scholarly journals How can health services establish digital health learning ecosystems? A qualitative evaluation of a national digital health transformation programme in England (Preprint)

2020 ◽  
Author(s):  
Kathrin Cresswell ◽  
Aziz Sheikh ◽  
Bryony Dean Franklin ◽  
Marta Krasuska Krasuska ◽  
Hung The Nguyen ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Large Scale ◽  
Digital Health ◽  
Knowledge Exchange ◽  
Qualitative Evaluation ◽  
Strategic Decision ◽  
Structured Interviews ◽  
Inductive Methods ◽  
Learning Ecosystem ◽  
High Level

BACKGROUND The English Global Digital Exemplar (GDE) Programme is one of the first concerted efforts to create a digital health learning ecosystem across a national health service. OBJECTIVE To explore mechanisms supporting or inhibiting exchange of inter-organisational digital transformation knowledge. METHODS We conducted a formative qualitative evaluation of the GDE Programme. We used semi-structured interviews with clinical, technical and managerial staff, national programme managers and network leaders; non-participant observations of knowledge transfer activities through attending meetings, workshops and conferences; and documentary analysis of policy documents. Data were thematically analysed drawing on a theory-informed sociotechnical coding framework. We used a mixture of deductive and inductive methods, supported by NVivo software to facilitate coding. RESULTS We conducted 341 one-to-one and 116 group interviews, observed 86 meetings, and analysed 245 documents in 36 participating provider organisations. We also conducted 56 high-level interviews with policymakers and vendors; 84 observations of national meetings, workshops, and conferences; and analysed 80 national documents. Formal processes put in place by the GDE Programme to initiate and reinforce knowledge transfer and learning have accelerated the growth of informal knowledge networking and helped establish the foundations of a learning ecosystem. However, formal networks were most effective where supported by informal networking. Benefits of networking were enhanced (and costs reduced) by geographical proximity, shared culture and context, common technological functionality, regional and strategic alignments, and professional agendas. CONCLUSIONS Strategic decision makers can stimulate effective knowledge transfer in large-scale digital health transformation initiatives. Knowledge exchange is most effective when sustained through informal networking driven by mutual benefits of sharing knowledge and learning. Policy interventions to enhance incentives and reduce barriers to sharing across the ecosystem may be more productive than promoting particular knowledge transfer mechanisms.

scholarly journals Using Blueprints to promote interorganizational knowledge transfer in digital health initiatives—a qualitative exploration of a national change program in English hospitals

2021 ◽  
Author(s):  
Robin Williams ◽  
Aziz Sheikh ◽  
Bryony Dean Franklin ◽  
Marta Krasuska ◽  
Hung The Nguyen ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Digital Health ◽  
Healthcare Providers ◽  
Qualitative Evaluation ◽  
National Program ◽  
Healthcare Organizations ◽  
Program Managers ◽  
Health Initiatives ◽  
Inductive Methods ◽  
Networking Tool

Abstract Objective The Global Digital Exemplar (GDE) Program is a national attempt to accelerate digital maturity in healthcare providers through promoting knowledge transfer across the English National Health Service (NHS). “Blueprints”—documents capturing implementation experience—were intended to facilitate this knowledge transfer. Here we explore how Blueprints have been conceptualized, produced, and used to promote interorganizational knowledge transfer across the NHS. Materials and Methods We undertook an independent national qualitative evaluation of the GDE Program. This involved collecting data using semistructured interviews with implementation staff and clinical leaders in provider organizations, nonparticipant observation of meetings, and key documents. We also attended a range of national meetings and conferences, interviewed national program managers, and analyzed a range of policy documents. Our analysis drew on sociotechnical principles, combining deductive and inductive methods. Results Data comprised 508 interviews, 163 observed meetings, and analysis of 325 documents. We found little evidence of Blueprints being adopted in the manner originally conceived by national program managers. However, they proved effective in different ways to those planned. As well as providing a helpful initial guide to a topic, we found that Blueprints served as a method of identifying relevant expertise that paved the way for subsequent discussions and richer knowledge transfers amongst provider organizations. The primary value of Blueprinting, therefore, seemed to be its role as a networking tool. Members of different organizations came together in developing, applying, and sustaining Blueprints through bilateral conversations—in some circumstances also fostering informal communities of practice. Conclusions Blueprints may be effective in facilitating knowledge transfer among healthcare organizations, but need to be accompanied by other evolving methods, such as site visits and other networking activities, to iteratively transfer knowledge and experience.

