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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 purpose of this paper is to validate and measure the overall evaluation of electronic health record (EHR) and identify the factors that influence the health information systems (HIS) assessment in Brazil.

From February to May 2020, this study surveyed 262 doctors and nurses who work in hospitals and use the EHR in their workplace. This study validated the National Usability-focused HIS Scale (NuHISS) to measure usability in the Brazilian context.

The results showed adequate validity and reliability, validating the NuHISS in the Brazilian context. The survey showed that 38.9% of users rated the system as high quality. Technical quality, ease of use and benefits explained 43.5% of the user’s overall system evaluation.

This study validated the items that measure usability of health-care systems and identified that not all usability items impact the overall evaluation of the EHR.

NuHISS can be a valuable tool to measure HIS usability for doctors and nurses and monitor health systems’ long-term usability among health professionals. The results suggest dissatisfaction with the usability of HIS systems, specifically the EHR in hospital units. For this reason, those responsible for health systems must observe usability. This tool enables usability monitoring to highlight information system deficiencies for public managers. Furthermore, the government can create and develop actions to improve the existing tools to support health professionals.

From the scale validation, public managers could monitor and develop actions to foster the system’s usability, especially the system’s technical qualities – the factor that impacted the overall system evaluation.

To the best of the authors’ knowledge, this study is the first to validate the usability scale of EHR systems in Brazil. The results showed dissatisfaction with HIS and identified the factors that most influence the system evaluation.

The purpose of this paper is to investigate the way technology affects the provision of prehospital emergency care, upgrading the quality of services offered and significantly reducing the risk of premature termination of the patients.

The paper presents the development of the eEKAB, a pilot emergency medical information system that simulates the main services offered by the Greek National Instant Aid Centre (EKAB). The eEKAB was developed on an agile system methodology. From a technical perspective, the features and the technology were mainly chosen to provide reliable and user-friendly interfaces that will attract many users. eEKAB is based on three important pillars for offering health care to the patients: the “On-time Incident Reporting”, the “On-time Arrival at the Incident” and “Transfer to the Health Center”. According to the literature review, the emergency medical services (EMS) systems that combine all the features are very few.

It reduces the total time of the EMS procedures and it allows for an easier management of EMS, by providing a better allocation of human resources and a better geographical distribution of ambulances. The evaluation displayed that it is a very helpful application for the ambulance drivers as it reduces the ambulance response time to arrive in the patient's location and contributes significantly to the general performance of the prehospital medical care system. Also, the survey verified the importance of implementing eEKAB on a larger scale beyond the pilot usage. It is worth mentioning that the younger ambulance drivers had a more positive view for the purpose of the application.

The paper clearly identifies implications for further research. Regarding interoperability, the mobile app cooperates with the Operational Center of EKAB, while further collaboration could be achieved with other operational ambulance handling center, mainly, of the private sector. The system can evolve to include better communications among the EKAB departments. Particularly, the ambulance crew as well as the doctors should be informed with more incident features such as the emergency signal so that they know whether to open the siren, the patient's name, etc. The authors are currently working on implementing some features to provide effective medical health services to the patient in the ambulance.

eEKAB will have very significant implications in case of its enforcement, such as the reduction of the total time of EMS procedures with a corresponding reduction of the operating costs of an accident management system and an ambulance fleet handling system while in parallel informing in time the doctors/clinics. It will provide better distribution of ambulances as well as of total human resources. It will greatly assist ambulance drivers, while reducing ambulance response time to reach the patient's location. In other words, the authors will have a better performance of the whole prehospital care system.

Providing emergency care before the hospital is of great importance for upgrading the quality of health services provided at the accident site, thus significantly reducing the risk of premature death of patients. This in itself has a significant social implication.

