Information Technology Vendors Research Articles

Incorporating health IT into primary care transformation.

To understand the role of health information technology (IT) vendors and health IT functionality in supporting advanced primary care. We synthesized multiple rounds of surveys and interviews (2017-2022) from a mixed-methods evaluation of Comprehensive Primary Care Plus (CPC+), a multipayer model developed by CMS. CPC+ was the first federal advanced primary care reform effort that formalized health IT vendors' roles in supporting health IT implementation and specified detailed health IT requirements for practices. We conducted content analysis to identify cross-cutting themes related to health IT for both practices and vendors, comparing similarities and differences across participants and (when possible) over time. Vendors and practices reported advances in registries and dashboards for improved information management within the practice as well as strengthened relationships between vendors and practices that supported health IT implementation. However, CPC+ practices noted several gaps or challenges using existing functionalities, and both vendors and practices reported broader challenges for more transformative health IT change, particularly the lack of interoperable health information exchange needed to support care management and care coordination. Key factors constraining vendors' investment in further advances included long product development schedules, making it difficult to respond to rapidly evolving model requirements. Vendors also shared that CPC+ practices represented a small fraction of their client base, so investing in developing new functionality was not strategic unless it was more broadly relevant outside CPC+. Continued collaboration among health IT vendors, practices, policy makers, and payers could support continued technological improvements, particularly related to information exchange and communication. Aligning requirements more closely with other federal and private models could also help mitigate the risk for vendors.

Incapacité des logiciels d’aide à la prescription hospitaliers à sécuriser l’utilisation des solutions concentrées de potassium injectable

To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to: prescribe an ampoule of concentrated potassium chloride 10% 10mL intravenously without any diluents (80%); prescribe 4g of KCl in a bag of 500mL of NaCl 0,9% (98%); prescribe a solution that contains 6 grams of KCl per liter (94%); prescribe the administration of an injectable ampoule orally by means of a free text comment (83%). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampoules as administration solvent (50%); an injectable vial to be administered by oral route (52%). At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicle, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.

Managing Organizational Risk to Avoid Dispute For DX

Although not only information technology (IT) systems but also collaborative work with IT vendors and IT users are indispensable for digital transformation (DX), disputes between IT vendors and IT users (IT disputes) have often been observed, after the abortions of IT projects and successive claims to compensate for individual losses. The vendors and users waste tremendous resources as well as opportunities, however, the root causes of IT disputes and measures to prevent similar incidents are not clarified. Lessons learned from such disputes have not been identified specifically enough to prevent the same troubles in the future. The goal of this paper is to identify the lessons learned. Applying a new analytical technique for troubled IT project cases, we identify individual root causes and business risks, whose threats have been overlooked by organizations, and derive the lessons learned. We also show specific management practices for avoiding the same disputes based on the lessons learned. Moreover, after showing that current institutes of project management have not considered the risk and have not involved the lessons learned in the management standards, we propose a revised organizational project management standard with specific practices for less loss of our social and economic activities in the future DX era.

Examining motivation of IT vendors to share knowledge with clients

To reduce information technology (IT) development costs, more firms have begun to outsource IT-related activities by partnering with IT vendors. As knowledge is a valuable asset in IT development, knowledge sharing between vendors and business clients becomes critical. However, the motivation behind IT vendors’ willingness to share knowledge with client firms is not sufficiently understood. To shed light on the nature of knowledge sharing within vendor–client partnerships, we examine the influence of performance feedback and managerial mindset on vendors’ motivation to share knowledge with their clients. We adopt a multi-method approach involving both a scenario-based field experiment with 164 vendor managers (Study 1) and a field survey of 112 vendor managers involved in IT development (Study 2). We find that when vendors’ performance exceeds their aspiration levels, they are motivated to share knowledge with clients. Such motivational effects are more pronounced for vendor managers exhibiting abstract mindsets. Our study is of significant value to researchers and practitioners, affording both groups a keener, deeper, and more robust appreciation for how knowledge sharing in vendor–client partnerships can be managed more effectively.

