Elie Geisler

A framework for assessing e-health preparedness

Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a countrys preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative.

Health technology assessment. Evaluation of biomedical innovative technologies.

This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

Why Effectiveness of Robot-Mediated Neurorehabilitation Does Not Necessarily Influence Its Adoption

This paper discusses the reasons why evidence of clinical effectiveness is not enough to facilitate adequate adoption of robotic technologies for upper-limb neurorehabilitation. The paper also provides a short review of the state of the art technologies. In particular, the paper highlights the barriers to the adoption of these technologies by the markets in which they are, or should be, deployed. On the other hand, the paper explores how low rates of adoption may depend on communication biases between the producers of the technologies and potential adopters. Finally, it is shown that, although technology-efficacy issues are usually well-documented, barriers to adoption also originate from the lack of solid evidence of the economic implications of the new technologies.

The unintended consequences of metrics in technology evaluation

This paper describes science and technology (ST (2) metrics can influence ST (3) incorrect selection and implementation of metrics can have negative unintended consequences on the research and research documentation generated and (4) before implementing metrics, an organization should identify and evaluate the intended and unintended consequences of the specific metrics’ implementation, and identify the impact of these consequences on the organizations core mission.

The major barriers and facilitators for the adoption and implementation of knowledge management in healthcare operations

The importance of Knowledge Management (KM) to organisations in todays competitive environment is being recognised as paramount and significant. This is particularly evident for healthcare both globally and in the USA. The US healthcare system is facing numerous challenges in trying to deliver cost effective, high quality treatments and is turning to KM techniques and technologies for solutions in an attempt to achieve this goal. We examine this by outlining the primary barriers encountered in the adoption and implementation of specific KM technologies in healthcare settings and then examine these in the context of an orthopaedic case vignette. In doing so, we show the benefit of KM tools and techniques for enhancing healthcare delivery.

Tacit and explicit knowledge: empirical investigation in an emergency regime

Tacit knowledge has long been recognised as an important component of how individuals perform. But how can tacit knowledge be measured in organisational situations? This paper explores the role of tacit knowledge in performance of individuals and teams in emergency regime of the Emergency Department (ED) of a main hospital. Content analysis of two cases support the proposition that when explicit research – in the form of protocols of care – are unsuccessful, yet a patient is saved, tacit knowledge is the only component of knowledge that can explain this surge in performance.

Health technology assessment in the context of private and public models of national health systems

The increasing costs of healthcare delivery in all industrialized countries are raising serious concerns about the financial sustainability of national and regional healthcare delivery systems. Studies have shown that innovations in medical technology are one of the stronger factors that drive the upward trend of healthcare delivery costs. Many national and regional healthcare agencies and policy makers are recognizing the need for more accurate knowledge on the generation and diffusion of innovations in healthcare technologies. The focus of this paper is a comparison of the assessment of health and medical technologies in two different models of national health delivery systems: Italy and the United States. The role of health technology as a significant driver of the rising costs of healthcare delivery is well documented. Less studied is the manner in which health technologies are acquired and adopted by providers in different national systems. The authors frame the issues and compare the factors that impinge upon the diffusion of medical technologies from industry to providers in a publicly planned and funded health system and in a mostly privately-funded national health system. As the two national systems seem to converge in many aspects of national policy making, the authors explore the assessment of healthcare technologies in the short and longer terms. Are there differences and similarities in the assessment methodologies used by the different systems and, if so, how do these affect the healthcare delivery system? The authors suggest some possible answers.

Epistemetrics: Conceptual Domain and Applications of Knowledge Management (Km) in Health Care

By and large, the emerging field of knowledge management (KM) has failed to deliver on its promises. The literature contains a variety of attempts to define the field, to explain its core components, and to discuss its relevance and utility to organizations. But, much of this literature is replete with narratives and descriptive statements, albeit with some cases of implementation. There is a lack of a cohesive set of research questions and an even more striking lack of an appropriate, generally accepted methodology for research in knowledge management. This void becomes particularly apparent when we begin to examine the role of KM in health care and how, by incorporating KM techniques, superior health care operations might ensue. Clearly, it is almost impossible to reach such consensus and convergence when there is a lack of metrics of what constitutes knowledge and how we process it. This paper describes the subfield of epistemetrics, the metrics of knowledge in relation to the application of KM to enabling effective, efficient, and quality health care delivery. It fills the need in the literature of having a coherent system to measure knowledge. Epistemetrics is the metrics of knowledge, and is composed of three inter-related parts: what we measure in knowledge; how we measure; and why we measure (what is the value generated by knowledge). This paper describes the conceptual domain of epistemetrics and suggests some applications of knowledge management in the healthcare context. We contend that by taking such an approach the nascent field of knowledge management will be able to mature into a substantive and rigorous discipline, which in turn will be able to provide health care with needed solutions.

Commercialization of Technological Innovations: The Effects of Internal Entrepreneurs and Managerial and Cultural Factors on Public–Private Inter-Organizational Cooperation

Why do scientists and engineers in government laboratories and private companies cooperate and exchange and commercialize technology? What are the factors that impact the propensity to commercialize and the success of such collaborations? These research questions were explored in the extant literature, but the focus has mainly been on the impacts of incentives that employees of public technology laboratories received from their management. This paper reports the findings from a study of 43 government laboratories and 51 industrial companies in the United States. The study expanded the focus of previous research by considering the set of managerial, economic, cultural, and organizational factors as well as the impacts of internal entrepreneurship — in both the public laboratories and private industry. The study also contributed to the literature on internal entrepreneurship by expanding and empirically testing the integrative concept of intrapreneurship. The results show that internal entrepreneurship of the scientific and technical workforce in both types of organizations is the most powerful predictor of commercialization and technology transfer in the public–private cooperation. Other factors found to impact the success of the commercialization effort are senior management support and a culture that encourages cooperation across organizational boundaries. This paper contributes to the state of knowledge in that it establishes empirically that the incentives most likely to work to improve cooperation between public and private technology organizations are those that create a supportive environment for internal entrepreneurs within these organizations, rather than a basket of the usual incentives designed to foster a specific behavior. These findings also contribute to the making of technology policy in developed countries as well as in the emerging world, where the need to encourage cooperation between public and private technology enterprise is increasingly recognized as a powerful economic and technological foundation for growth and prosperity.

Home Healthcare Services: un caso istruttivo per lo sviluppo di un approccio “Service-Dominant- Logic” nel marketing dei servizi ad alta tecnologia

I servizi sanitari domiciliari si basano su tecnologie che trovano applicazione sia in ambito clinico che in quello amministrativo-gestionale, generalmente conosciute come “telemedicina”. L’obiettivo del presente capitolo e di descrivere un caso nella implementazione di servizi sanitari domiciliari avviato da un rilevante ospedale statunitense per pazienti con malattie croniche, al fine di presentare una evidenza empirica delle difficulta incontrate nell’esperimento. Vi sono due principali risultati derivanti dallo studio. Il primo e che le principali barriere alla implementazione dei servizi technology-based di assistenza domiciliare in remoto non sono di natura tecnologica, ma sono ancorate nella logica di marketing di tali servizi verso i pazienti. Il secondo e che se utilizzassimo l’approccio della service-dominant logic per l’erogazione di servizi sanitari domiciliari technology-based, potremmo accelerare il ritmo di implementazione di tali servizi e il valore del servizio offerto. La rilevanza dei risultati del caso presentato nel capitolo e di una lezione appresa dal settore dei servizi sanitari ma applicabile ad altri settori dell’economia dei servizi.