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The ecosystem concept has attracted attention in information system research to explain business competition, innovation and many other emerging phenomena. Existing studies focus more on a single ecosystem type or a single ecosystem goal and pay little attention to the ecosystem’s evolution. The objective of the study is to investigate the factors that impact the evolution of the information ecosystem (IE) to gain a better understanding of strategic thinking.

The IE involves many actors, so the multi-case study approach is conducted with purposeful sampling to recruit all the significant ecosystem actors. The collected qualitative data are analyzed by coding data, exploring data relationships and structuring pattern steps; institutional theory is used as a theoretical framework.

The results demonstrate that industry practices, laws and regulations, new actors and the mimetic pressure of outsourcers drive the growth of the ecosystem. Strategy intention, cost pressure and normative pressure all contribute to the IE’s evolution.

The concept of ecosystems has attracted attention in information system research. The study investigates the factors contributing to the evolution of the IE from an institutional theory perspective. Our suggestion is that new players can find a niche in offering information technology (IT)/ information services (IS)-related solutions to survive in the ecosystem; however, they need to pay attention to the normative pressure.

This study aims to examine the mediating role of social influence on the relationship between key predictors of E-pharmacy adoption among young consumers based on the unified theory of adoption and use of technology (UTAUT).

This study employs a quantitative correlational research design. Based on cluster sampling, data was collected from 306 university students from three public universities in southwestern Nigeria. Data was analysed using partial least square structural equation modeling.

The primary determinant driving the adoption of e-pharmacy is performance expectancy. Social influence plays a partial mediating role in linking performance expectancy to e-pharmacy adoption. In contrast, it fully mediates the relationship between effort expectancy, facilitating conditions and the adoption of e-pharmacy services.

This study provides theoretical clarity on recent issues within the UTAUT framework. Findings highlight the complexity of how social factors interact with individual beliefs and external conditions in determining technology acceptance.

Research includes information relevant to access the impact of e-pharmacy services on healthcare accessibility, affordability and quality in developing countries.

The findings extend the adoption of technology literature in healthcare and offer a new understanding of adoption dynamics. The results emphasize the importance of performance expectancy in driving e-pharmacy adoption, providing a clear direction for stakeholders to enhance service quality and user experience of e-pharmacy. Additionally, the mediating effect of social influence highlights the significance of peer recommendations, celebrity endorsements and social media campaigns in shaping consumer adoption of e-pharmacies among young people.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

This study aimed to investigate the sensemaking strategies employed by early-career employees working within organizationally constrained environments.

Grounded in the sensemaking-as-accomplishment framework, a longitudinal multi-case study was conducted, involving three early-career employees. These participants were interviewed multiple times concerning tasks they themselves identified as anomalous and ambiguous.

The study's findings illuminate how early-career employees utilize sensemaking strategies to accomplish anomalous-ambiguous tasks. These strategies are interwoven with deliberate efforts to mitigate organizational constraints that exist in the organization or arise during the execution of complex tasks.

Notable limitation pertains to the time gap between task completion and the interviews. Conducting real-time interviews concurrently with task execution or immediately afterward was not feasible due to constraints in participant availability. This research has implications for organizational learning initiatives, particularly those encompassing employee-driven self-learning components. Insights derived from studies like this can inform the development of effective self-learning schemes within organizations.

Previous sensemaking research focused on what takes place in high-reliability organizations. This study explored sensemaking strategies in workplaces that are organizationally constrained.

This study aims to focus on the supply chain (SC) cost drivers of healthcare industries in the USA, as SC costs have increased 40% over the last decade. The second-most significant expense, the SC, accounts for 38% of total expenses in a typical hospital, while most other industries can operate within 10% of their operating cost. This makes healthcare centers supply-chain-sensitive organizations with limited facilities for high-quality healthcare services. As the cost drivers of healthcare SC are almost unknown to managers, their jobs become more complex.

Guided by pragmatism and positivism paradigms, a cross-sectional study has been designed using quantitative and deductive approaches. Both primary and secondary data were used. Primary data were collected from health centers across the country, and secondary data were from healthcare-related databases. This study examined the attributes that explain the most significant variation in each contributing factor. With multiple regression analysis for predicting cost and Student's t-tests for the significance of contributing factors, the authors of this study examined different theories, including the market-based view and five-forces, network and transaction cost analysis.

This study revealed that supply, materials and services represent the most significant expenses in primary care. Supply-chain cost breakdown results in four critical factors: facility, inventory, information and transportation.

This study examined the data from primary and secondary care institutions. Tertiary and quaternary care systems were not included. Although tertiary and quaternary care systems represent a small portion of the healthcare system, future research should address the supply chain costs of highly specialized organizations.

This study suggests methods that can help to improve supply chain operations in healthcare organizations worldwide.

This study presents an empirically proven methodology for testing the statistical significance of the primary factors contributing to healthcare supply chain costs. The results of this study may lead to positive policy changes to improve healthcare organizations' efficiency and increase access to high-quality healthcare.

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.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

This paper aims to discover and analyze the challenges hampering blockchain technology’s (BT’s) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views.

An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization.

The study’s results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power.

This work has been conducted in the Indian context, so careful generalization of the results is needed.

This work will give health-care stakeholders a better perspective regarding blockchain’s adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges’ impact on blockchain’s adoption in the Indian health-care sector.

The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector.

The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships that exist amongst those obstacles.

Potential barriers and their interrelationships in their respective contexts have been uncovered. Using MICMAC analysis, the categorization of these barriers was done based on their degree of reliance and driving power (DP). Furthermore, an interpretive structural modeling (ISM) framework for the barriers to mHealth activities in India has been proposed.

The study explores a total of 15 factors that reduce the efficiency of mHealth adoption in India. The findings of the Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) investigation show that the economic situation of the government, concerns regarding the safety of intellectual technologies and privacy issues are the primary obstacles because of the significant driving power they have in mHealth applications.

Promoters of mHealth practices may be able to make better plans if they understand the social barriers and how they affect each other; this leads to easier adoption of these practices. The findings of this study might be helpful for governments of developing nations to produce standards relating to the deployment of mHealth; this will increase the efficiency with which it is adopted.

At this time, there is no comprehensive analysis of the factors that influence the adoption of mobile health care with social cognitive theory in developing nations like India. In addition, there is a lack of research in investigating how each of these elements affects the success of mHealth activities and how the others interact with them. Because developed nations learnt the value of mHealth practices during the recent pandemic, this study, by investigating the obstacles to the adoption of mHealth and their inter-relationships, makes an important addition to both theory and practice.