bluuebunny/crossref_metadata_2025 huggingface dataset:
Team Software Process in GSD Teams
Authors: Hernández-López Adrián , Colomo-Palacios Ricardo , García-Crespo Ángel , Soto-Acosta Pedro
Published: February 2011

Distributed software development is becoming the norm for the software industry today as an organizational response to globalization and outsourcing tendencies. In this new environment, centralized models for software development team building models have to be reanalyzed. Team Software Process (TSP) guides engineering teams in developing software-intensive products and is intended to improve the levels of quality and productivity of a team’s software development project. In this paper, the authors assess the difficulty of using TSP in distributed software development environments. The objective of this assessment is twofold; firstly, know the general difficulty for using TSP in these environments, and secondly, know the caveats to be addressed in future software development team building models designed specifically for distributed environments.
A Dynamic Approach to Introduce Competency Frameworks
Authors: Echavarren Alfonso Urquiza
Published: February 2011

Although a wide consensus exists about potential business benefits derived from Competency based HR management practices, reality shows that in practice, Competency Management deployment cases are scarce and difficult to implement. This HR business related problem directly affects IT Software industries, both in HRMS applications development and consultancy related services. Market indicators reflect ‘unbalance’ between potential organizational benefits and actual applications deployment. In this context, defining useful, business-oriented Competency Frameworks has become an important challenge for many organizations willing to progress along through continuous HRM improvement processes. This paper addresses the major issues underlying this Competency Management unbalance. A new business-oriented approach proposing an alternative, scope extended methodology is outlined in this publication, after field validation and wide acceptance from experts in functional HR management and IT Systems professionals from various large size organizations. Therefore, the findings resulting from this research work have both theoretical and practical implications in helping IT management in defining efficient HRMS Competency based applications and deployment strategies.
Peer Assist Live Streaming Overlay for Next-Generation-Networks
Authors: Müller Julius , Magedanz Thomas , Fiedler Jens
Published: February 2011

The rapid evolution of the telecommunication domain increases the performance of different access networks continuously. New services, especially in the domain multimedia content distribution, require higher and higher bandwidth at the user’s and service provider’s side. Multimedia services like Video on Demand, IPTV, and live streaming were introduced in the past and are still improved in quality and quantity. Multimedia streams and Peer to Peer (P2P) file sharing dominates the worldwide Internet traffic nowadays and will continue further (Schulze, 2009). The user acceptance of enjoying multimedia content over the Internet will grow steadily together with the increasing quality of the available multimedia content. Network operators and service providers have to face the growths by increasing their service platform with higher performance and bandwidth or introducing a scalable solution. In this paper, the authors present an algorithm for scalable P2P live streaming in Next-Generation-Networks (NGN) that addresses this challenge. An evaluation proves the performance of the implementation of this algorithm in a demo scenario.
Effect of Personal Innovativeness, Attachment Motivation and Social Norms on the Acceptance of Camera Mobile Phones
Authors: Rouibah Kamel , Abbas Hasan A.
Published: February 2011

This study develops a model to assess the consumer acceptance of Camera Mobile Phone (CMP) technology for social interaction. While there has been considerable research on technology adoption in the workplace, far fewer studies have been done to understand the motives of technology acceptance for social use. To fill in this gap, the authors develop a model that is based on the theory of the technology acceptance model, the theory of reasoned action, the attachment motivation theory, innovation diffusion theory, and the theory of flow. The first research methods used was a qualitative field study that identified the variables that most drive CMP acceptance and build the research model using a sample of 83 consumers. The second method was a quantitative field study, which collected from a sample of 240 consumers in Kuwait in order to test the model. Results reveal the “social use” and “use before shopping” uses, explaining 32.3% and 30% of the variance, respectively. Most importantly, the study reveals that personal innovativeness, attachment motivation, and social norms have an important effect on CMP acceptance.
MICA
Authors: Prause Christian R. , Jentsch Marc , Eisenhauer Markus
Published: February 2011

Thousands of small and medium-sized companies world-wide have non-automated warehouses. Picking orders are manually processed by blue-collar workers; however, this process is highly error-prone. There are various kinds of picking errors that can occur, which cause immense costs and aggravate customers. Even experienced workers are not immune to this problem. In turn, this puts a high pressure on the warehouse personnel. In this paper, the authors present a mobile assistance system for warehouse workers that realize the new Interaction-by-Doing principle. MICA unobtrusively navigates the worker through the warehouse and effectively prevents picking errors using RFID. In a pilot project at a medium-sized enterprise the authors evaluate the usability, efficiency, and sales potential of MICA. Findings show that MICA effectively reduces picking times and error rates. Consequentially, job training periods are shortened, while at the same time pressure put on the individual worker is reduced. This leads to lower costs for warehouse operators and an increased customer satisfaction.
Survivability Enhancing Techniques for RFID Systems
Authors: Zuo Yanjun
Published: February 2011