IT vendor integration as catalyst of IT outsourcing success

PurposeThis paper aims to explain how small- and medium-sized firms (SMEs) create information technology (IT) business value through blended IT outsourcing (ITO). The explanatory framework it proposes enables SMEs to replicate IT capability outcomes (i.e. enhance their economic, strategic and technological competences, namely, ITO success) by endorsing an ITO strategy catalyzed by IT vendor integration.Design/methodology/approachThis study uses covariance-based structural equation modeling to test the proposed research model. Data are collected from 251 knowledge-intensive business SMEs located in Science and Technology Parks in Spain.FindingsThe results demonstrate empirically that SMEs can replicate IT capability benefits (i.e. enhance their non-IT competences) through blended ITO in which IT, conceptualized as a transversal supporting activity, is outsourced to an IT vendor while the value creation process remains with the buyer. The integration (i.e. process integration and information sharing) of an IT-proficient vendor catalyzes ITO success. More specifically, the results show that, although process integration is not directly related to competence enhancement, fosters information sharing, which directly facilitates ITO success. The results also show that IT vendor proficiency accounts for ex ante trust.Practical implicationsManagers should think of transformational ITO as a strategy to enhance firm competences. For blended ITO strategies to succeed, managers must have a comprehensive understanding of the business they run, as it is important to create conditions that foster inter-firm information sharing. To achieve these conditions, managers should take special care in selecting boundary spanners, who are the pivotal links in competence enhancement.Originality/valueWhile most research focuses on ongoing trust (i.e. trust develops as ITO evolves), this study focuses on initial (i.e. ex ante) trust and analyzes IT vendor proficiency (expert, experienced and reputed) to examine trust as an antecedent of ITO. This study also draws on previous conceptualizations of vendor integration to develop and analyze a two-step integration model to explain how IT vendor integration (i.e. process integration and information sharing) catalyzes enhancement of the buyer’s non-IT competences. This study focuses on SMEs, which are often neglected in ITO studies.

A Review of 50 Years of International Literature on the External Environment of Building Practice-Based Research Networks (PBRNs).

This article is the second part of a novel scoping review of the international literature that presents those key elements that underpin the foundational activities of Practice-Based Research Networks (PBRNs). In this article, we examine the external environment and the intersection between the internal and external environment domains. We searched electronic databases, including MEDLINE (PubMed), OVID, CINAHL (EBSCOhost), Scopus, and SAGE for publications in English between 1/1/1965 and 9/15/2021. We also searched reference lists of selected publications, gray literature and other online sources. Inductive thematic analysis was applied to construct the main themes, subthemes, and key elements from a scoping review covering up to 10 years of reported experiences of each of the 98 PBRNs that met the inclusion criteria. In this study we present 2 main themes: "Stakeholders at the Intersection Between the Internal and External Environment" and the "External Environment." The first is linked to the subthemes "Patient and Community Stakeholders" and "Other Healthcare Stakeholders" and 11 key elements. The second relates to the subthemes "National Health System," "Institutional/Governmental Support, National/State Policy and Regulatory Environment" "Professional Organizations," "Leveraging Previous Research and PBRN Experience and Interacting with Other Networks" and "Health Information Technology (HIT) and HIT Vendors" and 21 key elements. Despite variations in geography, time, and healthcare context, PBRNs shared many similar developmental experiences over the past 5 decades. Their external environment contributed significantly to their developmental trajectories during the first 10 years of their operation.

Advancing Patient Safety Surrounding Medical Devices: Barriers, Strategies, and Next Steps in Health System Implementation of Unique Device Identifiers

BackgroundThe requirement for medical device manufacturers to label their devices with a unique device identifier (UDI) was formalized by the 2013 US Food and Drug Administration Unique Device Identification System Rule. However, parallel regulatory requirement for US health systems to use UDIs, particularly the electronic documentation of UDIs during patient care is lacking. Despite the lack of regulation, some health systems have implemented and are using UDIs. To assess the current state, we studied representative health system UDI implementation experiences, including barriers and the strategies to overcome them, and identified next steps to advance UDI adoption.MethodsSemi-structured interviews were performed with health system personnel involved in UDI implementation in their cardiac catheterization labs or operating rooms. Interviews were transcribed and analyzed using the framework methodology of Ritchie and Spencer. An expert panel evaluated findings and informed barriers, strategies, and next steps.ResultsTwenty-four interviews at ten health systems were performed. Identified barriers were internal (lack of organizational support, information technology gaps, clinical resistance) and external (information technology vendor resistance, limitations in manufacturer support, gaps in reference data, lack of an overall UDI system). Identified strategies included relationship building, education, engagement, and communication. Next steps to advance UDI adoption focus on education, research, support, and policy.Conclusions and ImplicationsDelineation of UDI implementation barriers and strategies provides guidance and support for health systems to adopt the UDI standard and electronically document UDIs during clinical care. Next steps illuminate critical areas for attention to advance UDI adoption and achieve a comprehensive UDI system in health care to strengthen patient care and safety.

Current Status of the Health Information Technology Industry in China from the China Hospital Information Network Conference: Cross-sectional Study of Participating Companies.