Identifying Enablers of Participant Engagement in Clinical Trials of Consumer Health Technologies: A Qualitative Study of flu@home (Preprint)

2020 ◽  
Author(s):  
Spurthy Dharanikota ◽  
Cynthia M LeRouge ◽  
Victoria Lyon ◽  
Polina Durneva ◽  
Matthew Thompson
Keyword(s):  
Clinical Trials ◽  
Technology Acceptance ◽  
Attribution Theory ◽  
Financial Incentives ◽  
Large Scale ◽  
Digital Health ◽  
Drop Out ◽  
Evidence Based ◽  
Structured Interviews ◽  
Health Technologies

BACKGROUND Clinical trials are fraught with challenges such as inadequate enrollment, lack of fidelity to interventions, and high drop-out rates. However, such trials are essential to support large-scale implementation of crucial consumer healthcare technologies (CHTs) such as smartphone supported home diagnostic tests (Smart-HT). A rise in the recent trend of self-managing health using CHTs highlights the importance of efficient and successful CHT trials. Understanding the reasons underlying individuals’ participation in trials could inform the design and execution of future trials of CHTs. OBJECTIVE We aimed to identify the enablers of participation in clinical trials of CHTs and summarize our findings in an evidence-based framework. We used an instantiation of a specific CHT currently in trial, Smart-HT, which is an app accompanied by home-based diagnostic testing of influenza called flu@home. METHODS Based on the digital health engagement model (DIEGO) and technology acceptance model (TAM), we proposed a preliminary research framework of enablers for participants’ engagement in trials of CHTs. Further, based on the attribution theory, we categorized the enablers into dispositional and situational factors. The framework guided the confidential and semi-structured interviews and resultant transcript coding. 31 individuals who previously participated in the diagnostic accuracy pilot study of flu@home were recruited to complete the semi-structured interviews via email and received a 25$ gift card once completing the interview. RESULTS In addition to finding support and a detailed understanding of the proposed preliminary framework, we identified new themes in our analysis that extend our evidence-based framework. Situationally, we found that financial incentives and insurance status influenced trial engagement for flu@home. Motivation to advance medical research, personal innovativeness, altruism, curiosity, positive attitude, and potential to minimize doctor’s visits emerged as new dispositional enablers for trial engagement in our study. CONCLUSIONS Our findings and proposed framework provide insights into the context of trial engagement for CHTs that require testing, particularly an instantiation of Smart-HT involving testing for influenza. We suggest several trial design and trial engagement strategies to enhance these trials' financial and scientific viability, paving the way for advancements in patient care. Furthermore, our study also offers practical strategies to trial organizers to enhance participants’ enrollment and engagement in clinical trials of CHTs.

scholarly journals General practitioners’ perceptions towards the use of digital health services for citizens in primary care: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028251 ◽  
Author(s):  
Asbjørn Johansen Fagerlund ◽  
Inger Marie Holm ◽  
Paolo Zanaboni
Keyword(s):  
Primary Care ◽  
Health Services ◽  
General Practitioners ◽  
Computer Literacy ◽  
Large Scale ◽  
Digital Health ◽  
The Elderly ◽  
Structured Interviews ◽  
Electronic Prescription ◽  
Qualitative Interview Study

ObjectivesTo explore general practitioners’ (GPs) perceptions towards use of four digital health services for citizens: an electronic booking service to make reservations with the GP; an electronic prescription service to request renewal of maintenance drugs; a service for text-based non-clinical enquiries to the GP office and a service for text-based electronic consultation (e-consultation) with the GP.DesignA qualitative study based on semi-structured interviews.SettingPrimary care.ParticipantsNine GPs who were early adopters of the four services were interviewed.MethodOne moderator presented topics using open-ended questions, facilitated the discussion and followed up with further questions. Phone interviews were conducted, audio recorded and transcribed verbatim. Qualitative data were analysed using the framework method.ResultsThe use of digital services in primary care in Norway is growing, although the use of text-based e-consultations is still limited. Most GPs were positive about all four services, but there was still some scepticism regarding their effects. Advantages for GP offices included reduced phone load, increased efficiency, released time for medical assessments, less crowded waiting rooms and more precise communication. Benefits for patients were increased flexibility, autonomy and time and money savings. Children, the elderly and people with low computer literacy might still need traditional alternatives.ConclusionsMore defined and standardised routines, as well as more evidence of the effects, are necessary for large-scale adoption.