Radio Frequency Identification (RFID) has been applied in various high security and high integrity settings. As an important ubiquitous technique, RFID offers opportunities for real-time item tracking, object identification, and inventory management. However, due to the high distribution and vulnerability of its components, an RFID system is subject to various threats which could affect the system’s abilities to provide essential services to users. Although there have been intensive studies on RFID security and privacy, there is still no complete solution to RFID survivability. In this paper, the authors classify the RFID security techniques that could be used to enhance an RFID system’s survivability from three aspects, i.e., resilience, robustness and fault tolerance, damage assessment and recovery. A threat model is presented, which can help users identify devastating attacks on an RFID system. An RFID system must be empowered with strong protection to withstand those attacks and provide essential functions to users.
Mobile Agent Based Network Defense System in Enterprise Network
Authors: Cai Yu
Published: February 2011

Security has become the Achilles’ heel of many organizations in today’s computer-dominated society. In this paper, a configurable intrusion detection and response framework named Mobile Agents based Distributed (MAD) security system was proposed for enterprise network consisting of a large number of mobile and handheld devices. The key idea of MAD is to use autonomous mobile agents as lightweight entities to provide unified interfaces for intrusion detection, intrusion response, information fusion, and dynamic reconfiguration. These lightweight agents can be easily installed and managed on mobile and handheld devices. The MAD framework includes a family of autonomous agents, servers and software modules. An Object-based intrusion modeling language (mLanguage) is proposed to allow easy data sharing and system control. A data fusion engine (mEngine) is used to provide fused results for traffic classification and intrusion identification. To ensure Quality-of-Service (QoS) requirements for end users, adaptive resource allocation scheme is also presented. It is hoped that this project will advance the understanding of complex, interactive, and collaborative distributed systems.
Managing E-Procurement in Public Healthcare
Authors: Federici Tommaso , Resca Andrea
Published: February 2011

In large parts of Europe, the development of healthcare is subject to contrasting forces: explosion in spending, while governments are faced with budget constraints, and pressures to be innovative, technologically advanced in order to improve the services’ quality. Even though e-procurement initatives can be seen as a solution to the first issue in this dilemma, such initiatives have not been widely deployed and have not delivered the expected benefits so far. In this perspective, as case study of an e-procurement implementation of an Italian local healthcare agency has been examined because of the comprehensive design of the e-procurement system, the differentiation of tools adopted and the multiple solutions already implemented or in progress. The aim of this work is to reconstruct, by following a knowledge management approach, the steps that led to the introduction of e-procurement as a new operating practice, by redesigning supply purchasing, supply chain and logistic processes.
Decentralisation and Health Systems Performance in Developing Countries
Authors: Anifalaje Adebusoye A.
Published: February 2011

This article attempts to elucidate the intricacies of primary health care delivery in Nigeria. Among myriad complexities, the central proposition made herein is that the absence of an effective regulatory and enforcement framework in developing countries results in a prominent informal decision space. The findings show that the prominence of an informal decision space compromises the objectives of an information-based public health system. The article concludes that decentralisation in developing countries must have a coordinated top-down and bottom-up development component for it to be effective in improving the performance of primary health systems. One of the implications of the study is that researching decentralised healthcare delivery requires analytical models which are able to illuminate the complexities of local accountability in developing countries. The study also reveals the need to further research the dynamics of democratic decentralisation in developing countries as this goes beyond administrative structures but involve socio-cultural institutions.
Drivers for Wireless Technology Acceptance in Indian Healthcare
Authors: Gururajan Raj
Published: February 2011

The outcomes of clinical usefulness as a driver of wireless technology for Indian healthcare are reported here. Using both qualitative and quantitative techniques, 30 physicians were interviewed and 200 health professionals were surveyed. The outcomes established that in addition to technology factors, other factors such as clinical factors, administration factors and communication factors play a crucial role in determining the uptake of wireless technology for healthcare. These factors were further validated using a PLS model.
Preparing Healthcare Organizations for New IT Systems Adoption
Authors: Breas Robert , Guah Matthew Waritay
Published: February 2011