BackgroundThe China Hospital Information Network Conference (CHINC) is one of the most influential academic and technical exchange activities in medical informatics and medical informatization in China. It collects frontier ideas in medical information and has an important reference value for the analysis of China's medical information industry development.ObjectiveThis study summarizes the current situation and future development of China's medical information industry and provides a future reference for China and abroad in the future by analyzing the characteristics of CHINC exhibitors in 2021.MethodsThe list of enterprises and participating keywords were obtained from the official website of CHINC. Basic characteristics of the enterprises, industrial fields, applied technologies, company concepts, and other information were collected from the TianYanCha website and the VBDATA company library. Descriptive analysis was used to analyze the collected data, and we summarized the future development directions.ResultsA total of 205 enterprises officially participated in the exhibition. Most of the enterprises were newly founded, of which 61.9% (127/205) were founded in the past 10 years. The majority of these enterprises were from first-tier cities, and 79.02% (162/205) were from Beijing, Zhejiang, Guangdong, Shanghai, and Jiangsu Provinces. The median registered capital is 16.67 million RMB (about US $2.61 million), and there are 35 (72.2%) enterprises with a registered capital of more than 100 million RMB (about US $15.68 million), 17 (8.3%) of which are already listed. A total of 126 enterprises were found in the VBDATA company library, of which 39 (30.9%) are information technology vendors and 57 (45.2%) are application technology vendors. In addition, 16 of the 57 (28%) use artificial intelligence technology. Smart medicine and internet hospitals were the focus of the enterprises participating in this conference.ConclusionsChina's tertiary hospital informatization has basically completed the construction of the primary stage. The average grade of hospital electronic medical records exceeds grade 3, and 78.13% of the provinces have reached grade 3 or above. The characteristics are as follows: On the one hand, China's medical information industry is focusing on the construction of smart hospitals, including intelligent systems supporting doctors' scientific research, diagnosis-related group intelligent operation systems, and office automation systems supporting hospital management, single-disease clinical decision support systems assisting doctors' clinical care, and intelligent internet of things for logistics. On the other hand, the construction of a compact county medical community is becoming a new focus of enterprises under the guidance of practical needs and national policies to improve the quality of grassroots health services. In addition, whole-course management and digital therapy will also become a new hotspot in the future.

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

Precision Nursing.

Precision Nursing.

Time and Financial Costs for Physician Practices to Participate in the Medicare Merit-based Incentive Payment System: A Qualitative Study.

The Merit-based Incentive Payment System (MIPS) is a major Medicare value-based purchasing program, influencing payment for more than 1 million clinicians annually. There is a growing concern that MIPS increases administrative burden, and little is known about what it costs physician practices to participate in the program. To examine the costs for independent physician practices to participate in MIPS in 2019. This qualitative study identified and interviewed leaders of physician practices participating in the US Centers for Medicare & Medicaid Services (CMS) MIPS program, including those in MIPS alternative payment models. Time required and financial costs were calculated from responses to in-depth, semistructured interviews conducted from December 12, 2019, to June 23, 2020. Physician practices were categorized by size (small, 1-9 physicians; medium, 10-25; and large, ≥50), specialty (primary care, general surgery, or multispecialty), and US census region. Participants were asked about 2019 costs related to clinician and staff time, information technology, and external vendors. Time was converted to financial costs using the Medical Group Management Association's Provider Compensation and the Management and Staff Compensation databases. Annual time spent by staff on MIPS-related activities and mean per-physician costs to physician practices in 2019. Leaders of 30 physician practices (9 [30.0%] small primary care, 6 [20.0%] small general surgery, 4 [13.3%] medium primary care, 4 [13.3%] medium general surgery, and 7 [23.3%] large multispecialty) represented all US census regions, and 14 of the 30 (46.7%) practices participated in a MIPS alternative payment model in 2019. The mean per-physician cost to practices of participating in MIPS was $12 811 (interquartile range [IQR], $2861-$17 715). Physicians, clinical staff, and administrative staff together spent 201.7 (IQR, 50.9-295.2) hours annually per physician on MIPS-related activities. Medical assistants and nursing staff together spent a mean of 99.2 (IQR, 0-163.3) hours per physician each year; frontline physicians spent 53.6 (IQR, 0.6-55.8) hours; executive administrators spent 28.6 (IQR, 3.1-26.7) hours; other clinicians and staff spent a combined 20.3 (IQR, 0-36.8) hours. Physician time accounted for the greatest proportion of overall MIPS-related costs (54%; $6909; IQR, $94-$9905). In this qualitative study, physician practice leaders reported significant time and financial costs of participating in the MIPS program. Attention to reducing the burden of MIPS may be warranted.

