Query: improving safety with information technology

title: Improving safety with information technology.
abstract: Information technology can improve patient safety by preventing errors and facilitating rapid response to adverse events. Computerized prescribing by physicians reduces the rate of medication related errors. Systems that automatically page clinicians about serious laboratory abnormalities and remote monitoring of patients in intensive care units also appear promising.

title: patient safety Improving Safety with Information Technology
abstract: From the Division of General Medicine and Primary Care, Department of Medicine (D.W.B. and the Department of Surgery (A.A.G. Brigham and Women's Hospital; the Center for Applied Medical Information Systems, Partners HealthCare System (D.W.B. and Harvard Medical School (D.W.B. A.A.G. all in Boston. Address reprint requests to Dr. Bates at the Division of General Medicine and Primary Care, Brigham and Women's Hospital, 75 Francis St. Boston, MA 02115, or at dbates@ partners.org.

title: Innovating Mindfully with Information Technology

title: Process Innovation: Reengineering Work Through Information Technology
abstract: The business environment of the 1990s demands significant changes in the way we do business. Simply formulating strategy is no longer sufficient; we must also design the processes to implement it effectively. The key to change is process innovation, a revolutionary new approach that fuses information technology and human resource management to improve business performance. The cornerstone to process innovation's dramatic results is information technology a largely untapped resource, but a crucial "enabler" of process innovation. In turn, only a challenge like process innovation affords maximum use of information technology's potential. Davenport provides numerous examples of firms that have succeeded or failed in combining business change and technology initiatives. He also highlights the roles of new organizational structures and human resource programs in developing process innovation. Process innovation is quickly becoming the byword for industries ready to pull their companies out of modest growth patterns and compete effectively in the world marketplace.

title: Improving Patient Safety with Information Technology
abstract: Adverse drug events resulting from medication errors are a significant problem in the U.S. (Bates, 1996; Classen, Pestotnik, Evans, Lloyd, Burke, 1997) Traditionally hospitals have relied on voluntary reporting of errors. As a result it is estimated that only 5 10% of medication errors that result in harm to patients are reported (Cullen, Bates, Small, et al. 1995) Most of these errors result from deficiencies in system design (Leape, Bates, Cullen, et al. 1995; Gwande, Thomas, Zinner, et al. 1999; Anderson, 2003) Based on these studies, the Institute of Medicine recommended that confidential voluntary reporting systems be adopted in all health care organizations and that information technology be implemented to reduce medication errors (Kohn, Corrigan Donaldson, 2000) However, little progress has been made since the IOM report (Leape Berwick, 2005)

title: Why Information Technology Inspired but Cannot Deliver Knowledge Management
abstract: Recent developments in information technology have inspired many companies to imagine a new way for staff to share knowledge and insights. Instead of storing documents in personal files and sharing personal insights with a small circle of colleagues, they can store documents in a common information base and use electronic networks to share insights with their whole community, even people scattered across the globe. However, most companies soon discover that leveraging knowledge is actually very hard and is more dependent on community building than information technology. This is not because people are reluctant to use information technology, rather it is because they often need to share knowledge that is neither obvious nor easy to document, knowledge that requires a human relationship to think about, understand, share, and appropriately apply. Ironically, while information technology has inspired the "knowledge revolution," it takes building human communities to realize it.

title: Information technology as competitive advantage: the role of human
abstract: This paper investigates linkages between information technology (IT) and firm performance. Although showing recent signs of advance, the existing IT literature still relies heavily on case studies, anecdotes, and consultants' frameworks, with little solid empirical work or synthesis of findings. This paper examines the IT literature, develops an integrative, resource based theoretical framework, and presents results from a new empirical study in the retail industry. The findings show that ITs alone have not produced sustainable performance advantages in the retail industry, but that some firms have gained advantages by using ITs to leverage intangible, complementary human and business resources such as flexible culture, strategic planning IT integration, and supplier relationships. The results support the resource based approach, and help to explain why some firms outperform others using the same ITs, and why successful IT users often fail to sustain IT based competitive advantages.

title: A Multilevel Model of Resistance to Information Technology Implementation
abstract: To better explain resistance to information technology implementation, we used a multilevel, longitudinal approach. We first assessed extant models of resistance to IT. Using semantic analysis, we identified five basic components of resistance: behaviors, object, subject, threats, and initial conditions. We further examined extant models to (1) carry out a preliminary specification of the nature of the relationships between these components and (2) refine our understanding of the multilevel nature of the phenomenon. Using analytic induction, we examined data from three case studies of clinical information systems implementations in hospital settings, focusing on physicians' resistance behaviors. The resulting mixed determinants model suggests that group resistance behaviors vary during implementation. When a system is introduced, users in a group will first assess it in terms of the interplay between its features and individual and/or organizational level initial conditions. They then make projections about the consequences of its use. If expected consequences are threatening, resistance behaviors will result. During implementation, should some trigger occur to either modify or activate an initial condition involving the balance of power between the group and other user groups, it will also modify the object of resistance, from system to system significance. If the relevant initial conditions pertain to the power of the resisting group vis a vis the system advocates, the object of resistance will also be modified, from system significance to system advocates. Resistance behaviors will follow if threats are perceived from the interaction between the object of resistance and initial conditions. We also found that the bottom up process by which group resistance behaviors emerge from individual behaviors is not the same in early versus late implementation. In early implementation, the emergence process is one of compilation, described as a combination of independent, individual behaviors. In later stages of implementation, if group level initial conditions have become active, the emergence process is one of composition, described as the convergence of individual behaviors.

title: Building the Virtual State: Information Technology and Institutional Change
abstract: From the Publisher: "In Building the Virtual State, Jane Fountain explains how government must evolve to become part of the Internet revolution. Fountain calls on government agencies to abandon outmoded bureaucratic tendencies in favor of a less centralized approach to providing services. This requires a change not only in the way government executives think, but also in the way they view their relationships with citizens. They must answer questions regarding costs and maintenance of Internet portals, and at the same time assure citizens that their privacy will be protected." The creation of this "virtual state," Fountain argues, will not be easy, exposing much of the structural obsolescence of our current bureaucracy. However, if our government is to serve its central purpose to work for its citizens and provide them with the opportunity to excel it must embrace this change. It must negotiate the solutions to the internal questions of management, as well as external questions of protection of privacy and capability of use by all citizens. The outcome of this struggle will likely determine the extent to which the American government will be recast in the Information Age and whether its citizens will emerge as winners or losers.

title: Understanding Information Technology Usage: A Test of Competing Models
abstract: The Technology Acceptance Model and two variations of the Theory of Planned Behavior were compared to assess which model best helps to understand usage of information technology. The models were compared using student data collected from 786 potential users of a computer resource center. Behavior data was based on monitoring 3,780 visits to the resource center over a 12 week period. Weighted least squares estimation revealed that all three models performed well in terms of fit and were roughly equivalent in terms of their ability to explain behavior. Decomposing the belief structures in the Theory of Planned Behavior provided a moderate increase in the explanation of behavioral intention. Overall, the results indicate that the decomposed Theory of Planned Behavior provides a fuller understanding of behavioral intention by focusing on the factors that are likely to influence systems use through the application of both design and implementation strategies.