Information systems exist for hospitals but even the most advanced systems concentrate on relatively simple coordination, resource allocation and documentation aspects of healthcare operations. At the same time the need to improve health care performance by means of more sophisticated IT systems is widely felt. In practice, however, the adoption of new IT is usually a difficult and a very slow process. To analyse the underlying reasons, we identified a set of key bottlenecks in the IT adoption process by interviewing large groups of healthcare actors. We conclude that health care organizations should be better prepared in order to facilitate easier IT systems’ adoption. To do so, a readiness framework is considered to be helpful, the contours of which are sketched in this article. It is also discussed how, based on clarified clinical pathways, workflow management can assist in framing optimization of resource utilisation, clinical decision-making, staff training and quality improvement in healthcare delivery.
Physician Characteristics and EMR Attitudes
Authors: Meinert David , Peterson Dane K.
Published: February 2011

Despite the numerous purported benefits of Electronic Medical Records (EMR), the medical profession has been extremely reluctant to embrace the technology. One of the barriers believed to be responsible for the slow adoption of EMR technology is resistance by many physicians who are not convinced of the advantages of using EMR systems. This study examined potential characteristics of physicians that might help identify those individuals that are most likely to pose a threat to the successful implementation of an EMR system in a multi-specialty clinic. The results demonstrated that older physicians and physicians with only minimal computer skills are more likely to have negative attitudes regarding EMR technology. Medical specialists were most likely to have positive attitudes with respects to the use of EMR systems, while primary care physicians were most likely to have doubts regarding the purported benefits of EMR technology.
Wireless for Managing Health Care
Authors: Alasaarela Esko , Nemana Ravi , DeMello Steven , Oliver Nick S. , Miyazaki Masako
Published: February 2011

The Wirhe project is an international collaborative study that focused on the future of healthcare needs, technology requirements and solutions for effective use of wireless technologies for health care delivery. This paper presents results of a Wirhe survey of 85 experts and individual interviews with 35 experts. Key findings include: 1) both notable quality improvements and process enhancements can be expected from effectively utilizing wireless technologies and mobile solutions, 2) integration of personal health monitoring and professional health management is a key issue to be addressed and 3) health promotion and illness prevention efforts can grow by utilizing mobile solutions. We propose a framework that can be used in developing wireless health care solutions for managing diseases and related health problems. This framework can also be used to structure and stratify the needs of technologies and solutions, and to estimate their market potential.
Multi-Dimensional Criteria for the Evaluation of E-Health Services
Authors: Hamid Alalwany , Sarmad Alshawi
Published: February 2011

E-health is an emerging field in the intersection of information systems, healthcare and business, referring mainly to healthcare services delivered and enhanced through the use of information and communication technologies (ICT). An important area of research is the evaluation of e-health services. A holistic e health evaluation framework should address the aspects that are hampering healthcare services from embracing the full potential of ICT towards successful e-health initiatives. In order to build a holistic evaluation framework for e-health services, this article suggests framework characteristics for the appropriate evaluation for e-health services. The article argues that e-health services evaluation framework should be criteria based. The criteria have to be multi-dimensional that grounded in, or derived from, one or more specific perspectives or theories. The proposed evaluation criteria in this article can serve as part of an e-health evaluation framework, improve our understanding of the role of information systems in health care, and develop our ability to deliver high quality services.
Evaluation of a Fuzzy Ontology-Based Medical Information System
Authors: Parry David
Published: February 2011

Evidence-based medicine (EBM) requires appropriate information to be available to clinicians at the point of care. Electronic sources of information may fulfill this need but require a high level of skill to use successfully. This paper describes the rationale and initial testing of a system to allow collaborative search and ontology construction for professional groups in the health sector. The approach is based around the use of a browser using a fuzzy ontology based on the National Library of Medicine (NLM) Unified Medical Language System (UMLS). This approach may provide high quality information for professionals in the future.
Differences in Computer Usage of U.S. Group Medical Practices
Authors: Sobol Marion , Prater Edmund
Published: February 2011

Research on the use of information technology in healthcare has focused on hospitals and Health Management Organizations (HMOs). However, little has been done to study the use of IT in group medical practices. In 1994, we conducted a pilot study of group medical practices and then repeated this pilot study in 2003 to obtain a longitudinal picture of the IT services used by these private practices. Researchers can use this to form ideas of the important issues and changes involved in IT usage in group medical practices over the past decade thus providing a needed benchmark to fill a gap in the existing literature and that can be used to compare domestic as well as international practices. For example, an expanded form of this study will be conducted in Taiwan this summer.
Applying Adaptive Structuration Theory to Health Information Systems Adoption
Authors: Schwieger Dana , Melcher Arlyn , Ranganathan C. , Wen H. Joseph
Published: February 2011

