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The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

The effectiveness of independent directors in making autonomous decisions for better corporate governance in organizations has often been questioned. This paper aims to investigate their role in company’s decision making in India and the reasons behind their ineffectiveness.

This paper examines the regulatory environment and ongoing reforms in which independent directors operate. It identifies crucial factors such as ownership patterns, the appointment and selection process that affect their autonomy. The analysis draws from newspaper articles, blogs, India’s regulatory requirements, The Companies Act and relevant related literature.

The findings reveal that the independence of directors remains largely in form but not in function. This paper recommends a fair and more robust selection through an independent authority, and disclosure of the resignations of independent directors. Independent directors should be given more powers and their risk-reward scheme should be analyzed.

The paper emphasizes the need for independent directors to be truly independent from the senior management, promoters, and other existing directors. It calls for tighter and more transparent appointment procedures to ensure that independent directors are not influenced by senior management and can bring objectivity to the company board.

This paper seeks to evaluate the factors that contribute to congestion at port entrances, propose a comprehensive approach to managing port gates that addresses the factors causing traffic jams and assess the outcomes of resolving the issue through an optimal model for incoming container truck traffic.

The study employed a one-way ANOVA and a one-way MANOVA to examine the impact of congestion-causing factors on the waiting time of trucks in each lane at the entrance gate. The purpose of this was to comprehend the intricate issue and demonstrate the outcomes of the resolution. We used the identified factors that were causing congestion to develop a management strategy for the port gate. As part of this strategy, we implemented a policy where traffic flows in the opposite direction in certain lanes. The Simulation of Urban Mobility program introduced the microscopic traffic simulation model as a discrete event simulation.

The examination of variables influencing the congestion at the port entrance revealed that there were four factors contributing to the congestion: (1) the quantity of lanes; (2) the level of bookings; (3) the factors related to the traffic signal cycle and (4) the assignment of lane types. The one-way MANOVA analysis of the three factors yielded significant evidence for a single pair of interactions. (1) The factors to consider are the quantity of lanes, the level of booking and the assignment of lane types. If the entrance to the rear alley consists of two lanes with a width of 1.85 at the 50% capacity level, and if the critical value of the uneven queue coefficient is reached, it can result in a maximum reduction of the average waiting time by 15.02%.

This study is unique because it examines the surrounding environment and operational behavior of the port to identify how individual and group congestion factors interact. It uses various statistical tools to determine the allocation of the number of port entrances with a reversible lane policy and appointment level. Additionally, it analyzes the detailed results using microscopic traffic simulation modeling. The established foundational model can assist operators in simulating the queue length and mean waiting time of trucks for this specific waiting line in other ports with comparable entrance characteristics.

This paper aims to appraise the effectiveness of gender quotas in breaking the glass ceiling for women on boards (WoBs) in companies that are legally obliged to comply with quotas (listed companies and state-owned companies, LP) and in those that are not (unlisted companies and nonstate-owned companies, NLNP). Furthermore, it investigates the glass cliff phenomenon, according to which women are more likely to be appointed to apical positions in underperforming companies.

A balanced panel data of the top 116 Italian companies by total assets, which are present in both 2010 and 2017, is used for estimating ANOVA tests across sectors and fixed-effects panel regression models.

WoBs significantly increased in both the LP and the NLNP companies, and this increase was greater in the financial sector. Furthermore, the relationship between the percentage of WoBs and firm performance is not linear but depends on the financial corporate health. Specifically, the situation in which a woman ascends to a leadership position in challenging circumstances where the risk of failure is high (glass cliff phenomenon) is only present in companies with the lowest performance in the sample, in other words, when negative values of Roe and negative or zero values of Roa occur together.

These findings have relevant policy implications that encourage the adoption of gender quotas even in specific top positions, such as CEO or president, as this could lead to a “double spillover effect” both vertically, that is, in other job positions, and horizontally, toward other companies not targeted by quotas. Practical interventions to support women in glass cliff positions, on the other hand, relate to the extent of supervisor mentoring and support to prevent women from leaving director roles and strengthen their chances for career advancement.

The authors explore the ability of gender quotas to break through the glass ceiling in companies that are not legally obliged to do so, and to the best of the authors’ knowledge, for the first time, the glass cliff phenomenon in the Italian context.

In the context of an evolving digital-based global economy, this study aims to investige the impact of digital transformation (DT) on a firm’s internal control (IC) quality. It also explores how the personal traits of (CEOs) – such as age, gender and educational background – intersect with DT to shape the IC quality in various types of state-owned enterprises (SOEs).

