Managing Computer Impact

Managing Computer Impact: An International Study of Management and Organizations

Managing Computer Impact describes research undertaken in eight organizations in five countries. The approach determines the impact of computer-based information systems on organizations and management. Results at several levels of analysis support the conclusion that few changes are determined by computer technology.

Managing Computer Impact: An International Study of Management and Organisations Ken Eason

Link to Google Books

BJORN-ANDERSON, N. EASON, K.D. & ROBEY, D. (1986) Managing Computer Impact, Ablex, Norwood NJ.

Early Evaluation of the Organisational Implications of CSCW Systems

Evaluation of Computer Systems which Support Cooperative Work (CSCW)

Abstract:
Computer systems which support cooperative work will undoubtedly change the way people interact with one another in a working setting. In stimulating these changes, the CSCW system will be a force for organisational change. Over the past twenty years there has been a tradition of impact research, in which investigators have studied the impact computer-based information systems implemented within organisations have had upon those organisations. The results have been many and varied. Some studies show that computer systems lead to the centralisation of power, while others show decentralisation of power. At the level of the individual job there are studies which show the empowerment of the individual and the opposite: the creation of the “white collar assembly line.” A study from 1983 demonstrated both job enrichment and deskilling from two different computer systems in the same organisation. There is widespread agreement that there can be substantial change, but very little agreement on the form that it takes. We have argued elsewhere (Eason 1988) that the reason for these diverse results is that computer systems are not deterministic, and that they can be used to achieve many different organisational effects. There is an opportunity in the design and development process to plan the organisational outcomes and to achieve the impact that is desired by the members of the organisation.

Early Evaluation of the Organisational Implications of CSCW Systems Ken Eason

Springer Link to Article

Eason K.D. and Olphert C.W. (1996) Early evaluation of the organisational implications of CSCW Systems, In Thomas P. (ed) ‘CSCW Requirements and Evaluation, Springer-Verlag, London 75-89

Psychological Processes in the Use of Electronic Journals

Paper presented at the UKSG 23rd Annual Conference, Keele, April 2000

Abstract:
Evidence of user behaviour with electronic journals from the SuperJournal project is reviewed to identify the psychological processes being employed. The article reviews patterns of use, the dominance of browsing as the means of seeking information, the depth, breadth and range of use and the tendency to print. The article concludes that the dominant user approach is a coping strategy that maximises success for minimum psychological effort.

PDF Link to Paper

Eason K.D. and Harker S.D.P. Psychological processes in the use of electronic journals, Serials 13(2) 67-72

The Use and Usefulness of Functions in Electronic Journals: The Experience of the Superjournal Project

Value to users of a range of functions of electronic journals and their usefulness in the specific context of the SuperJournal Project.

Abstract:
For the evaluation of each of the functions three types of data were analysed in relation to each other and in light of other contextual data: logged data of usage, survey data on user satisfaction, and survey data on the perceived importance of the function. The analysis shows that basic browsing, printing and search make up the core functions of electronic journals; other functions, such as saving of bibliographic data, alerting, customising, links with external resources and communication, serve as peripheral functions. The usefulness of both the core functions and the peripheral functions in a specific service is influenced by various implementation factors. However, it is the realised usefulness of the core functions which determines the use of a service.

Emerald Insight Link

Eason K. D. Yu, L. and Harker S.D.P. The use and usefulness of functions in electronic journals: The experience of the Superjournal Project. Program 34(1) 1-28

 

Patterns of Use of Electronic Journals

This paper classifies a spectrum of user behaviour with electronic journals into a typology of eight categories of user/use.

Abstract:
On the basis of a twenty‐two month transaction log of SuperJournal and using K‐Means cluster analysis, this paper classifies a spectrum of user behaviour with electronic journals into a typology of eight categories of user (or eight patterns of use): the searcher, the enthusiastic user, the focused regular user, the specialised occasional user, the restricted user, the lost user, the exploratory user and the tourist. It examines the background and experience with SuperJournal of each type of user to illuminate its formation. The examination shows that the contents (both coverage and relevance) and ease of use of a system as they were perceived by the user were the most significant factors affecting patterns of use. Users’ perceptions of both factors were affected by a range of intervening factors such as discipline, status, habitual approach towards information management, availability of alternative electronic journal services, purpose of use, etc. As any service is likely to attract a great variety of users, so will it lead to differing patterns of use. This paper demonstrates the need for a service to meet the requirements of users with these varied patterns.