Adaptive Structuration Theory (AST) is rapidly becoming an important theoretical paradigm for comprehending the impact of advanced information technologies. In this paper, a modified AST model was designed to illustrate the changing inter-relationships among the variables affecting the adoption and application of a new technology into a medical organization setting. Using findings from a case study conducted over a 10-month period, the authors apply the case to the model to illustrate the complex interactions between medical billing technology and organizational processes. As the organization attempted to install and implement the new system, they found that in order to maintain daily operations, they would have to modify and adapt several aspects of the organization, technology, and operations. As the system was slowly integrated into operations and the organization’s needs evolved through the adaptation process, the study, in turn, found that different iterations of the model could emphasize different structures. The case illustrated that the capacity to manage health information systems (HIS) often requires the organization to prioritize its needs and focus its energies on a critical structure while temporarily disregarding others until the primary healthcare processes are under control.
The M-Health Reference Model
Authors: Olla Phillip , Tan Joseph
Published: February 2011

The reference model presented in this article encourages the breakdown of M-Health systems into the following five key dimensions: (1) Communication Infrastructure: a description of mobile telecommunication technologies and networks; (2) Device Type: the type of device being used, such as PDA, sensor, or tablet PC; (3) Data Display: describes how the data will be displayed to the user and transmitted, such as images, e-mail, and textual data; (4) Application Purpose: identification of the objective for the M-Health system; (5) Application Domain: definition of the area in which the system will be implemented. Healthcare stakeholders and system implementer can use the reference model presented in this article to understand the security implications of the proposed system and to identify the technological infrastructure, business requirements, and operational needs of the M-Health systems being implemented. A reference model that encapsulates the emerging M-Health field is needed for cumulative progress in this field. Currently, the M-Health field is disjointed, and it is often unclear what constitutes an M-Health system. In the future, M-Health applications will take advantage of technological advances such as device miniaturizations, device convergence, high-speed mobile networks, and improved medical sensors. This will lead to the increased diffusion of clinical M-Health systems, which will require better understanding of the components that constitute the M-Health system.
The Internet, Health Information, and Managing Health
Authors: Reddick Christopher G.
Published: February 2011

This article examines the use of the Internet for gathering health information by boomers and seniors. This study attempts to determine whether online health seekers (individuals that have Internet access and have searched for health information online) have changed their behaviors from the information they found online. Essentially, has online health information helped them to manage their health more effectively? This research analyzes the Kaiser Family Foundation e-Health and the Elderly public opinion dataset of access by boomers and seniors to online health information. The major results indicate that boomers marginally use online health information more than seniors for the management of their health. The most significant results indicated that boomers and seniors who are more aware and have positive feelings toward online health information would use it more to manage their health.
User Acceptance of Computerized Physician Order Entry
Authors: Liang Huigang , Xue Yajiong , Wu Xiaocheng
Published: February 2011

Computerized physician order entry (CPOE) holds potential of reducing medical errors, improving care quality, and cutting healthcare costs. Yet, its success largely depends on physicians’ acceptance and subsequent usage. This study examines whether Technology Acceptance Model (TAM) can be applied to explain physician acceptance of CPOE. A survey was conducted in a large general hospital in China, and 103 data were collected from 200 physicians. The data analysis provided support for all relationships predicted by TAM but failed to support the relationship between ease of use and attitude. A follow-up analysis showed that this relationship is moderated by CPOE experience. Under the condition of high CPOE experience, perceived ease of use has no effect on attitude, whereas under the condition of low CPOE experience, perceived ease of use positively affects attitude. Implications for healthcare informatics are discussed.
Factors Motivating the Acceptance of New Information and Communication Technologies in UK Healthcare
Authors: Osbourne Janice A , Clarke Malcolm
Published: February 2011

This paper discusses the use of three published models, the Technology acceptance model (TAM), Rogers diffusion of Innovation theory (IDT), and the Triandis theory of interpersonal behaviour (TIB), and attempts to bring them together in an integrated model to better predict the adoption of new information and communication technologies by a cohort of health professionals within UK primary care in an attempt to aid implementers in bringing technology in at an organizational level.
The Competitive Forces Facing E-Health
Authors: Wickramasinghe Nilmini , Misra Santosh , Jenkins Arnold , Vogel Douglas R.
Published: February 2011

Superior access, quality, and value of healthcare services has become a national priority for healthcare to combat the exponentially increasing costs of healthcare expenditure. E-Health in its many forms and possibilities appears to offer a panacea for facilitating the necessary transformation for healthcare. While a plethora of e-health initiatives keep mushrooming both nationally and globally, there exists to date no unified system to evaluate these respective initiatives and assess their relative strengths and deficiencies in realizing superior access, quality and value of healthcare services. Our research serves to address this void. This is done by focusing on the following three key components: 1) understanding the Web of players (regulators, payers, providers, healthcare organizations, suppliers, and last but not least patients) and how e health can modify the interactions between these players as well as create added value healthcare services, 2) understand the competitive forces facing e-health organizations and the role of the Internet in modifying these forces, and 3) from analyzing the Web of players combined with the competitive forces for e-health organizations we develop a framework that serves to identify the key forces facing an e-health and suggestions of how such an organization can structure itself to be e-health prepared.
The PsyGrid Experience
Authors: Ainsworth John , Harper Robert
Published: February 2011