Composite Techniques of Structural Equation Modeling and Analytic Hierarchy Process for Information Technology Vendor Selection

This paper had developed an effective information technology (IT) vendor selection model for banking & financial services industries (BFSI). For any business, profitability and growth depends on the right vendor selection in their purchase process. This paper identifies ten most influencing and important criteria with 43 sub-criteria to comprehend the vendor selection process. Furthermore, the authors developed a vendor selection score model using Structural Equation Modelling (SEM) and Analytic Hierarchy Process (AHP). This article intends to inform practice and conclude with practical recommendations to BFSI for vendor selection. The proposed composite technique identified the most eligible vendor to meet up with the buyer’s strategies. This article suggests the most desirable vendor for the required benefit. Vendor 1 (Silverlake) with a score of 44% promised to be the most recommended one that also performed consistently in the sensitivity test.

Health Information System's Responses to COVID-19 Pandemic in China: A National Cross-sectional Study.

After the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Chinese hospitals and health information technology (HIT) vendors collaborated to provide comprehensive information technology support for pandemic prevention and control. This study aims to describe the responses from the health information systems (HIS) to the COVID-19 pandemic and provide empirical evidence in the application of emerging health technologies in China. This observational descriptive study utilized a nationally representative, cross-sectional survey of hospitals in China (N = 1,014) from 30 provincial administrative regions across the country. Participants include hospital managers, hospital information workers, and health care providers. Among all the responses, the most popular interventions and applications include expert question-and-answer sessions and science popularization (61.74%) in online medical consultation, online appointment registration (58.97%) in online medical service, and remote consultation (75.15%) in telehealth service. A total of 63.71% of the participating hospitals expanded their fever clinics during the pandemic, 15.38% hospitals used new or upgraded mobile ward rounds systems, and 44.68% hospitals applied online self-service systems. Challenges and barriers include protecting network information security (57.00%) since some hospitals experienced cybersecurity incidents. 71.79% participants hope to shorten wait time and optimize the treatment process. Health care workers experienced increased amount of work during the pandemic, while hospital information departments did not experience significant changes in their workload. In the process of fighting against the COVID-19, hospitals have widely used traditional and emerging novel HITs. These technologies have strengthened the capacity of prevention and control of the pandemic and provided comprehensive information technology support while also improving accessibility and efficiency of health care delivery.

IT Outsourcing and Vendor Cost Improvement Strategies under Asymmetric Information

ABSTRACTIn this article, we study the scenario under which two information technology (IT) vendor firms compete for the outsourcing requirements of a client firm. The vendors' cost structures are private information. In addition, the vendors can improve their unit costs through learning‐by‐doing and by making investments in process improvement, that is, induced learning. We study the impacts of vendor‐based learning and process improvement in the asymmetric cost setting on the client firm's outsourcing strategy and the vendor firms' process improvement investments. Our analysis reveals that the client firm may adopt the single‐sourcing strategy or a combination of dual and single‐sourcing strategies depending on the learning efficiency of the vendor base. We also find that high heterogeneity in the vendor cost structure increases the first‐period outsourcing requirements of the client firm. Our findings provide interesting managerial implications for the IT outsourcing industry.

Customer Knowledge Management in SMEs Facing Digital Transformation

This paper provided a novel definition of customer knowledge management (CKM) as the logical intersection of customer relationship management (CRM) and knowledge management (KM). The main aim was to investigate the digital technologies supporting small and medium enterprises (SMEs) operating in creative industries in their customer knowledge management strategies. To achieve this aim, a survey involving 73 handicraft and/or retail SMEs operating in luxury jewelry industry was conducted. The survey results pointed out that in a few years the scenario has changed and that surveyed SMEs make more intensive use of traditional technologies supporting customer knowledge management processes rather than more innovative digital technologies, which are also cheap and easy to use. This finding showed the difficulties of SMEs operating in creative industries to be responsive to the rapid technological changes that are affecting CKM, as well as the lack of support from information technology vendors in the decision-making process for choosing adequate digital systems.

Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study.

BackgroundThe United States is in the midst of an opioid epidemic. Long-term use of opioid medications is associated with an increased risk of dependence. The US Centers for Disease Control and Prevention makes specific recommendations regarding opioid prescribing, including that prescription quantities should not exceed the intended duration of treatment.ObjectiveThe purpose of this study was to determine if opioid prescription quantities written at our institution exceed intended duration of treatment and whether enhancements to our electronic health record system improved any discrepancies.MethodsWe examined the opioid prescriptions written at our institution for a 22-month period. We examined the duration of treatment documented in the prescription itself and calculated a duration based on the quantity of tablets and doses per day. We determined whether requiring documentation of the prescription duration affected these outcomes.ResultsWe reviewed 72,314 opioid prescriptions, of which 16.96% had a calculated duration that was greater than what was documented in the prescription. Making the duration a required field significantly reduced this discrepancy (17.95% vs 16.21%, P<.001) but did not eliminate it.ConclusionsHealth information technology vendors should develop tools that, by default, accurately represent prescription durations and/or modify doses and quantities dispensed based on provider-entered durations. This would potentially reduce unintended prolonged opioid use and reduce the potential for long-term dependence.