scholarly journals On the Combinatory Nature of Knowledge Transfer Conditions: A Mixed Method Assessment

2021 ◽  
Author(s):  
Emily Bacon ◽  
Michael D. Williams ◽  
Gareth H. Davies
Keyword(s):  
Comparative Analysis ◽  
Knowledge Transfer ◽  
Mixed Method ◽  
Knowledge Exchange ◽  
Qualitative Comparative Analysis ◽  
Future Research ◽  
Structural Modelling ◽  
Structured Interviews ◽  
Transfer Success ◽  
Method Approach

AbstractOrganisations are increasingly creating inter-organisational ecosystem partnerships to innovate openly. Despite effective knowledge management significantly supporting ecosystem infrastructures, empirical insights into the importance of and interdependencies between conditions for successful knowledge exchange across ecosystem contexts remain unexplored within existing literature. This study implements a mixed-method approach to ascertain which conditions are responsible for knowledge transfer success across innovation ecosystems. Interpretive Structural Modelling was employed to analyse questionnaires with key ecosystem stakeholders, in order to impose a hierarchical structure upon the conditions. The configurational nature of these conditions, and their combinations into solutions for success was ascertained through analysing semi-structured interviews using fuzzy-set Qualitative Comparative Analysis. Results reveal multiple, mutually exclusive pathways to knowledge transfer success, grouped into three solution types, increasing understanding of the interrelated nature of the knowledge transfer conditions. Limitations and implications for future research are provided.

scholarly journals Guiding the evolution of product-line configurations

2021 ◽  
Author(s):  
Michael Nieke ◽  
Gabriela Sampaio ◽  
Thomas Thüm ◽  
Christoph Seidl ◽  
Leopoldo Teixeira ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Quantitative Evaluation ◽  
Real World ◽  
Large Scale ◽  
Qualitative Evaluation ◽  
Product Line ◽  
Industrial Product ◽  
Behavior Changes ◽  
Product Lines

AbstractA product line is an approach for systematically managing configuration options of customizable systems, usually by means of features. Products are generated for configurations consisting of selected features. Product-line evolution can lead to unintended changes to product behavior. We illustrate that updating configurations after product-line evolution requires decisions of both, domain engineers responsible for product-line evolution as well as application engineers responsible for configurations. The challenge is that domain and application engineers might not be able to interact with each other. We propose a formal foundation and a methodology that enables domain engineers to guide application engineers through configuration evolution by sharing knowledge on product-line evolution and by defining automatic update operations for configurations. As an effect, we enable knowledge transfer between those engineers without the need for interactions. We evaluate our methodology on four large-scale industrial product lines. The results of the qualitative evaluation indicate that our method is flexible enough for real-world product-line evolution. The quantitative evaluation indicates that we detect product behavior changes for up to $$55.3\%$$ 55.3 % of the configurations which would not have been detected using existing methods.

scholarly journals Driving digital health transformation in hospitals: a formative qualitative evaluation of the English Global Digital Exemplar programme

2021 ◽  
Vol 28 (1) ◽  
pp. e100429
Author(s):  
Marta Krasuska ◽  
Robin Williams ◽  
Aziz Sheikh ◽  
Bryony Franklin ◽  
Susan Hinder ◽  
...  
Keyword(s):  
Case Studies ◽  
Health Informatics ◽  
Large Scale ◽  
Local Governance ◽  
Digital Health ◽  
National Level ◽  
Qualitative Evaluation ◽  
Digital Transformation ◽  
Sociotechnical Theory ◽  
The Impact