The key aim of the PsyGrid project was the creation of an information system to ascertain and characterise a large, representative cohort of schizophrenics, beginning from their first episode of psychosis. The cohort was to be drawn from eight geographically dispersed regions of Eng-land, covering in total one-sixth of the entire population. In order to meet the current and future requirements we needed to build a secure distributed system, which not only could support remote data collection, but could also be integrated with other data sets, applications, and workflows for statistical analysis. We concluded that a service-oriented architecture was required and that the implementation technology should be Web services. In this article we present the design, deployment and operation of the PsyGrid data collection system as a case study in applying Web services to health informatics. The major problems we faced were related to the deployment of Web services into an existing network infrastructure, but overall found Web services to be the most suitable middleware technology.
A Framework for the Design of Web Service Based Clinical Management Systems to Support Inter and Intra Organizational Patient Journeys
Authors: McGregor Carolyn
Published: February 2011

The clinical management of premature and ill term babies is challenged by the necessity of several inter and intra organizational patient journeys. Premature and ill-term babies born in regional Australia and Canada must be moved to another hospital with Neonatal Intensive Care Unit (NICU) facilities. NICU babies requiring surgery must be moved to a Level IV NICU for surgery. Current clinical management supports the transfer of limited patient data via paper or telephone exchange. In this article a framework for the design of Web-service-based clinical management systems to support inter and intra organizational patient journeys is presented. A series of Web services are described and integrated and coordinated through BPEL processes enabling greater support for inter- and intra-organizational transfer of patient data. This framework is demonstrated through a NICU case study. A key benefit of this framework is that it enables the establishment of “on demand” patient journeys eliminating the need to establish permanent point-to-point connections.
Exploring a UML Profile Approach to Modeling Web Services in Healthcare
Authors: Raghupathi Wullianallur , Gao Wei
Published: February 2011

The Web services paradigm offers numerous potential benefits to the health care area. These include interoperability, portability, scalability, and compliance with universal standards. How-ever, development of large-scale Web services applications in health care is relatively scarce. Multiple challenges are slowing the diffusion of information technology practices in health care, starting with the absence of modeling tools and methodologies that are the bases for building such technology. This article describes a UML profile approach to developing Web services applications in the health care area, emphasizing the use of such extensions as stereotyping and tagging to model the unique elements of health care processing. We apply these ideas to a health clinic example. From here, one can imagine building incrementally upon these ideas to develop frameworks for Web services applications in health care. The benefits would enhance the overall quality of health care delivery and lower costs.
Choosing Technologies for Handheld and Ubiquitous Decision Support
Authors: Woollatt Darren , Koop Paul , Jones Sara , Warren Jim
Published: February 2011

Wireless, handheld devices are becoming increasingly popular in health care settings, but the full potential of their role in patient-specific decision support remains to be achieved. This article presents a multicriteria framework for choosing technologies apropos to handheld and ubiquitous decision support architecture. This framework is illustrated through architectural middleware choices made in the context of a podiatry and diabetes care network. Performance issues are found to be very important in the handheld space, and minor aspects of connectivity and other constraints drive significant changes in choices of architectural approach. The resulting architecture employs layers, including serialized objects, XML payloads, event notification, Web services, and dynamic class loading, with the mix varying among the system interfaces. The overall recommendation is that organizations wishing to fully exploit mobile technology must use a flexible policy and pursue a process of technology choice that is scenario-based and iterative to take into account discoveries from prototyping and field-test experience.
QoS Provisioning in Sensor Enabled Telemedicine Networks
Authors: Chigan Chunxiao , Oberoi Vikram
Published: February 2011

Enabled by the advances of the wireless sensor network technologies, wireless LANs will play a critical role in providing ubiquitous connectivity for future telemedicine applications. This paper focuses on how to provide QoS over the wireless channel between the Body Sensor Network (BSN) Gateway and the wireless Access Points (AP). Telemedicine applications require the periodic report data and the emergency messages transmitted to the remote health care center in a timely manner. However, unlike the voice and multimedia applications which can be supported by traditional QoS techniques, the sporadic nature of the emergency data in telemedicine systems makes it nontrivial to provide sufficient QoS. This article investigates several alternative schemes for QoS support in the telemedicine systems, and an express dual channel (EDC) based QoS mechanism is proposed. Not only is the proposed mechanism simple and resource efficient, but also it provides the bounded maximum delay guarantee for the unpredictable emergency data transmission for telemedicine applications.
The Effects of Confidentiality on Nursing Self-Efficacy with Information Systems
Authors: Lending Diane , Dillon Thomas W.
Published: February 2011