IT vendors’ legitimation strategies and market share: The case of EMR systems

This study investigates the legitimation strategies adopted by information technology (IT) vendors and their respective influence on market share. We conducted an analysis of the public discourse on websites of top Electronic Medical Record (EMR) vendors in Ontario, Canada. A total of 815 segments extracted from these websites were analyzed. Our findings indicate that strategies under the cognitive and pragmatic forms of legitimacy were strongly represented in the EMR vendors’ discourses compared with regulative and normative strategies. Furthermore, the link between legitimation strategies and market share has not yet been clearly established. Implications for practice and research are discussed.

Examining Exploitability Risk of Vulnerabilities: A Hazard Model

With the increasing number and severity of security incidents and exploits, information technology (IT) vendors, security managers, and consumers have begun to place more emphasis on security. Yet, fixing the sheer volume of vulnerabilities remains a challenge as IT vendors race against attackers to evaluate system vulnerabilities, prioritize them, and issue security patches before cybercriminals can exploit them. In this study, we posit that IT vendors can prioritize which vulnerabilities they should patch first by assessing their exploitability risk. Accordingly, we identified the vulnerabilities that cybercriminals will most likely exploit using vulnerability-related attributes and vulnerability types. To do so, we employed survival analysis and tested our models using historical data of vulnerabilities and exploits between 2007 and 2016. Our results indicate that IT vendors benefit the most from fixing remotely exploitable vulnerabilities; non-complex vulnerabilities; vulnerabilities that require no authentication; and vulnerabilities that affect confidentiality, integrity, and availability components. Furthermore, our findings suggest that IT vendors can mitigate the risk of exploit-related attacks by remedying code-injection vulnerabilities, buffer-overflow vulnerabilities, and numeric-error vulnerabilities.

Human Factors and Usability for Health Information Technology: Old and New Challenges.

Summary Objectives : Despite national mandates, incentives, and other programs, the design of health information technology (IT) remains problematic and usability problems continue to be reported. This paper reviews recent literature on human factors and usability of health IT, with a specific focus on research aimed at applying human factors methods and principles to improve the actual design of health IT, its use, and associated patient and clinician outcomes. Methods : We reviewed recent literature on human factors and usability problems of health IT and research on human-centered design of health IT for clinicians and patients. Results : Studies continue to show usability problems of health IT experienced by multiple groups of health care professionals (e.g., physicians and nurses) as well as patients. Recent research shows that usability is influenced by both designers (e.g., IT vendors) and implementers in health care organizations, and that the application of human-centered design practices needs to be further improved and extended. We welcome emerging research on the design of health IT for teams as team-based care is increasingly implemented throughout health care. Conclusions : Progress in the application of human factors methods and principles to the design of health IT is occurring, with important information provided on their actual impact on care processes and patient outcomes. Future research should examine the work of health IT designers and implementers, which would help to develop strategies for further embedding human factors engineering in IT design processes.

Electronic Communication of the Health Record and Information With Pediatric Patients and Their Guardians.

Communication of health data has evolved rapidly with the widespread adoption of electronic health records (EHRs) and communication technology. What used to be sent to patients via paper mail, fax, or e-mail may now be accessed by patients via their EHRs, and patients may also communicate securely with their medical team via certified technology. Although EHR technologies have great potential, their most effective applications and uses for communication between pediatric and adolescent patients, guardians, and medical teams has not been realized. There are wide variations in available technologies, guiding policies, and practices; some physicians and patients are successful in using certified tools but others are forced to limit their patients' access to e-health data and associated communication altogether. In general, pediatric and adolescent patients are less likely than adult patients to have electronic access and the ability to exchange health data. There are several reasons for these limitations, including inconsistent standards and recommendations regarding the recommended age for independent access, lack of routine EHR support for the ability to filter or proxy such access, and conflicting laws about patients' and physicians' rights to access EHRs and ability to communicate electronically. Effective, safe electronic exchange of health data requires active collaboration between physicians, patients, policy makers, and health information technology vendors. This policy statement addresses current best practices for these stakeholders and delineates the continued gaps and how to address them.