Emerald Insight Link to Paper

EASON, K.D., RICHARDSON, S, YU, L., Patterns of use of Electronic Journals, Journal of Documentation, Vol 56(5) pp 477-504. ISSN 00220418.

Patient Safety in Community Care: e-health systems and the Care of the Elderly at Home

Handbook of Research on Patient Safety and Quality Care through Health Informatics

This chapter reviews a number of technologies used for remote care: telecare, telehealth, telemedicine, electronic patient record systems, and technologies to support mobile working.

Abstract:

The increasing number of elderly people in need of health and social care is putting pressure on current services to develop better ways of providing integrated care in the community. It is a widely held belief that e-health technologies have great potential in enabling and achieving this goal. This chapter reviews a number of technologies used for this purpose: telecare, telehealth, telemedicine, electronic patient record systems, and technologies to support mobile working. In each case, technocentric-design approaches have led to problematic implementations and failures to achieve adoption into the routine of delivering healthcare. An examination of attempts to implement major changes in the service delivery of integrated care shows that e-health technologies can be successfully implemented when they are seen as an intrinsic part of the creation of a complete system. However, the design process required for successful delivery of these services is challenging; it requires sustained and integrated development work by clinical staff and technologists coordinating their work on process changes, organisational developments, and technology implementations.

Patient Safety in Community Care: e-health systems and the Care of the Elderly at Home Ken Eason

Link to IGI Global

Eason K. D. and Waterson P.E Patient Safety in Community Care: e-health systems and the care of the elderly at home In Michel V., Gulliver S., Rosenorn-Lang D. and Currie W. (eds) Patient Safety and Quality Dimensions of Health Informatics. IGI Global 198-213

The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly

Published in ‘Healthcare Administration: Concepts, Methodologies, Tools, and Applications’

Abstract:
Telehealth and telecare have been heralded as major mechanisms by which frail elderly people can continue to live at home but numerous pilot studies have not led to the adoption of these technologies as mainstream contributors to the health and social care of people in the community. This paper reviews why dissemination has proved difficult and concludes that one problem is that these technologies require considerable organisational changes if they are to be effective: successful implementation is not just a technical design issue but is a sociotechnical design challenge. The paper reviews the plans of 25 health communities in England to introduce integrated health and social care for the elderly. It concludes that these plans when implemented will produce organisational environments conducive to the mainstream deployment of telehealth and telecare. However, the plans focus on different kinds of integrated care and each makes different demands on telehealth and telecare. Progress on getting mainstream benefits from telehealth and telecare will therefore depend on building a number of different sociotechnical systems geared to different forms of integrated care and incorporating different forms of telehealth and telecare.

The Promise and Disappointment of Telehealth and Telecare

There is widespread belief that telehealth and telecare applications can be used to help people live independent lives at home even when they are suffering from multiple conditions that are severely disabling. In England the Department of Health has launched the 3 million lives programme to encourage their widespread deployment in community care. There are a variety of names given to technologies that support the health and social care of people in their own homes and in care homes. Telecare applications, often associated with social care, typically provide monitors and alarms in the home or on the person that can alert external agencies, e.g. in a call centre, when the person has a fall or another kind of emergency so that help can be sent. Telehealth and telemedicine are tools for health practitioners to deploy which, for example, enable test results to be collected at home and monitored by healthcare agencies or, in the case of telemedicine, enable remote real-time conversations between a patient and a medical specialist.

The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly Ken Eason

IGI Chapter Link

Eason K. D., Waterson P. and Davda P. (2013) The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly International Journal of Sociotechnology and Knowledge Development 5(4) 14-26

Bottom up & Middle Out Approaches to Electronic Patient Information Systems: A Focus on Healthcare Pathways

Published in ‘Journal Of Innovation in Health Informatics’

Background
A study is reported that examines the use of electronic health record (EHR) systems in two UK local health communities.

Objective
These systems were developed locally and the aim of the study was to explore how well they were supporting the coordination of care along healthcare pathways that cross the organisational boundaries between the agencies delivering health care.

Results
The paper presents the findings for two healthcare pathways; the Stroke Pathway and a pathway for the care of the frail elderly in their own homes. All the pathways examined involved multiple agencies and many locally tailored EHR systems are in use to aid the coordination of care. However, the ability to share electronic patient information along the pathways was patchy. The development of systems that enabled effective sharing of information was characterised by sociotechnical system development, i.e. associating the technical development with process changes and organisational changes, with local development teams that drew on all the relevant agencies in the local health community and on evolutionary development, as experience grew of the benefits that EHR systems could deliver.

