Maryati Mohd Yusof

An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit).

BACKGROUND AND PURPOSE The realization of Health Information Systems (HIS) requires rigorous evaluation that addresses technology, human and organization issues. Our review indicates that current evaluation methods evaluate different aspects of HIS and they can be improved upon. A new evaluation framework, human, organization and technology-fit (HOT-fit) was developed after having conducted a critical appraisal of the findings of existing HIS evaluation studies. HOT-fit builds on previous models of IS evaluation--in particular, the IS Success Model and the IT-Organization Fit Model. This paper introduces the new framework for HIS evaluation that incorporates comprehensive dimensions and measures of HIS and provides a technological, human and organizational fit. METHODS Literature review on HIS and IS evaluation studies and pilot testing of developed framework. The framework was used to evaluate a Fundus Imaging System (FIS) of a primary care organization in the UK. The case study was conducted through observation, interview and document analysis. RESULTS The main findings show that having the right user attitude and skills base together with good leadership, IT-friendly environment and good communication can have positive influence on the system adoption. CONCLUSIONS Comprehensive, specific evaluation factors, dimensions and measures in the new framework (HOT-fit) are applicable in HIS evaluation. The use of such a framework is argued to be useful not only for comprehensive evaluation of the particular FIS system under investigation, but potentially also for any Health Information System in general.

Investigating evaluation frameworks for health information systems

BACKGROUND AND PURPOSE Evaluation of health information systems (HIS) enables the assessment of the extent to which HIS are fulfilling their objectives in supporting the services of healthcare delivery. This paper presents an overview of evaluation in health informatics and information systems. METHODS Literature review on discourses, dimensions and methods of HIS and IS evaluation. A critical appraisal of selected HIS and IS evaluation frameworks is undertaken in order to identify HIS evaluation dimensions and measures. The frameworks are compared based on their inclusion of human, organizational and technological factors. RESULTS We found that an increasing number of evaluation studies deal with two distinct trends of HIS: one considers human and organizational issues and the other is concerned with the employment of a subjectivist approach. Our review indicates that current evaluation methods complement each other in that they evaluate different aspects of HIS and they can be improved upon. CONCLUSIONS Evaluation is complex; it is easy to measure many things but not necessarily the right ones. Nevertheless, it is possible to consider, a HIS evaluation framework with more comprehensive and specific measures that would incorporate technological, human and organizational issues to facilitate HIS evaluation.

Knowledge sharing in the public sector in Malaysia a proposed holistic model

Organizations are becoming increasingly aware of the importance of knowledge sharing to survive and remain competitive. Current knowledge sharing models have been found to be lacking as they only focus on the relationships between factors that influence knowledge sharing. An integrated approach that is capable of a simultaneous investigation of the various factors that affect knowledge sharing initiatives, quality of knowledge management and its impact on organizational performance has not been widely attempted. This study aims to develop a holistic knowledge sharing model for the public sector in Malaysia that is based on an integrated approach, which combines factors that influence knowledge management (input), knowledge sharing quality (process) and workers’ performance as well as service delivery (output) that encompasses the individual, organization and technology. This study will firstly present a review of the literature of current models in knowledge sharing, which will then form the take-off point for the development of the proposed holistic model. Such a holistic model is deemed appropriate and necessary to steer knowledge sharing initiatives in tandem with forming the base for policy-making of such initiatives.

A case study evaluation of a Critical Care Information System adoption using the socio-technical and fit approach.

BACKGROUND Clinical information systems have long been used in intensive care units but reports on their adoption and benefits are limited. This study evaluated a Critical Care Information System implementation. METHODS A case study summative evaluation was conducted, employing observation, interview, and document analysis in operating theatres and 16-bed adult intensive care units in a 400-bed Malaysian tertiary referral centre from the perspectives of users (nurses and physicians), management, and information technology staff. System implementation, factors influencing adoption, fit between these factors, and the impact of the Critical Care Information System were evaluated after eight months of operation. RESULTS Positive influences on system adoption were associated with technical factors, including system ease of use, usefulness, and information relevancy; human factors, particularly user attitude; and organisational factors, namely clinical process-technology alignment and champions. Organisational factors such as planning, project management, training, technology support, turnover rate, clinical workload, and communication were barriers to system implementation and use. Recommendations to improve the current system problems were discussed. Most nursing staff positively perceived the systems reduction of documentation and data access time, giving them more time with patients. System acceptance varied among doctors. System use also had positive impacts on timesaving, data quality, and clinical workflow. CONCLUSIONS Critical Care Information Systems is crucial and has great potentials in enhancing and delivering critical care. However, the case study findings showed that the system faced complex challenges and was underutilised despite its potential. The role of socio-technical factors and their fit in realizing the potential of Critical Care Information Systems requires continuous, in-depth evaluation and stakeholder understanding and acknowledgement. The comprehensive and specific evaluation measures of the Human-Organisation-Technology Fit framework can flexibly evaluate Critical Care Information Systems.

