Maria Cucciniello

The Role of Mobile Technologies in Health Care Processes: The Case of Cancer Supportive Care

Background Health care systems are gradually moving toward new models of care based on integrated care processes shared by different care givers and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care. Objective This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care. Methods We carried out a review of literature with the aim of identifying studies related to the use of mHealth in cancer care and cancer supportive care. The final sample size consists of 106 records. Results There is scant literature concerning the use of mHealth in cancer supportive care. Looking more generally at cancer care, we found that mHealth is mainly used for self-management activities carried out by patients. The main tools used are mobile devices like mobile phones and tablets, but remote monitoring devices also play an important role. Text messaging technologies (short message service, SMS) have a minor role, with the exception of middle income countries where text messaging plays a major role. Telehealth technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mHealth is mainly used during the treatment of patients, especially for self-management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities. Conclusions Since mHealth seems to be employed only for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded into broader information systems. If the purpose of introducing mHealth is to promote the adoption of integrated care models, using mHealth should not be limited to some activities or to some phases of the health care process. Instead, there should be a higher degree of pervasiveness at all stages and in all health care delivery activities.

Transparency for Trust in Government: How Effective is Formal Transparency?

Many countries refer to transparency not only as the right to access information, but also as a tool for enhancing government efficiency and accountability. However, the practice of transparency is still linked to the need to comply with legal obligations, not necessarily meeting citizens’ needs. The purpose of this article is twofold: it measures the levels of transparency of governments and the needs of citizens for government information and consequently assesses whether there is a gap, offering recommendations for reducing it. This should contribute to reaching higher levels of useful rather than formal transparency and may help in facilitating government-constituent relations.

Assessing Transparency in Government: Rhetoric, Reality and Desire

Transparency in government is a highly regarded value and a critical ingredient for efficient and well-functioning economic and political markets. Many countries, including Italy, refer to transparency as a tool to enhance government accountability, as a principle to promote in order to reduce corruption in public administration and as a means for circulating information on government performance. However, transparency is preached more often than it is practiced in many cases (Heald 2006). Conversely, not all of the information disclosed is easily accessible or accessed by external stakeholders. The purpose of this paper is to assess the degree of transparency of governments and to ascertain the type of information that can be accessed by external stakeholders, especially the general public, in order to evaluate the performance of their government. In particular, the paper focuses on the information disclosed through government websites and assesses the case of larger municipalities in Italy. The paper presents the findings of the analysis and suggests some recommendations for academics and policy makers.

Evaluation of the Impacts of Innovation in the Health Care Sector: A comparative analysis

Assessing impacts related to the adoption of an innovation represents a particular challenge. However, the use of innovation in government organizations does have some effects: some intended, others unintended; some desirable, others undesirable. Findings in literature now suggest that the use of innovation in government organizations produces beneficial results for the most part. The purpose of this article is to provide a multi-dimensional framework for assessing the impacts of innovation on an organization’s performance as perceived by individual stakeholders and at organizational level. In particular, this framework is designed to evaluate the impacts resulting from the introduction of electronic medical records, namely an organizational, cultural, and technological innovation that many health care providers are currently undertaking. It provides the results of a comparative analysis carried out in Spain and Italy and discusses the need for a more systematic evaluation assessment of the innovation processes.

Coordination Mechanisms for Implementing Complex Innovations in the Health Care Sector

Abstract Coordination is a central element in the public sector, especially for introducing complex innovations. In health care, this issue takes on great importance since many stakeholders are involved, pursuing multiple interests, and influencing the outputs and outcomes of the health care system. This paper discusses the introduction of a specific health care innovation (i.e. electronic patient records) in two Italian regions, and it aims to contribute to the debate on coordination in health care, depicting the coordination mechanisms that took place in two different contexts in order to introduce the same kind of innovation, and highlighting any potential enabling conditions.

Understanding key factors affecting electronic medical record implementation: a sociotechnical approach

