Joseph Tan

Strategic IT applications in health care

Accordingly, using IT in a strategic and innovative manner to support health-related decision making represents a serious challenge for health care organization management, as well as for systems developers. Traditional, nonstrategic IT focuses on information processing, mostly for well-structured, routine task situations and operational work processes (such as patient data management systems for streamlining patient admissions and bed assignments). Such applications are concerned primarily with improving the efficiency of operational tasks, rather than the effectiveness of strategic and integrative decision processes. In this sense, strategic IT focuses on the information requirements of ad hoc and poorly structured decision tasks. The applications concentrate on giving an organization an IT-based strategy for meeting competitive challenges (such as by using emerging Web technologies to integrate health care organizaInformation technology plays an increasingly central role in the U.S. health care industry. A survey by Sheldon I. Dorenfest & Associates of Chicago estimated IT spending on health care in 2002 would be

E-health: impacts of internet technologies on various healthcare and services sectors

21.6 billion [9]. Further exponential growth can be expected as the industry implements further large-scale electronic medical record keeping; provides remote diagnostics via telemedicine; upgrades hospital information systems (HISs); sets up intranets and extranets for sharing information; and uses public networks, including the Internet and community health information networks, to distribute health-related information.

Applying epidemiological principles to ergonomics: A checklist for incorporating sound design and interpretation of studies

In the last several years, healthcare providers and consumers have been slow, even reluctant, to embrace healthcare internet applications primarily because of the limited availability of technologies that would ensure data security in general and patient confidentiality in particular. Today, with advances in internet security technologies such as data encryption, electronic signatories and firewalls, healthcare users are more willing to adopt the internet for its many potential benefits, for example, increased efficiencies, lower cost, easier access to media-rich information and knowledge and faster decision making. Present-day healthcare consumers, for example, demand easy access to multi-media information and in-depth knowledge in order to make informed decisions. Similarly, healthcare providers and managers are interested in reducing costs while preserving and maintaining high quality healthcare. This article highlights the traditional characteristics, tasks and functions of various health services sectors including hospitals, insurance companies, physician offices, nursing homes, home healthcare agencies and pharmaceutical companies. More specifically, it focuses on the impacts of healthcare internet usage in these various sectors and presents the benefits as well as risks and concerns of modern day healthcare internet applications.

Surgical Waiting Lists I: Definition, Desired Characteristics and Uses

The primary purpose of this paper is to provide a checklist of scientific requirements necessary for the design of sound ergonomics studies. Ergonomics researchers will be able to use the checklist when designing a study and preparing it for publication. Practitioners can use the checklist to critically appraise study results, thereby having greater confidence when applying ergonomic recommendations to the workplace. A secondary purpose of the paper is to pilot the checklist on a sample of papers in the ergonomics literature and to assess its reliability. While there are checklists to assess the epidemiological rigour of studies, none have been adapted to address methodological issues in ergonomics. Two epidemiologists independently searched five ergonomics journals (Applied Ergonomics, Ergonomics, Human Factors, International Journal of Human-Computer Interaction and Journal of Human Ergology) for research studies on VDT use and visual function published between 1990 and 1995. Twenty-one articles were reviewed. Each paper was scored according to the checklist. Overall, the reviewers found that the articles did not consistently fulfill some of the checklist criteria. An insufficient sample size was the most serious omission. Inter-rater reliability of the checklist was excellent for 11 of 14 items on the checklist (Kappa > 0.74), good for two items (Kappa between 0.40 and 0.74) and poor for one item. As ergonomics is gaining acceptance as an integral part of occupational health and safety, individuals in this field must be cognizant of the fact that study results are being applied directly to workplace procedures and design. It is incumbent upon ergonomists to base their work on a solid research foundation. The checklist can be used as a tool to improve study designs and so ultimately has implications for improving the fit between the worker and the work environment.

Human processing of two-dimensional graphics: information-volume concepts and effects in graph-task fit anchoring frameworks

In the first of this two-part series, the authors define waiting lists, review the waiting list situation in Canada, discuss factors affecting such lists, outline their desired characteristics and describe the analysis and use of waiting list data. The manner in which lists are compiled results in significant differences which makes the meaning of waiting lists difficult to determine. From the literature reviewed and interviews with various health service executives, the authors show that waiting lists, as compiled today, are not a valid and reliable measure of the extent of unmet demands for hospital care. In Part II, which will be published in the next issue of FORUM, the authors will present the results of an exploratory survey done to determine how waiting lists and times are presently being compiled and used in secondary and tertiary hospitals. These findings will be summarized and compared to the desired characteristics and uses of a waiting list as presented in Part I.