BackgroundThere is currently a strong drive internationally towards creating digitally advanced healthcare systems through coordinated efforts at a national level. The English Global Digital Exemplar (GDE) programme is a large-scale national health information technology change programme aiming to promote digitally-enabled transformation in secondary healthcare provider organisations by supporting relatively digitally mature provider organisations to become international centres of excellence.AimTo qualitatively evaluate the impact of the GDE programme in promoting digital transformation in provider organisations that took part in the programme.MethodsWe conducted a series of in-depth case studies in 12 purposively selected provider organisations and a further 24 wider case studies of the remaining organisations participating in the GDE programme. Data collected included 628 interviews, non-participant observations of 190 meetings and workshops and analysis of 9 documents. We used thematic analysis aided by NVivo software and drew on sociotechnical theory to analyse the data.ResultsWe found the GDE programme accelerated digital transformation within participating provider organisations. This acceleration was triggered by: (1) dedicated funding and the associated requirement for matched internal funding, which in turn helped to prioritise digital transformation locally; (2) governance requirements put in place by the programme that helped strengthen existing local governance and project management structures and supported the emergence of a cadre of clinical health informatics leaders locally; and (3) reputational benefits associated with being recognised as a centre of digital excellence, which facilitated organisational buy-in for digital transformation and increased negotiating power with vendors.ConclusionThe GDE programme has been successful in accelerating digital transformation in participating provider organisations. Large-scale digital transformation programmes in healthcare can stimulate local progress through protected funding, putting in place governance structures and leveraging reputational benefits for participating provider organisations, around a coherent vision of transformation.

scholarly journals Organizing Safe Spaces: #MeToo Activism in Sweden

2021 ◽  
Author(s):  
Karin Hansson ◽  
Malin Sveningsson ◽  
Hillevi Ganetz
Keyword(s):  
News Media ◽  
Large Scale ◽  
Social Stigma ◽  
Structured Interviews ◽  
Safe Spaces ◽  
Increased Risk ◽  
Supportive Culture ◽  
Technical Systems ◽  
High Level ◽  
Over Time

AbstractNetworked online environments can effectively support political activism. In Sweden, the #metoo movement resulted in over 100,000 people participating in activities challenging sexual harassment and abuse, including collecting testimonies via social media and drafting and discussing petitions published in print news media. Participation involved many risks, such as social stigma, losing one’s job, or misogynist terrorism, which meant that participation required a high level of trust among peers. Human-computer interaction (HCI) research on trust generally focuses on technical systems or user-generated data, less focus has been given to trust among peers in vulnerable communities. This study, based on semi-structured interviews and surveys of participants and organizers of 47 petitions representing different sectors in society, found that trust was aggregated over networks of people, practices, institutions, shared values, and technical systems. Although a supportive culture based on a feeling of solidarity and shared feminist values was central for safe spaces for participation, when activism was scaled up, social interaction had to be limited due to increased risk. HCI research views trust as a process of crossing distances, increasing over time; however, our results reveal that trust decreased over time as the movement grew and public exposure increased, a trend most evident when the participants actually came from a tightly knit community. Therefore, this study points out the significance to balance the need for transparency and community with the need for anonymity and distance in the development of tools to support large-scale deliberative processes that involve conflicts and risks.

scholarly journals Finnish Biodiversity Information Facility - Improving the Taxonomic Coverage and Deepening the Information Content Through Collaboration

2019 ◽  
Vol 3 ◽  
Author(s):  
Kari Lahti ◽  
Liselott Skarp
Keyword(s):  
Species Identification ◽  
Large Scale ◽  
Knowledge Exchange ◽  
Dna Barcode ◽  
Similar Species ◽  
Observation Data ◽  
Distributed Information ◽  
The Status ◽  
High Level ◽  
Biodiversity Information