The study uses the data from China A-shares non-financial enterprises, listed on Shanghai and Shenzhen stock exchanges between 2007 and 2020. Using the fixed effect regression method alongside various statistical techniques, such as propensity score matching, alternative analysis and instrumental variables analysis, yields robust findings. These methods effectively address issues related to functional form misspecification and potential biases from omitted explanatory variables.

The findings reveal a positive impact of DT on firm IC quality, and this impact is more pronounced in firms when the CEO is female, young and possesses a higher level of education. Notably, the study also distinguishes between central and local state-owned enterprises (SOEs), highlighting that DT has a greater influence on IC quality in central SOEs, where CEOs often have higher political ranks and closer to government monitoring. Overall, the findings are robust and consist to alternative variable and other statistical methods.

Following are the significant implications for both academia and business. First, firms that effectively adopt DT to enhance IC not only gain a strategic advantage over competitors but also establish efficient risk management practices and a robust IC system. Second, better IC resulting from DT can enhance investor and stakeholder confidence. This is particularly important for publicly traded companies, where investors and analysts closely scrutinize the robustness of IC systems. Third, DT could result in cost savings over time, as automation and streamlined processes may reduce the need for manual efforts and resource-intensive tasks associated with IC.

The findings are contributed to the literature in multiple ways. It enhances our comprehension of the intricate DT-IC quality relationship, and provides valuable insights into the transformative impact of DT on organizational operations and risk management. It also introduces a novel perspective by investigating how CEOs personal traits intersect with DT to shape IC quality, contributing to upper echelons theory. Furthermore, it expands the discussions on firm ownership by considering the types of SOEs (central vs. local), in the DT-IC quality context.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This study aims to investigate the levels of the sense of community among students enrolled in online student communities at Anadolu University Open Education System (OES), as well as their motivations for joining these communities and their expectations.

An explanatory sequential design incorporating mixed research methods was employed as the research framework for this study. Quantitative data were collected from 1,065 students enrolled in online student communities during the 2021–2022 academic year, while qualitative data were obtained from 14 students after the survey using an extreme case sampling method. The quantitative data were analyzed using descriptive statistics, independent samples t-tests, one-way analysis of variance tests, correlation analysis and regression analysis. The qualitative data were analyzed using content analysis.

The study results indicate that students enrolled in online student communities generally have higher levels of a sense of community. These levels did not significantly differ based on gender, employment status, entry type to the university, program studied or membership status in more than one community. However, significant differences were observed in terms of age, time spent in communities and meeting attendance. Additionally, students' perceptions of social presence had a significant effect on their sense of community.

This study is the first to investigate the sense of community in online student communities at Anadolu University's OES.

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

There are two main objectives in this study. First, we aim to develop a set of constructs for health task management support (HTMS) features to evaluate which health-related tasks are supported by mobile health application (mHealth app) functions. Second, drawing on innovation resistance theory (IRT), we examine the impacts of the newly developed HTMS dimensions on perceived usefulness, alongside other barrier factors contributing to technology anxiety.

Using a mixed-method research design, this research seeks to develop new measurement scales that reflect how mHealth apps support older adults’ health-related needs based on interviews. Subsequently, data were collected from older adults and exploratory factor analysis was used to confirm the validity of the new scales. Partial least squares structural equation modeling (PLS-SEM) was used to analyze survey data from 602 older adults.

The PLS-SEM results indicated that medical management task support, dietary task support, and exercise task support were positively associated with perceived usefulness, while perceived complexity and dispositional resistance to change were identified as antecedents of technology anxiety. Perceived usefulness and technology anxiety were found to positively and negatively influence adoption intention, respectively.

This study enriches the information systems literature by developing a multidimensional construct that delineates how older adults’ health-related needs can be supported by features of mHealth apps. Drawing on IRT, we complement the existing literature on resistance to innovation by systematically examining the impact of five types of barriers on technology anxiety.

Artificial intelligence (AI) applications are increasingly used for day-to-day operations in healthcare. Each has a relatively limited scope or task, and several find application in managerial and organizational processes. More and more, AI and machine learning (ML) devices have received US FDA approval in the last decade. This chapter covers the main AI applications in healthcare, with a focus on organizational AI solutions (administrative AI), the main AI developers, their investment and real-world data and case studies in healthcare and other sectors. AI can be applied in resource management and procurement, resource allocation, clinical case management, staff work shift scheduling and handling of emergencies. AI applications are becoming ubiquitous in hospital (e.g. emergency room and operating theatre) and outpatient settings (e.g. ambulatory care and dentistry clinics). Their implementation is expected to bring direct benefits for patient care and satisfaction. This chapter gives a broad definition of AI in healthcare settings, with a focus on administrative applications and their use in case study data.