The paper demonstrates a solid understanding in the field of the EMS systems and the corresponding medical services offered. It proposes the development of an effective, feasible and innovative EMS information system that will improve the existing emergency health care system in Greece (EKAB). An in depth literature review and presentation of the adopted new technologies and the respective architecture take place. An evaluation and statistical validation were conducted for proving the high applicability of eEKAB in case of real-life running.

This paper examines the port of Mombasa’s attempted implementation of computer-based terminal operating systems (TOS); the challenges faced and the outcomes. In addition to enhancing its operations efficiency, a key motivation for the technology was to facilitate better integration and connectivity to the Belt and Road as a key gateway along the key route. It utilised a qualitative single-case methodology, involving a combination of semi-structured interviews, non-participant observations and content analysis of relevant policy documents and reports provided by the port. The paper finds that the attempt to adopt and implement TOS at the port mostly failed as a result of a complex combination of technological, organisational and environmental factors. Most importantly, the wider business environment was ill equipped with the necessary information communication technology (ICT) infrastructure to support effective implementation. There was also a general lack of appropriately skilled workers to support and drive the same.

Studies showed that a proactive delivery system employing innovative artificial intelligence (AI) in urban services might perform better. This has become an important national policy for many countries. Thus, this study aims to explore the influence of AI in urban services in Malaysia.

Official documents such as Structure Plan and Government Transformation Programme Policy Document covering various levels of cities in Malaysia, articles related to urban studies mostly written by researchers regarding urban growth in Malaysia and the Urban Development Bulletin from the Federal Department of Town and Country Planning from 1957 to date were reviewed and analysed.

The findings show that the influence of AI in urban services has long existed and been carefully planned by local authorities since colonial times. The development of global digital technology influences the upgrading of AI in urban services in Malaysia. Also, the success of AI in these municipal services is influenced by the rate of information technology literacy among the urban population. These developments have led to the definition of a conceptual city.

This paper's findings and conclusion were based on reviewed literature but did not compromise the strength of this paper. Thus, as part of the implications for future research, mixed-methods research design has been suggested.

As part of the implications, this article intends to promote AI in urban services in Malaysia and other developing countries with similar urban services challenges.

This paper encourages AI applications in urban services because it enhances service delivery performance. This intends to key stakeholders to promote AI via policies across Malaysia's urban services as part of the study implications.

The introduction of information technology (IT) in port operations has been a tremendous contributor to transformation in world trade. This study was carried out to examine the influence of IT on the efficiency of seaport operations.

The study is quantitative in nature, and it relied on a closed-ended self-administered questionnaire to collect primary data. Structural equation modeling (SEM) was used to test the theoretical model and hypothesis.

The results indicate that IT has a positive direct effect on port operational efficiency (OE) and an indirect effect on port OE through organizational culture (OC). The mediating role of OC is statistically insignificant.

This is among the first few attempts in Sub-Saharan Africa (SSA) that provides researchers with a contemporary view of IT and seaport operations.

The purpose of this paper is to provide practitioners and researchers a more condensed and structured perspective on the adoption of information management systems by the health-care industry, given the spread and the increased amount of research concerning the topic.

This paper is a literature review. A Technology (What?) – Context and before adoption Analysis (When and Why?) – Implementation (How?) – Outcomes (What for?) framework is used to present the trends concerning information technology adoption in an accessible manner.

The main finding is that small or large health-care organizations should no longer focus on information systems’ adoption but should adopt a digital transformation paradigm. By considering this paradigm, management practices related to information technologies’ adoption projects should be complemented by practices related to the continuous organizational changes and readaptation of the organizational strategy, to benefit the advantages information systems can offer.

The main recommendation for health-care industry managers is to adopt specific practices to manage the digital transformation process of their organizations, as they should understand that it is no longer about adopting information technologies, but about managing the associated organizational change.

Instead of focusing on specific information systems’ adoption as other papers do, this paper provides a holistic understanding of the information technologies and management practices which are used in the field.