The Finnish Biodiversity Information Facility FinBIF (LINK: species.fi), operational since late 2016, is one of the more recent examples of comprehensive, all-inclusive national biodiversity research infrastructures. FinBIF integrates a wide array of biodiversity information approaches under the same umbrella. These include species information Fig. 1 (e.g. descriptions, photos and administrative attributes); citizen science platforms enabling recording, managing and sharing of observation data; an e-learning environment for species identification; management and sharing of restricted data among authorities; building a national DNA barcode reference library and linking it to species occurrence data; community-driven species identification support; large-scale and multi-technology digitisation of natural history collections; and IUCN Red Listing to conduct a periodic national assesment of the status of the threatened species. To improve the taxonomic coverage and the content of species information, FinBIF is starting a process to collaborate with the species information community at large, in order to collate already existing but not yet openly distributed information. This also means digitisation of information from analogue sources. In addition, the attempt is to join forces with Scandinavian counterparts, namely Artdatabanken (LINK: https://www.artdatabanken.se/) and Artsdatabanken (LINK: https://www.artsdatabanken.no/), for more efficient knowledge exchange within the countries sharing the same biogeographical region and thus similar species composition. The aim is also to reach politically high level agreement for deeper and wider commitment to collaborate in compiling, digitising and sharing relevant biodiversity information over the national borders.

scholarly journals Organizational structure and knowledge-practice diffusion in the MNC

2014 ◽  
Vol 18 (4) ◽  
pp. 710-727 ◽  
Author(s):  
Nathaniel Lupton ◽  
Paul Beamish
Keyword(s):  
Knowledge Transfer ◽  
Organizational Structure ◽  
Multinational Corporations ◽  
Knowledge Exchange ◽  
Formal Structure ◽  
Control Mechanisms ◽  
Transfer Of Knowledge ◽  
It Services ◽  
Structured Interviews ◽  
Content Type

Purpose – This study aims to examine the interaction of formal and informal cross-border knowledge-sharing practices of four large multinational corporations (MNCs) in aerospace, software, IT services and telecommunications industries. The goal was to determine the manner in which coordination and control mechanisms facilitated knowledge transfer. Design/methodology/approach – Case studies comprised secondary data and semi-structured interviews with corporate headquarters and subsidiary managers in large MNCs conducted in the USA, Canada, Mexico, China, India and Eastern Europe. Findings – The primary finding of this study is that knowledge transfer mechanisms arise as a result of both formal and informal structures of the MNC. Formal structures which create either mutual dependencies or occasions for knowledge exchange facilitate transfer. Formal structure which inhibits knowledge transfer can be overcome by knowledge brokers and evaluation metrics. Research limitations/implications – These findings suggest that knowledge transfer is more informal than formal, but that MNC headquarters does play a role, intended or not, through shaping the interdependencies among geographically distributed units. Managers should be mindful of both the manner in which tasks and the organization are structured, as these have an indirect impact on the development of knowledge channels. Originality/value – This paper investigates the role of organizational structure and its effect, both intended and unintended, on the transfer of knowledge-based practices. While knowledge transfer has been heavily researched, this study examines the phenomenon at a finer-grained level of analysis.

Social inequality in the evolution of human societies

2019 ◽  
pp. 98-120
Author(s):  
Georgi Derluguian
Keyword(s):  
Social Inequality ◽  
Large Scale ◽  
Human Beings ◽  
Mass Violence ◽  
Public And Private ◽  
Tangible Assets ◽  
Transition To Agriculture ◽  
New Institutions ◽  
High Level ◽  
Political Economic

The author develops ideas about the origin of social inequality during the evolution of human societies and reflects on the possibilities of its overcoming. What makes human beings different from other primates is a high level of egalitarianism and altruism, which contributed to more successful adaptability of human collectives at early stages of the development of society. The transition to agriculture, coupled with substantially increasing population density, was marked by the emergence and institutionalisation of social inequality based on the inequality of tangible assets and symbolic wealth. Then, new institutions of warfare came into existence, and they were aimed at conquering and enslaving the neighbours engaged in productive labour. While exercising control over nature, people also established and strengthened their power over other people. Chiefdom as a new type of polity came into being. Elementary forms of power (political, economic and ideological) served as a basis for the formation of early states. The societies in those states were characterised by social inequality and cruelties, including slavery, mass violence and numerous victims. Nowadays, the old elementary forms of power that are inherent in personalistic chiefdom are still functioning along with modern institutions of public and private bureaucracy. This constitutes the key contradiction of our time, which is the juxtaposition of individual despotic power and public infrastructural one. However, society is evolving towards an ever more efficient combination of social initiatives with the sustainability and viability of large-scale organisations.

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