The objective of this study is to gain an understanding of nurses’ perceptions of the confidentiality of computerized charts and determine if these perceptions influence nursing self-efficacy. A questionnaire was mailed to 600 hospital nursing staff just prior to the implementation of an integrated clinical and administrative hospital-wide information system. One hundred and thirty-nine questionnaires were returned for a response rate of 23%. The measurements consisted of perceived confidentiality, self-efficacy, selfreported technology use, self-assessed computer expertise, and attitude. We found that nurses recognize confidential information and that nurses do not think that computerized records are more or less confidential than paper records. Perceived confidentiality and self-efficacy are related. Because nurses that have lower self-efficacy also think that the data found in a computer is less confidential and that there is less of a need for confidentiality for computerized data, hospitals should take steps to improve self-efficacy by enhancing confidentiality training.
Charting Health Information Technology Futures for Healthcare Services Organizations
Authors: Rastogi Avnish , Daim Tugrul , Tan Joseph
Published: February 2011

As health organizations strive to improve operational efficiencies and increase worker productivity, new forms of health information technologies (HITs) are constantly being developed. This article surveys the extant HIT literature and adopts a case analysis approach to identifying emerging health information technologies. The understanding of HIT trend is further enriched through the applications of technologyforecasting techniques, specifically, scenario analysis and U.S. patent searches. The article focuses on five emerging HITs and their impact on the future of U.S. Healthcare Services Delivery.
Gastrointestinal Motility Online Educational Endeavor
Authors: Au Shiu-chung , Gupta Amar
Published: February 2011

Medical information has been traditionally maintained in books, journals, and specialty periodicals. A growing subset of patients and caregivers are now turning to diverse sources on the internet to retrieve healthcare related information. The next area of growth will be sites that serve specialty fields of medicine, characterized by high quality of data culled from scholarly publications and operated by eminent domain specialists. One such site being developed for the field of Gastrointestinal Motility provides authoritative and current information to a diverse user base that includes patients and student doctors. Gastrointestinal Motility Online leverages the strengths of online textbooks, which have a high degree of organization, in conjunction with the strengths of online journal collections, which are more comprehensive and focused. Gastrointestinal Motility Online also utilizes existing Web technologies such as Wiki-editing and Amazonstyle commenting, to automatically assemble information from heterogeneous data sources.
Assessing Physician and Nurse Satisfaction with an Ambulatory Care EMR
Authors: Wager Karen A.
Published: February 2011

Evaluating clinician satisfaction with an electronic medical record (EMR) system is an important dimension to overall acceptance and use, yet project managers often lack the time and resources to formally assess user satisfaction and solicit feedback. This article describes the methods used to assess clinician satisfaction with an EMR and identify opportunities for improving its use at a 300-physician academic practice setting. We administered an online survey to physicians and nurses; 244 (44%) responded. We compared physician and nurse mean ratings across 5 domains, and found physicians’ satisfactions scores were statistically lower than nurses in several areas (p
Exploiting Process thinking in Health Care
Authors: Paavola Teemu
Published: February 2011

In Finland, a project designed to modernize processes and reduce the waiting list for joint replacement surgery has recently been completed. The new surgery arrangements for artificial joint patients were monitored for a period of 1 year. The new arrangements involved relocating the anaesthesia phase outside the operating theatre. The reorganization of the patient care process for joint replacement surgery succeeded in achieving a 50% increase in operations. While conventional operations can often be pushed up a notch with state-of-the-art technology, for example, this article supports the argument that process thinking can be exploited effectively to support new ways of work and improve productivity in health care. Paying enough attention to this at the planning stage can be vital to the success of new IT system implementation.
An Empirical Investigation into the Adoption of Open Source Software in Hospitals
Authors: Munoz-Cornejo Gilberto , Seaman Carolyn B. , Koru A. Günes
Published: February 2011

