Benjamin L. Schooley

Towards end-to-end government performance management: Case study of interorganizational information integration in emergency medical services (EMS) ☆

Abstract A recent line of e-government research has emphasized the importance of interorganizational information sharing in the public domain. This research extends these information-sharing dimensions to explore information sharing relative to service performance. It utilizes a time-critical information services (TCIS) conceptual framework as an analytical lens. TCIS highlights multiple dimensions of information sharing, including operational, organizational, and governance factors as well as timeliness and quality as key performance metrics. A case study approach was employed to examine the exchange of performance-related information in a key time information critical service: a county-wide emergency medical services (EMS) system. The paper first explains the theoretical foundations for the study, stemming from interorganizational systems (IOS) literature, e-government IOS, and even more specifically, IOS in emergency medical services (EMS). The paper discusses performance measures in EMS, describes the TCIS analytical lens, the study methodology, and the case study under investigation. Case study findings are reported along operational, organizational, and governance dimensions. In general, the case study illustrates promising factors that can enhance information sharing across organizations, while noting that considerable gaps remain in achieving an end-to-end IT-enabled performance approach. Future research should aim to better understand how to overcome these gaps, including addressing the usability constraints that can confront professionals working in time information critical circumstances, such as trauma conditions.

Time-critical information services

Emergency medical services have never been more ready for the implementation of time-critical interorganizational information services for the public good.

Inter-organizational Emergency Medical Services: Case Study of Rural Wireless Deployment and Management

Over the last two decades, use of mobile communications for emergency services (e.g. 911) has grown exponentially. This rise of mobile networks has increased reliance on new private and public partnerships to deliver these time critical services. Drawing upon complex systems theory and Inter-organizational Systems (IOS) dynamics, a framework is developed for investigating technology, organizational and policy dimensions of Emergency Medical Services (EMS). The case study for this investigation is rural Minnesota, where a series of semi-structured interviews were conducted and supplemented by analysis of candidate EMS system evaluations. The twofold objectives of the study were to explore the nature of inter-organizational dynamics in this setting and to set forth an architecture for measuring and enhancing performance. Key technology concerns included gaps in wireless coverage, complex system upgrades, and lagging integration of wireless communications into existing infrastructures. These issues were intertwined with organizational aspects, such as the challenges in developing coordinated relationships among agencies and between the public and private sectors. Several policy levers were also influential, such as federal standards that had been set forth for E-911 location information and funding initiatives in the transportation area. The final section draws upon these findings to suggest an EMS architecture that portrays the entire system as well as critical IOS linkages. While IOS has traditionally examined supply chains, these findings are aimed to contribute to understanding more complex, dynamic and heterogeneous socio-technical processes. The paper concludes with a discussion of management and research implications.

SafeRoadMaps: communication of location and density of traffic fatalities through spatial visualization and heat map analysis

Road traffic injuries are the number one, non-disease-related, cause of death in the world; more than 1.2 million people die each year on the roads, and between 20 and 50 million sustain non-fatal injuries. In 2008, in the United States, there were 37 261 motor vehicle fatalities – the result of 34 017 motor vehicle crashes. Clearly, there is an urgent need for governmental agencies, and other key institutions, to increase and sustain action to prevent motor vehicle injuries. This article reports on the iterative development of SafeRoadMaps, a publicly accessible system for presenting accident frequencies and characteristics based on geographic location (www.saferoadmaps.org). The system was developed to visually communicate and allow analysis of public health issues related to rural and urban road transportation safety. One of the distinctive features of this online system is the use of ‘heat maps’ as a visual means for communicating the spatial density of traffic fatalities. The article begins with a review of the action research design approach utilized for the analysis, design and implementation of this system, continues with an overview of the system and its visualization methods to communicate safety information to travelers and other stakeholders, and concludes with a summary of findings from end-user feedback, including the systems potential to raise user awareness and affect driving behavior.

Time-critical information services: analysis and workshop findings on technology, organizational, and policy dimensions to emergency response and related e-governmental services

This paper discusses a general framework for understanding and researching end-to-end performance of inter-organizational e-governmental services and reports the findings from an expert workshop held at the National Center for Digital Government. The focus of this paper is on time-critical information services (TCIS) - the medical necessity to deliver emergency services as rapidly as possible coupled with the dependence of these services upon accurate and timely information from multiple organizations. The authors outline a TCIS model and then discuss an invitational workshop that allowed for expert (academic and practitioner) input and feedback on TCIS dimensions and the best means for understanding their occurrence in on-the-ground emergency services. Workshop participants analyzed TCIS from a socio-technical perspective and provided conceptual, practitioner and methodological critiques and suggestions. Overall, participants found the concept of TCIS to be a valid model for understanding, researching, and developing e-government systems within the specific context of emergency response as well as within the broader context of time-critical services to the public. Workshop recommendations focused on the need to closely assess inter-agency and inter-organizational information exchanges along and between three levels: technical, organizational, and governance. The paper concludes with a discussion about future research directions based on the analytical framework and workshop findings.