The critical success factor approach to strategic alignment: seeking a trail from a health organization's goals to its management information infrastructure.

This report discusses the findings from three related experiments on the effects of information volume in graph‐task fit anchoring frameworks reported in the literature. Information volume is operationally defined as the size of a data matrix (SDM), that is, the total number of points in a graphical display. The anchoring frameworks specify that an extraction task has high or low x‐value anchoring depending on whether or not the x‐component is represented in the question (as a given or unknown value). A total within‐subject repeated measure experimental design was used to test the effects of SDM on speed and accuracy of data extraction. These experiments also integrated different frameworks to relate the information‐volume effects. Results indicated that increased SDM adversely affected only data extraction time, not accuracy. A significant graph format by information volume interaction was observed; and training did reduce perceived information complexity, especially for high data volume displays. Also, ...

A model for achieving total quality-management information technology infrastructure within an integrated delivery system.

The critical success factor (CSF) approach is a technique that will aid health administrators, planners and managers to identify, specify and sort among the most relevant and critical factors determining an organizations survival and success. Following a top-down management perspective, this paper discusses the CSF methodology as a strategic information management process comprising several important phases: (i) understanding the external factors such as the organizations industry, market and environment; (ii) achieving strong support and championship from top management; (iii) encouraging the proactive involvement of management and staff in generic CSF identification; (iv) educating and directing the participation of staff members in CSF verification and further refinement of generic CSFs into specific CSFs; and (v) aggregating, prioritizing and translating activity-related CSFs into organizational information requirements for the design of the organizations management information infrastructure. The implementation of this CSF approach is illustrated in the context of a British Columbia community hospital, with insights provided into key issues for future health researchers and practitioners.

Surgical waiting lists II: Current practices and future directions using the Province of British Columbia as a test study.

The strategic development and deployment of a health management information technology infrastructure is discussed from two perspectives for radiologists and for other medical technologists: the integrated delivery system (IDS) perspective and a total qualitymanagement (TQM) perspective. On the one hand, an IDS perspective is important because of the need to prepare radiologists and other medical practitioners to thrive within rapidly changing health organizational models and evolving health service delivery partnership systems. On the other, a TQM perspective is important due to the need to realize an appropriate, efficient, and cost-effective health information infrastructure for developing seamless, integrated radiological and other medical imaging services. Apart from intelligently pursuing an aligned organizational business strategy with the organizational information system strategy, senior radiological managers and medical technologists of health organizations need to pay particular attention to key quality principles for effecting changes in organizational structures and processes to fit changes in information technological requirements, implementations, and innovations.

Going north on a north-bound trail: a model for achieving health management goals and objectives.

n the second part of this article, we first discuss the methodology used to evaluate and obtain informaI tion about the current surgical waiting list situation in British Columbia. Emphasis is on surgical waiting lists because such lists for medical treatment are scarce (Dr. Charles Wright, Vice-president Medicine, Vancouver General Hospital, pers. com., 1992). This is followed by a presentation of the results. Based on a comparison of these results with what we have discussed about the desired characteristics and uses of surgical waiting lists in Part I of this article, we then identify the major performance gaps, provide insights on future directions and discuss alternatives and recommended methods for improving waiting times data compilation and uses. Finally, we conclude with a note on generalizing the findings of the present survey.

Healthcare marketing and internet technology management

A basic managerial problem in decision making is to synthesise and priorise information relating to the achievement of organisational goals and objectives. This paper discusses the role of critical success factors in health services planning as a means for sorting out and specifying relevant information necessary for achieving organisational goals and managerial objectives. The proposed approach enhances existing planning procedures for health care organisations. Within a conceptual framework of the health care system, managerial insights are provided for the realisation of organisational goals via measurable managerial objectives using critical success factors as pointers to success. More importantly, this paper introduces a planning model which incorporates the CSF concept for developing new health care programmes and for evaluating or restructuring existing programmes.