Open source software (OSS) has gained considerable attention recently in healthcare. Yet, how and why OSS is being adopted within hospitals in particular remains a poorly understood issue. This research attempts to further this understanding. A mixed-method research approach was used to explore the extent of OSS adoption in hospitals as well as the factors facilitating and inhibiting adoption. The findings suggest a very limited adoption of OSS in hospitals. Hospitals tend to adopt general-purpose instead of domain-specific OSS. We found that software vendors are the critical factor facilitating the adoption of OSS in hospitals. Conversely, lack of in-house development as well as a perceived lack of security, quality, and accountability of OSS products were factors inhibiting adoption. An empirical model is presented to illustrate the factors facilitating and inhibiting the adoption of OSS in hospitals.
Developing a User Centered Model for Ubiquitous Healthcare System Implementation
Authors: Yu Jongtae , Guo Chengqi , Kim Mincheol
Published: February 2011

In the advent of pervasive computing technologies, the ubiquitous healthcare information system, or u-health system, has emerged as an innovative avenue for many healthcare management issues. Drawing upon practices in healthcare industry and conceptual developments in information systems research, this article aims to explain the latent relationships amongst user-oriented factors that lead to individual’s adoption of the new technology. Specifically, this study focuses on the introduction of chronic disease u-health system. Using the ordinary line square (OLS) regression analysis, we are able to discover the insights concerning which constructs affect service subscriber’s behavioral intention of use. Based on the data collected from over 440 respondents, empirical evidences are presented to support that factors such as medical conditions, perceived need, consumer behavior, and effort expectancy significantly influence the formation of usage intention.
Towards Process-of-Care Aware Emergency Department Information Systems
Authors: Ceglowski Andrzej S. , Churilov Leonid
Published: February 2011

The critical role of emergency departments (EDs) as the first point of contact for ill and injured patients has presented significant challenges for the elicitation of detailed process models. Patient complexity has limited the ability of ED information systems (EDIS) in prediction of patient treatment and patient movement. This article formulates a novel approach to building EDIS Activity Views that paves the way for EDIS that can predict patient workflow. The resulting Activity View pertains to “what is being done,” rather than “what experts think is being done.” The approach is based on analysis of data that is routinely recorded during patient treatment. The practical significance of the proposed approach is clinically acceptable, verifiable, and statistically valid process-oriented clusters of ED activities that can be used for targeted process elicitation, thus informing the design of EDIS. Its theoretical significance is in providing the new “middle ground” between existing “soft” and “computational” process elicitation methods.
Applying Dynamic Causal Mining in Health Service Management
Authors: Wang Yi
Published: February 2011

This article describes an application that illustrates the role of data mining technology in identifying hidden causal knoledge from health and medical data repositories. Across the health care and medical enterprises, a wide variety of data is being generated at a rapid rate. Current information technologies tends to focus on a more statical side of causal knowledge and do not address the dynamic causal knowledge. This article shows that the dynamic causal relation data can be captured for treatment, payment, operations purposes and administrative directed insights. Accessing this currently unrealized knowledge potential would enable the delivery of actionable knowledge to medical practitioners, healthcare system managers, policy planners and even patients to make a significant difference in overall healthcare.
TreeWorks
Authors: Harper Paul , Leite Jr. Evandro
Published: February 2011

Decision trees are hierarchical, sequential classification structures that recursively partition the set of observations (data) and are used to represent rules underlying the observations. This article describes the development of TreeWorks, a tool that enhances existing decision tree theory and overcomes some of the common limitations such as scalability and the ability to handle large databases. We present a heuristic that allows TreeWorks to cope with observation sets that contain several distinct values of categorical data, as well as the ability to handle very large datasets by overcoming issues with computer main memory. Furthermore, our tool incorporates a number of useful features such as the ability to move data across terminal nodes, allowing for the construction of trees combining statistical accuracy with expert opinion. Finally, we discuss ways that decision trees can be combined with Operational Research health care models, for more effective and efficient planning and management of health care processes.
Evaluation Challenges for Bridging Semantic Gap
Authors: Horsthemke William H. , Raicu Daniela S. , Furst Jacob D.
Published: February 2011

Evaluating the success of prediction and retrieval systems depends upon a reliable reference standard, a ground truth. The ideal gold standard is expected to result from the marking, labeling, and rating of domain experts. However experts disagree and lack of agreement challenges the development and evaluation of image-based feature prediction. This paper addresses the success and limitations in bridging the semantic gap between CT-based pulmonary nodule image features and radiologists’ ratings of diagnostic characteristics. The prediction of diagnostic characteristics promises to automatically annotate images with medically meaningful descriptions usable for indexing and retrieving in content-based image retrieval (CBIR) and computer aided diagnosis (CADx). Successful results in predicting texture characteristics will be contrasted with less successful results for boundary shapes. The two primary differences in agreement between radiologists will be discussed; the first concerns agreement about the existence of a nodule, while the second considers the variability in radiologists’ ratings.
Physicians' User Experiences of Mobile Pharmacopoeias and Evidence-Based Medical Guidelines
Authors: Oinas-Kukkonen Harri , Raisanen Teppo , Leiviska Katja , Seppanen Matti , Kallio Markku
Published: February 2011