Integrated Patient Health Information Systems to Improve Traffic Crash Emergency Response and Treatment

This research explores how a wide range of automobile crash, emergency responder, hospital, and trauma information could be useful to emergency medical practitioners for making decisions about automobile crash victims. We use a framework from prior research to consider, devise and examine emergency medical practitioner use of information systems for improving emergency response services and outcomes. This paper first provides an overview of clinical decision support systems focused on car crash emergency and trauma response. Concepts are grounded in a case study investigation conducted in Minnesota at the State and local level (Mayo Clinic). Operational data from 911 communications, ambulance response, and trauma data systems were linked together to demonstrate a data integration proof of concept to emergency medical practitioners. Interviews and focus groups discussions were then conducted to discuss the current and potential value of integrating inter-organizational data for real-time decision support. Analysis across these various methods provided a multi-layered understanding which led to a descriptive architecture for a crash trauma information system.

A Real World Perspective: Employee Perspectives of Employer Sponsored Personal Health Record (PHR) Systems

Many employers now provide electronic personal health records (PHR) to employees as part of a free or low cost health benefit program. This paper reports findings from a survey distributed to employees of a large U.S. corporation. The survey focused on identifying employee concerns and expectations from an employer sponsored PHR system and to help understand the utilization and adoption of PHR systems sponsored by the employer. Despite some past research showing significant demand for PHR products across the general public, especially those that are offered for free, responses indicated many barriers. Participants responded with their concerns and expectations prior to using the system as well as their difficulty or ease of use. Key issues are discussed, including current and future role of employers in the PHR marketplace, including the need to x93tetherx94 these offerings to larger health care provider networks in order for employees to realize the value added.

Learning Object Development and Repository Design for Digital Government Instruction

As the field of e-government expands and grows, the number of academic courses, professional workshops, online courses, and continuing education opportunities in this field also increases. Due to the interdisciplinary nature of the field, learning and teaching content tends to be pulled from numerous paper and electronic sources. This pilot study explored the potential structure and benefits of an online repository of electronic learning objects for the field of e-government. Design research was used as a methodology to design, implement, and evaluate an online learning object repository within the context of a University e-government course. The pilot project is described, qualitative evaluation findings reported, and implications and future research directions are presented.

A Normative Enterprise Architecture for Guiding End-to-End Emergency Response Decision Support

This article examines the underlying architecture guiding the development and use of enterprise decision support systems that maintain the delivery of time critical public services. A normative architecture, developed from comparative cases involving San Mateo County and Mayo Clinic Emergency Medical Services systems, provides a collection of characteristics meant to guide an emergency response system toward a high level of performance and enable optimal decision-making. At a national symposium, academics and practitioners involved in promoting effective emergency response information systems provided validation for the architecture and next steps for enhancing emergency response information systems. Normative architecture characteristics and expert perspectives from the symposium are integrated into a framework that offers an enterprise approach for delivering time-critical emergency response services. This article provides recommendations for navigating toward a more incremental approach in developing enterprise-oriented emergency information services and examines future trends involving the application of normative architectural concepts to real-world emergency medical settings. “overload and miscues” and supports the “coordination of efforts of a great number of organizations and individuals” (Zwass, 2010, p. ix). For example, the perspectives provided by various emergency response organizations that received automobile crash data as part of the Minnesota Mayday System revealed that the new and additional data they received was DOI: 10.4018/jiscrm.2010040101 2 International Journal of Information Systems for Crisis Response Management, 2(2), 1-18, April-June 2010 Copyright

Inductive Design and Testing of a Performance Ontology for Mobile Emergency Medical Services

Ontology provides an overarching framework and vocabulary for describing system components and relationships. As such, they represent a means to devise, analyze and compare information systems. This research investigates the development of a software-based ontology within the context of a rural wireless emergency medical (EMS) services. Wireless EMS has developed in response to the unprecedented growth of wireless as a means to communicate in emergency situations. Using an inductive, field-based approach, this study devises and tests a new ontology-based framework for wireless emergency response in rural Minnesota. The ontology is developed by integrating concepts and findings from in-depth field reviews in Minnesota into an ontological software originating out of bioinformatics. This software, Protege 2000, is an open source ontological software system developed by Stanford University’s Medical Informatics group. Using Protege 2000, the authors developed a wireless EMS ontological framework populated by the real data gathered from field interviews and related data collection. This EMS framework distinguishes between classes of systems, instances within the classes, and the relationships among classes and instances. The next step in the research involved conducting a simulation of performance using a sample of case study data and demonstrated important linkages among system classes. It is expected that use of such performance ontology will assist researchers and program managers with identifying basic problems in terms of technical and non-technical rural EMS issues, as well as possible patterns of inconsistency or discrepancies across EMS deployments.