) is a topic that continues to grow in significance as organisations seek to gain and sustain competitive advantage in an increasingly global environment. Despite anecdotal evidence of organisations improving performance by pursuing a BPM approach, there is little theory that explains and substantiates this relationship. This study provides the first theory on the progression and maturity of BPM Initiatives within organisations and provides a vital starting block upon which future research in this area can build. The Researcher starts by clearly defining three key terms (BPM Initiative, BPM Progression and BPM Maturity), showing the relationship between these three concepts and proposing their relationship with Organisational Performance. The Researcher then combines extant literature and use of the Delphi Technique and the case study method to explore the progression and measurement of the BPM Initiatives within organisations. The study builds upon the principles of general theories including the Punctuated Equilibrium Model and Dynamic Capabilities to present theory on BPM Progression and BPM Maturity. Using the BPM Capability Framework developed through an international Delphi study series, the Researcher shows how the specific organisational context influences which capability areas an organisation chooses to progress. By comparing five separate organisations over an extended time the Researcher is able to show that, despite this disparity, there is some evidence of consistency with regard to the capability areas progressed. This suggests that subsequent identification of progression paths may be possible. The study also shows that the approach and scope taken to BPM within each organisation is a likely predictor of such paths. These outcomes result in the proposal of a formative model for measuring BPM Maturity.

A Business Continuity Management Simulator

Comprehensive BCM plan testing for complex information systems is difficult and expensive, if not infeasible. This paper suggests that a simulator could be employed to ameliorate these problems. A general model for such a BCM simulator is presented, and the implementation of a prototype simulator is described. The simulator reacts to system disturbances by seeking alternative configurations provided within the BCM plan, reporting the resource availabilities in the updated system and identifying any failure to meet the requirements placed on the system. The simulator then explores any changes in data security introduced by the proposed post disturbance configuration and reports any enhanced risk.

A software framework for risk-aware business process management

With the large diffusion of Business Process Managemen (BPM) automation suites, the possibility of managing process-related risks arises. This paper introduces an innovative framework for process-related risk management and describes a working implementation realized by extending the YAWL system. The framework covers three aspects of risk management: risk monitoring, risk prevention, and risk mitigation. Risk monitoring functionality is provided using a sensor-based architecture, where sensors are defined at design time and used at run-time for monitoring purposes. Risk prevention functionality is provided in the form of suggestions about what should be executed, by who, and how, through the use of decision trees. Finally, risk mitigation functionality is provided as a sequence of remedial actions (e.g. reallocating, skipping, rolling back of a work item) that should be executed to restore the process to a normal situation.

The Impact of Information Technology Investments on Firm Processes and Performance

This book provides the much needed international dimension on the payoffs of information technology investments. The bulk of the research on the impact of information technology investments has been undertaken in developed economies, mainly the United States. This research provides an alternative dimension - a developing country perspective on how information technology investments impacts organizations. Secondly, there has been much debate and controversy on how we measure information technology investment payoffs. This research uses an innovative two-stage model where it proposes that information technology investments will first impact the process and improvement in the processes will then impact the performance. In doing so, it considers sectors of information technology investment rather than taking it as one. Finally, almost all prior studies in this area have considered only the tangible impact of information technology investments. This research proposes that one can only better understand the benefits by looking at both the tangible and intangible benefits.

Is your organizational culture fit for business process management?

All processes are modeled, all process metrics defined, all process support systems are set up; yet still, processes are not running smoothly and departmental silos are more present than ever. Both practitioners and academics tell the same story. A successful business process management (BPM) implementation goes beyond using the right methods and putting the right systems in place. In fact, an important success factor for BPM is establishing the right organizational culture, that is, a culture that supports the achievement and maintenance of efficient and effective business processes.