Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health car...

The Triple Aim: Care, Health, And Cost

As the United States expends extraordinary efforts toward the digitization of its health-care system, and as policy makers across the globe look to information technology (IT) as a means of making health-care systems safer, more affordable, and more accessible, a rare and remarkable opportunity has emerged for the information systems research community to leverage its in-depth knowledge to both advance theory and influence practice and policy. Although health IT (HIT) has tremendous potential to improve quality and reduce costs in healthcare, significant challenges need to be overcome to fully realize this potential. In this commentary, we survey the landscape of existing studies on HIT to provide an overview of the current status of HIT research. We then identify three major areas that warrant further research: (1) HIT design, implementation, and meaningful use; (2) measurement and quantification of HIT payoff and impact; and (3) extending the traditional realm of HIT. We discuss specific research questions in each domain and suggest appropriate methods to approach them. We encourage information systems scholars to become active participants in the global discourse on health-care transformation through IT.

Research Commentary---The Digital Transformation of Healthcare: Current Status and the Road Ahead

This paper explores how service value is created in a network context and how the structure and dynamics of the value network as well as customer expectations influence the complexity of the services ecosystem. The paper then discusses what transformative role information and communication technology (ICT) plays in coordinating and delivering value and managing this complexity. A conceptual model is developed for understanding and investigating the nature, delivery, and exchange of service value and assessing the complexity of a service value network. Three central arguments are presented. First, value in the services economy is driven and determined by the end consumer and delivered through a complex web of direct and indirect relationships between value network actors. Second, the complexity of service value networks not only depends on the number of actors but also on the conditional probabilities that these actors are involved in delivering the service to the consumer. Third, ICT plays a central role in reducing complexity for consumers by providing greater levels of value network integration, information visibility, and means to manage and anticipate change.

Complexity of service value networks: conceptualization and empirical investigation

An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations.

https://www.medline.com/media/mkt/pdf/research/or-safety-lean/The-Promise-of-Lean-in-Healthcare-Article.pdf

The Promise of Lean in Health Care

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61047-8.pdf

Redefining global health-care delivery

A solution to get the problem off, have you found it? Really? What kind of solution do you resolve the problem? From what sources? Well, there are so many questions that we utter every day. No matter how you will get the solution, it will mean better. You can take the reference from some books. And the redefining health care creating value based competition on results is one book that we really recommend you to read, to get more solutions in solving this problem.

Redefining Health Care: Creating Value-Based Competition on Results

Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as 'hybrid-professional managers' as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations.

/pdf/from-leader-to-leadership-clinician-managers-and-where-to-3j4tqzjpy1.pdf

From Leader to Leadership: Clinician Managers and Where to Next?

Nursing students' belongingness and workplace satisfaction: Quantitative findings of a mixed methods study

Exploring information use within everyday or community contexts is a recent area of interest for information literacy research endeavors. Within this domain, health information literacy (HIL) has emerged as a focus of interest due to identified synergies between information use and health status. However, while HIL has been acknowledged as a core ingredient that can assist people to take responsibility for managing and improving their own health, limited research has explored how HIL is experienced in everyday community life. This article will present the findings of ongoing research undertaken using phenomenography to explore how HIL is experienced among older Australians within everyday contexts. It will also discuss how these findings may be used to inform policy formulation in health communication and as an evidence base for the design and delivery of consumer health information resources and services.

/pdf/exploring-health-information-use-by-older-australians-within-2sm3frivvi.pdf

Exploring Health Information Use by Older Australians within Everyday Life

Objective This paper provides a narrative overview of the literature concerning clinical decision-making processes when staff come under pressure, particularly in uncertain, dynamic and emergency situations Methods Studies between 1980 and 2015 were analysed using a six-phase thematic analysis framework to achieve an in-depth understanding of the complex origins of medical errors that occur when people and systems are under pressure and how work pressure affects clinical performance and patient outcomes Literature searches were conducted using a Summons Search Service platform; search criteria included a variety of methodologies, resulting in the identification of 95 papers relevant to the present review Results Six themes emerged in the present narrative review using thematic analysis: organisational systems, workload, time pressure, teamwork, individual human factors and case complexity This analysis highlights that clinical outcomes in emergency situations are the result of a variety of interconnecting factors These factors may affect the ability of clinical staff in emergency situations to provide quality, safe care in a timely manner Conclusions The challenge for researchers is to build the body of knowledge concerning the safe management of patients, particularly where clinicians are working under pressure This understanding is important for developing pathways that optimise clinical decision making in uncertain and dynamic environments What is known about the topic? Emergency departments (EDs) are characterised by high complexity, high throughput and greater uncertainty compared with routine hospital wards or out-patient situations, and the ED is therefore prone to unpredictable workflows and non-replicable conditions when presented with unique and complex cases What does this paper add? Clinical decision making can be affected by pressures with complex origins, including organisational systems, workload, time constraints, teamwork, human factors and case complexity Interactions between these factors at different levels of the decision-making process can increase the complexity of problems and the resulting decisions to be made What are the implications for practitioners? The findings of the present study provide further evidence that consideration of medical errors should be seen primarily from a 'whole-of-system' perspective rather than as being primarily the responsibility of individuals Although there are strategies in place in healthcare organisations to eliminate errors, they still occur In order to achieve a better understanding of medical errors in clinical practice in times of uncertainty, it is necessary to identify how diverse pressures can affect clinical decisions, and how these interact to influence clinical outcomes

Gary E. Day

Papers

Redefining Health Care: Creating Value-Based Competition on Results

From Leader to Leadership: Clinician Managers and Where to Next?

Nursing students' belongingness and workplace satisfaction: Quantitative findings of a mixed methods study

Exploring Health Information Use by Older Australians within Everyday Life

Decision-making under pressure: medical errors in uncertain and dynamic environments.