The need for context-specific adoption models led to the development of the firm technology adoption model (F-TAM) model. Among small to medium-scale enterprises (SMEs); however, firm-level factors were rather insignificant in engendering SME level adoption of technological innovation. This study aims to examine the effect of firm size and other moderating and mediating factors on the relationships between personal, firm, societal and technological factors proposed in the stakeholder-oriented F-TAM among SMEs.

A research instrument was developed, reviewed by experts, and pilot tested with a sample of 25 respondents. Data were purposively collected from four hundred (400) SMEs and analyzed with partial least squares structural equation modeling (PLS-SEM).

The study discovered that employees, societal and technological factors moderate the relationship between firm factors of adoption and firm adoption. Without these moderating effects, firm factors of adoption would have been insignificant at the SMEs’ level of organizational technology adoption. The study further discovered that firm size, as well as risk propensity, also affect the relationships proposed in the model.

Data was collected on voluntary adoption from the most cosmopolitan area of a developing country. It, therefore, needs further contextual validation across the country and different countries.

The engagement of innovations in firms must be planned with employees and society as major stakeholders.

The significance of this finding is the study’s emphasis on an eco-system approach for examining the phenomenon of innovation adoption. To the best of the authors’ knowledge, this study is the first to examine the effect of firm characteristics on is proposed eco-system of stakeholders.

The purpose of this study is to present the workflow on the integration of Maternal and Child Health Care Services (MCHCS) into the electronic Health Information System of the Iraqi Kurdistan (KRG-HIS).

As part of the cooperation between the University of Rome Tor Vergata-Italy and the Iraqi Kurdistan Ministry of Health, six PhD positions were granted for Iraqi students to create a local team of experts with the aim of supporting the scaling-up of the KRG-HIS. After specific training, the team then trained the staff members of the health centers, met health authorities and analyzed the local scenario to ensure that the KRG-HIS could be better tailored to regional needs. In 2019, the integration of MCHCS into the KRG-HIS was one of the main areas of research.

Health data collection was mostly paper-based, which made vital statistics and evaluation of outcomes difficult to measure. More than 15,000 paper-files from the Duhok Obstetrics and Gynaecology Hospital were retrieved from storage. Then data entered in the KRG-HIS. Theoretical and practical training sessions were conducted for local staff members, with 183 health operators already having been trained. Daily supervision of the online system and field visits were ensured.

There is a need to support health authorities in improving data collection on MCHCS, ensuring the future self-sufficiency of the HIS. Key to the process is the creation of a specialized team of local experts with the objective of “training the trainers”.

This study aims to estimate the value of the impact from digital transformation (DX) focusing on its automation effect, looking at the time and cost savings coming from the substitution effect with an adoption of digital technologies. For example, cloud and artificial intelligence technologies such as ChatGPT have the potential to change ways of working, substituting and replacing several of the tasks that are currently carried out by public administration (PA) employees and labor processes underpinning PA services.

The paper outlines a new framework to estimate the potential impact of DX on the public sector. The authors apply this framework to estimate the value of the impact of DX on the Italian PA, defining the latter by the collection of the value of its labor (i.e. PA workforce salaries) and by the collection of the value of its outputs (i.e. public services’ costs).

This study ultimately maps out the magnitude and trends of how likely the PA occupations and services could be substituted in a wider process of DX. To do this, the authors apply their framework to the Italian PA, and they triangulate secondary data collection, from official accounts of the Italian Ministry of Economics and the National Statistical Institute, with methodological antecedents from the UK Office for National Statistics and experts’ insights. Results provide a snapshot on the type and magnitude of PA jobs and services projected to be affected by automation over the next 10 years.

To the best of the authors’ knowledge, this paper provides for the first time an approach to estimate the value of the impact of DX on the public sector in a data-constrained environment – or in the lack of the required primary data. Once applied to the Italian PA, this approach provides a granular map of the automatability of each of the PA occupations and of the PA services. Finally, this paper mentions preliminary insights on potential challenges related to equity in public sector jobs and implications on recruitment processes.