Conclusions
The study concludes that whilst there may be a role for a national IT strategy, for example, to set standards for systems procurement that facilitate data interchange, most systems development work needs to be done at a ‘middle-out’ level in the local health community, where joint planning between healthcare agencies can occur, and at the local healthcare pathway level where systems can be matched to specific needs for information sharing.

BCS Journal Link

2012 EASON K. D., DENT M., WATERSON P., TUTT D., AND THORNETT A. Bottom up and middle out approaches to electronic patient information systems: A focus on healthcare pathways Informatics in Primary Care 20:1 51-56

Getting the Benefit from Electronic Patient Information that Crosses Organisational Boundaries – Final Report NIHR Service Delivery and Organisation Programme

Final Report National Institute for Health Research Service Delivery and Organisation Programme

Executive Summary Conclusions

Within the two LHCs studied, there are areas in which substantial progress has been made in creating working forms of integrated care in healthcare pathways. These islands of progress have produced solutions that are quite different from one another and they are the result of evolutionary processes over several years in the face of many difficulties. As a result, there are parts of the systems development process that are mature in the ways in which the challenge of integrated design is tackled. We would single out, for example, the long tradition that has now built up for engaging ‘hybrids’ as the go-betweens in the endless dialogue between informatics specialists and the healthcare user community. However, current electronic support for integrated care can only be described as patchy and, to build on what is already in place, there is a need to create more mature systems development processes that can cope with the many challenges of bringing together a diverse set of stakeholder interests across a number of different healthcare agencies to create the sociotechnical systems necessary to serve the specific needs of healthcare pathways.

Link to PDF

Eason K. D., Dent M., Waterson P., Tutt D., Hurd P. and Thornett A. Getting the benefit from electronic patient information that crosses organisational boundaries – Final Report NIHR Service Delivery and Organisation Programme, November 2012

The Implications of e-health System Delivery Strategies for Integrated Healthcare: Lessons from the UK & Elsewhere

Abstract:

Purpose
This paper explores the implications that different technical strategies for sharing patient information have for healthcare workers and, as a consequence, for the extent to which these systems provide support for integrated care.

Methods
Four technical strategies were identified and the forms of coupling they made with healthcare agencies were classified. A study was conducted in England to examine the human and organizational implications of systems implemented by these four strategies. Results were used from evaluation reports of two systems delivered as part of the NPfIT (National Programme for Information Technology) and from user responses to systems delivered in two local health communities in England. In the latter study 40 clinical respondents reported the use of systems to support integrated care in six healthcare pathways.

Results
The implementation of a detailed care record system (DCRS) in the NPfIT was problematic because it could not meet the diverse needs of all healthcare agencies and it required considerable local customization. The programme evolved to allow different systems to be delivered for each local health community. A national Summary Care Record (SCR) was implemented but many concerns were raised about wide access to confidential patient information. The two technical strategies that required looser forms of coupling and were under local control led to wide user adoption. The systems that enabled data to be transferred between local systems were successfully used to support integrated care in specific healthcare pathways. The portal approach gave many users an opportunity to view patient data held on a number of databases and this system evolved over a number of years as a result of requests from the user community.

Conclusions
The UK national strategy to deliver single shared database systems requires tight coupling between many users and has led to poor adoption because of the diverse needs of healthcare agencies. Sharing patient information has been more successful when local systems have been developed to serve particular healthcare pathways or when separate databases are viewable through a portal. On the basis of this evidence technical strategies that permit the local design of tight coupling are necessary if information systems are to support integrated care in healthcare pathways.

Highlights

  • Links between electronic patient databases and healthcare agencies are defined in terms of tightness of coupling, range and scale.
  • The English Detailed Care Record System was unable to serve the diverse needs of healthcare agencies and was not successfully deployed.
  • Tight coupling was successfully deployed at a local level between agencies engaged in integrated care in healthcare pathways.
  • Widespread uptake was also found when portal systems were deployed that permitted viewing of a range of patient databases.
  • Adoption of patient databases was greater when there was middle-out design and technical strategies delivered looser forms of coupling.

Link to PDF

Science Direct Link

Eason K.D. and Waterson P.E. (2013) The Implications of e-health system delivery strategies for integrated healthcare: lessons from the UK and elsewhere. International Journal of Medical Informatics. 85(5) 96-106 Doi:10.1016/j.ijmedinf.2012.11.004