This article studies physicians’ mobile user experiences with evidence-based medical guidelines and drug information databases through the concept of webflow. Data was collected among the 352 users of a mobile medical application. The response rate was 66.5% (n=234). The results demonstrate that rather than usefulness and ease of use it is the orientation and navigation within the system in par with perceived challenges, focused attention, and learning that lead to positive user experience. Finding relevant pieces of information becomes essential in system utilization. The results also support the claim that mobile applications are not only beneficial for patient safety but they may also improve the physicians’ computer and professional skills. Frequent use was noted to improve physicians’ computer skills, the feeling of being in control of the system, and their perception of the system’s ease of use. Moreover, learning may play a greater role for knowledge work than often suggested.
Physician Characteristics Associated with Early Adoption of Electronic Medical Records in Smaller Group Practices
Authors: O’Neill Laim , Talbert Jeffery , Klepack William
Published: February 2011

To examine physician characteristics and practice patterns associated with the adoption of electronic medical records (EMRs) in smaller group practices. Primary care physicians in Kentucky were surveyed regarding their use of EMRs. Respondents were asked if their practice had fully implemented, partially implemented, or not implemented EMRs. Of the 482 physicians surveyed, the rate of EMR adoption was 28%, with 14% full implementation and 14% partial implementation. Younger physicians were significantly more likely to use EMRs (p = 0.00). For those in their thirties, 45% had fully or partially implemented EMRs compared with 15% of physicians aged 60 and above. In logistic regression analyses that controlled for practice characteristics, age, male gender, and rural location predicted EMR adoption. Younger physicians in smaller group practices are more likely to adopt EMRs than older physicians. EMRs were also associated with an increased use of chronic disease management.
Challenges Associated with Physicians' Usage of Electronic Medical Records
Authors: Ilie Virginia , Van Slyke Craig , Courtney James F. , Styne Philip
Published: February 2011

Using the Theory of Planned Behavior, institutional and diffusion theories as theoretical foundations, this study investigates physicians’ attitudes towards and usage of electronic medical records (EMR). Interviews with seventeen physician-residents enrolled in a Family Practice residency program and eight attending physicians in the same clinic showed that most physicians held rather negative attitudes regarding the EMR system. EMR was often times seen as an intrusion in the patient-physician interaction. Other findings relate to how EMR impacts physicians’ time, expertise, and learning, as well as the length (and sometimes the accuracy) of clinical notes. Challenges associated with behavioral control issues such as availability of computers and the physical positioning of computers are shown to be very important in the context of this case. In this organization, physician-residents are required to use EMR because of its mandatory nature, however, if they had a choice or the power, the majority of them would use the paper chart.
Electronic Medical Records
Authors: Trimmer Ken , Cellucci Leigh W. , Wiggins Carla , Woodhouse William
Published: February 2011

Many policymakers, industry experts, and medical practitioners contend that the U.S. health care system—in both the public and private sectors—is in crisis. Among the numerous policy issues associated with the provision of US healthcare is the call for increased adoption and use of health care information technology (HIT) to address structural inefficiencies and care quality issues [11, p. 33]. This paper reports the first steps in a multi-phased research effort into Electronic Medical Records system adoption. The first two phases of our research applies the Unified Theory of Acceptance and Use of Technology as a lens to interpret the responses of physicians completing their Residency in Family Medicine and the third phase examines the role of organizational culture as a critical variable for effective strategy implementation in the same setting.
Electronic Health Records
Authors: Bourgeois Stacy , Yaylacicegi Ulku
Published: February 2011

Electronic health records (EHRs) have been proposed as a sustainable solution for improving the quality of medical care. This study investigates how EHR use, as implemented and utilized, impacts patient safety and quality performance. Data in this paper include nonfederal acute care hospitals in the state of Texas, and the data sources include the American Hospital Association, the Dallas Fort Worth Hospital Council, and the American Hospital Directory. The authors use partial least squares modeling to assess the relationship between hospital EHR use, patient safety, and quality of care. Patient safety is measured using 11 indicators as identified by the Agency for Healthcare Research and Quality (AHRQ) and quality performance is measured by 11 mortality indicators as related to 2 constructs, that is, conditions and surgical procedures. Results identify positive significant relationships between EHR use, patient safety, and quality of care with respect to procedures. The authors conclude that there is sufficient evidence of the relationship between hospital EHR use and patient safety, and that sufficient evidence exists for the support of EHR use with hospital surgical procedures.