BackgroundRecent health care policies have supported the adoption of Information and Communication Technologies (ICT) but examples of failed ICT projects in this sector have highlighted the need for a greater understanding of the processes used to implement such innovations in complex organizations. This study examined the interaction of sociological and technological factors in the implementation of an Electronic Medical Record (EMR) system by a major national hospital. It aimed to obtain insights for managers planning such projects in the future and to examine the usefulness of Actor Network Theory (ANT) as a research tool in this context.MethodsCase study using documentary analysis, interviews and observations. Qualitative thematic analysis drawing on ANT.ResultsQualitative analyses revealed a complex network of interactions between organizational stakeholders and technology that helped to shape the system and influence its acceptance and adoption. The EMR clearly emerged as a central ‘actor’ within this network. The results illustrate how important it is to plan innovative and complex information systems with reference to (i) the expressed needs and involvement of different actors, starting from the initial introductory phase; (ii) promoting commitment to the system and adopting a participative approach; (iii) defining and resourcing new roles within the organization capable of supporting and sustaining the change and (iv) assessing system impacts in order to mobilize the network around a common goal.ConclusionsThe paper highlights the organizational, cultural, technological, and financial considerations that should be taken into account when planning strategies for the implementation of EMR systems in hospital settings. It also demonstrates how ANT may be usefully deployed in evaluating such projects.

The Performance of mHealth in Cancer Supportive Care: A Research Agenda

Background Since the advent of smartphones, mHealth has risen to the attention of the health care system as something that could radically change the way health care has been viewed, managed, and delivered to date. This is particularly relevant for cancer, as one of the leading causes of death worldwide, and for cancer supportive care, since patients and caregivers have key roles in managing side effects. Given adequate knowledge, they are able to expect appropriate assessments and interventions. In this scenario, mHealth has great potential for linking patients, caregivers, and health care professionals; for enabling early detection and intervention; for lowering costs; and achieving better quality of life. Given its great potential, it is important to evaluate the performance of mHealth. This can be considered from several perspectives, of which organizational performance is particularly relevant, since mHealth may increase the productivity of health care providers and as a result even the productivity of health care systems. Objective This paper aims to review studies on the evaluation of the performance of mHealth, with particular focus on cancer care and cancer supportive care processes, concentrating on its contribution to organizational performance, as well as identifying some indications for a further research agenda. Methods We carried out a review of literature, aimed at identifying studies related to the performance of mHealth in general or focusing on cancer care and cancer supportive care. Results Our analysis revealed that studies are almost always based on a single dimension of performance. Any evaluations of the performance of mHealth are based on very different methods and measures, with a prevailing focus on issues linked to efficiency. This fails to consider the real contribution that mHealth can offer for improving the performance of health care providers, health care systems, and the quality of life in general. Conclusions Further research should start by stating and explaining what is meant by the evaluation of mHealth’s performance and then conduct more in-depth analysis in order to create shared frameworks to specifically identify the different dimensions of mHealth’s performance.

Managing health care in the digital world: A comparative analysis

Recently, most reforms affecting healthcare systems have focused on improving the quality of care and containing costs. This has led many scholars to advocate the adoption of Health Information systems, especially electronic medical records, by highlighting their potential benefits. This study is based on a comparative analysis using a multiple method approach to examine the implementation of the same electronic medical record system at two different hospitals. Its findings offer insights into the processes of the adoption of innovation and its implementation in a healthcare context. The need to innovate, the decision to innovate, the implementation process and consequently, the results produced are quite distinctive at each study site. This comparative case study reveals that what appears to be the same can be quite different: this can be due to several conditions at the organization, the organization’s characteristics, and the process of implementation adopted. We need to understand these elements in order to be able to plan and manage such programs in the future.

Assessing Public Preferences and the Level of Transparency in Government Using an Exploratory Approach

Any information disclosed by governments should serve the purpose it is meant to fulfill. This is an underlying pillar of transparency. Our article assesses whether the information citizens consider to be most relevant for interaction with the authorities is actually disclosed. Our research was conducted on the population of the 117 Italian provincial capitals. A sample of 500 Italian citizens were interviewed with the purpose of understanding which type of information they consider most relevant, given the choice of institutional, political, financial, and service delivery–related information. The results indicate that Italian provincial capitals currently fail to publish the information that citizens consider to be most relevant: Despite differences in opinions among users, the sample we analyzed tends to rate the importance of service-delivery transparency and financial transparency higher than institutional or political transparency, whereas most information disclosed by Italian provincial capitals is associated with data they are obliged to disclose in order to comply with transparency regulations.

Evaluation of Innovation Performance in the Public Sector: A Systematic Review of Studies

Innovation promises to produce beneficial results for the most part. Consequently, there has been a great deal of discussion in management literature by academics and practitioners in recent years as to the impacts of innovation, on account of the extensive adoption of innovation in the public sector. The debate is currently open on multiple levels: the return of investment after the adoption of innovation, its contribution to the transformation of public sector organizations, and its impacts on society. The purpose of this chapter, based on a systematic review of literature, is to: discuss the status and trends in measuring innovation impacts; present cases and experiences; and set the basis for drafting a road map for moving forward in this field.