Evaluation of the clinical process in a critical care information system using the Lean method: a case study.

BackgroundThere are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study.MethodsWe conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports.ResultsWe identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model.ConclusionsThe case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

RATIONALE, AIMS AND OBJECTIVES Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. METHODS Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. RESULTS From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. CONCLUSIONS Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future.

Application of semantic technology in digital library

Digital libraries play an important role in current activities involving digital documents. The research presented in this paper explores the future implementation of digital library by considering the semantic technology. This paper discuss our on-going research in developing a semantic digital library for academic institution. We aim to propose a prototype to populate the domain ontology in order to support semantic search in digital libraries. The research is focusing at the user level in extracting the information of the academic dissertations and populate to the ontology.

Ontological-based model for human resource decision support system (HRDSS)

This research concerns the development of Ontology-based model as an input to Human Resource Decision Support System (HRDSS) and to assist in the efficient and effective data analysis and leveraging the semantic content of ontology. These are to give intelligence support in decision-making and to proposed and develop suitable system architecture of the intelligence DSS model for the Human resource planning at national level. The initial model was developed based on the literature review on issues related to Human resource planning complex unstructured decision making process. We have been working on ontology to manage knowledge in human resource and integrate multiple data resources in order to support decision making in forecasting and projection for supply and demand in Human Resource Development.

Ontology-Driven Semantic Digital Library

This paper discusses an on-going research project in developing a semantic digital library for academic institution. It provides another view of semantic information retrieval for digital library from the perspective of semantic technology and ontology. We proposed an approach for managing, organizing and populating ontology for document collections in digital library. In this sense the document metadata and content are inserted and populated to a knowledge base which allows sophisticated query and searching. The paper also proposed an ontology based information retrieval model which is based on the classic vector space model which includes document annotation, instance-based weighting and concept-based ranking.

ICDTag: A Prototype for a Web-Based System for Organizing Physician-Written Blog Posts Using a Hybrid Taxonomy-Folksonomy Approach

Background Medical blogs have emerged as new media, extending to a wider range of medical audiences, including health professionals and patients to share health-related information. However, extraction of quality health-related information from medical blogs is challenging primarily because these blogs lack systematic methods to organize their posts. Medical blogs can be categorized according to their author into (1) physician-written blogs, (2) nurse-written blogs, and (3) patient-written blogs. This study focuses on how to organize physician-written blog posts that discuss disease-related issues and how to extract quality information from these posts. Objective The goal of this study was to create and implement a prototype for a Web-based system, called ICDTag, based on a hybrid taxonomy–folksonomy approach that follows a combination of a taxonomy classification schemes and user-generated tags to organize physician-written blog posts and extract information from these posts. Methods First, the design specifications for the Web-based system were identified. This system included two modules: (1) a blogging module that was implemented as one or more blogs, and (2) an aggregator module that aggregated posts from different blogs into an aggregator website. We then developed a prototype for this system in which the blogging module included two blogs, the cardiology blog and the gastroenterology blog. To analyze the usage patterns of the prototype, we conducted an experiment with data provided by cardiologists and gastroenterologists. Next, we conducted two evaluation types: (1) an evaluation of the ICDTag blog, in which the browsing functionalities of the blogging module were evaluated from the end-user’s perspective using an online questionnaire, and (2) an evaluation of information quality, in which the quality of the content on the aggregator website was assessed from the perspective of medical experts using an emailed questionnaire. Results Participants of this experiment included 23 cardiologists and 24 gastroenterologists. Positive evaluations on the main functions and the organization of information on the ICDTag blogs were given by 18 of the participants via an online questionnaire. These results supported our hypothesis that the use of a taxonomy-folksonomy structure has significant potential to improve the organization of information in physician-written blogs. The quality of the content on the aggregator website was assessed by 3 cardiology experts and 3 gastroenterology experts via an email questionnaire. The results of this questionnaire demonstrated that the experts considered the aggregated tags and categories semantically related to the posts’ content. Conclusions This study demonstrated that applying the hybrid taxonomy–folksonomy approach to physician-written blogs that discuss disease-related issues has valuable potential to make these blogs a more organized and systematic medium and supports the extraction of quality information from their posts. Thus, it is worthwhile to develop more mature systems that make use of the hybrid approach to organize posts in physician-written blogs.