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1 – 10 of over 1000Yoon Hee Kim, Luv Sharma and Daniel M. Walker
Extant research documents the cost benefits of group purchasing organizations (GPOs) to member hospitals, but understudies concerns about the market dominance of a few large GPOs…
Abstract
Purpose
Extant research documents the cost benefits of group purchasing organizations (GPOs) to member hospitals, but understudies concerns about the market dominance of a few large GPOs and the relatively weakened buyer power of hospitals in the US healthcare product supply chain. To fill the gap in the literature, this study investigates whether GPO size and a hospital’s relative power to its GPO affect the hospital’s supply expenses, and whether and how system membership moderates the power–performance link.
Design/methodology/approach
For this study, we collect the panel data from various secondary sources on GPO–hospital dyads, which include the seven largest GPOs and their 2,590 unique acute care hospital members in 51 states over the period of 2009–2017. To address the endogeneity issue associated with simultaneity, we establish a one-year time lag between dependent and independent variables and analyzed the 15,527 hospital-year observations using the time-series regression with fixed-effect.
Findings
We find that a hospital’s relative power to its GPO is the most critical factor to reduce its supply cost while GPO size has no effects. We also find that a nonsystem hospital achieves greater cost savings by leveraging its relative power to its GPO while a system hospital gains no benefits.
Originality/value
To the best of our knowledge, this study is the first to address the paradox of GPO size and a hospital’s relative power and the moderating role of system membership for the hospital’s purchasing efficiency using a large nation-wide dataset of US hospitals–GPO dyads.
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Noor Fadzlina Mohd Fadhil, Say Yen Teoh, Leslie W. Young and Nilmini Wickramasinghe
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive…
Abstract
Purpose
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.
Design/methodology/approach
A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.
Findings
This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.
Research limitations/implications
We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.
Practical implications
This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.
Social implications
Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.
Originality/value
This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.
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Byongcheon Choi and Cheolho Yoon
Recently, interest and necessity for cloud-based hospital information systems (HISs) have emerged as an appropriate alternative for revitalizing medical information exchange…
Abstract
Purpose
Recently, interest and necessity for cloud-based hospital information systems (HISs) have emerged as an appropriate alternative for revitalizing medical information exchange between hospitals, analyzing “big data” medical information and developing the use of new medical technologies. The purpose of this paper is to investigate factors that affect the switching of information systems in existing on-premise environments into cloud-based HISs.
Design/methodology/approach
A research model was developed using the push–pull–mooring model based on migration theory. The research model was analyzed using confirmatory factor analysis and path analysis using partial least squares structural equation modeling.
Findings
The results of this study showed that low compatibility, perceived value, low cost and inertia influenced the intention to switch to cloud-based HISs; low flexibility and low compatibility influenced dissatisfaction; and low cost, ease of maintenance and ease of managing indicators influenced perceived value.
Originality/value
This study is expected to be used as the basis for developing a research model in subsequent studies to analyze the transition to new innovative technologies. Also, in practice, it is expected to contribute to the activation of cloud computing environments in hospitals.
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Faisal Binsar, Tirta Nugraha Mursitama, Mohammad Hamsal and Rano Kartono Rahim
The adoption of digital technology has not been able to overcome the problem of patient healthcare service quality in Indonesian hospitals, especially in lower middle-class…
Abstract
Purpose
The adoption of digital technology has not been able to overcome the problem of patient healthcare service quality in Indonesian hospitals, especially in lower middle-class hospitals that are widely distributed in the regions, because its utilization has not been well coordinated. This research explores the influence of Digital Adoption Capability (DAC) on Hospital Performance (HP) for these service problems.
Design/methodology/approach
This research used a quantitative methodology design approach. Survey data were collected from 285 leaders of class C and D hospitals throughout Indonesia, who were selected at simple random from March to August 2023. Data analysis was carried out using the structural equation modeling method with the help of LISREL version 8.80 software.
Findings
The research found a positive and significant influence of DAC on HP. Digital Leadership (DL) plays an important role in performance, both directly and indirectly. ICT Literacy (ICT) and Patient-Centric (PC) do not have a direct influence on HP but provide significant results through DAC. This research also found Environmental Dynamism (ED) factors that significantly drive the need to improve performance through digital adoption.
Practical implications
Providing insight into increasing the role of digital technology to connect healthcare workers and patients to produce safe and quality healthcare services in an ever-changing environmental condition.
Originality/value
This model is very important for the management of small hospital organizations in the context of adopting digital technology to be able to provide better services to patients and improve hospital performance.
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Natália Ransolin, Tarcisio Abreu Saurin, Robyn Clay-Williams, Carlos Torres Formoso, Frances Rapport and John Cartmill
Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built…
Abstract
Purpose
Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole.
Design/methodology/approach
Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff.
Findings
Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied.
Originality/value
The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.
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René Nolio Santa Cruz, Hugo Vaz Sampaio, Carlos Becker Westphall, Maximiliano Dutra de Camargo and Daniela Couto Carvalho Barra
The objectives of the proposed model are: aiding nursing staff in documentation tasks, which can be onerous and stressful; and helping management by offering an estimate of the…
Abstract
Purpose
The objectives of the proposed model are: aiding nursing staff in documentation tasks, which can be onerous and stressful; and helping management by offering an estimate of the nursing workload, which can be considered for administrative purposes, such as staff scheduling.
Design/methodology/approach
An exploratory-descriptive study was conducted in order to identify, investigate, and describe the problem of documenting nursing activities and workload estimation in an intensive care unit. Technological solutions were explored, and models were proposed to address these issues.
Findings
Cross-dataset experiments were performed, and the model was able to offer an adequate estimate of the nursing workload. The results suggest that continuous retraining is essential for maintaining high accuracy. While the proposed model was considered in the context of an adult ICU, it can be adapted to other contexts, such as elderly care.
Research limitations/implications
While the proposed solution seems promising, further research is required, such as deploying this system in an ICU and facing challenges in the areas of computer security, medical ethics, and patient data privacy. More patients’ variables could also be collected to improve the workload estimates.
Originality/value
Nursing workload assessment is critical to improve the cost-benefit ratio in health care, offer high-quality patient care, and reduce unnecessary expenses, and this process is usually manual. An automated device can automatically document the amount of time spent in patient care activities in a more transparent, efficient, and accurate manner, freeing staff for more urgent activities and keeping management better informed about day-to-day nursing operations.
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Mohamed A. Khashan, Thamir Hamad Alasker, Mohamed A. Ghonim and Mohamed M. Elsotouhy
The success of an Electronic Health Record (EHR) system is determined by the numerous facilitators and obstacles that influence physicians' intentions toward using these…
Abstract
Purpose
The success of an Electronic Health Record (EHR) system is determined by the numerous facilitators and obstacles that influence physicians' intentions toward using these technologies. This study examines physicians' intentions to use EHR by applying the extended technology readiness and acceptance model (TRAM) factors, the result demonstrability, colleagues' opinions, perception of external control, and organizational support.
Design/methodology/approach
Convenience sampling was used to collect data from physicians in Egypt (n = 520). To evaluate the model's hypotheses, this study used the partial least squares structural equation modeling (PLS-SEM) method with WarpPLS.7.
Findings
The results revealed that positive TR factors (innovativeness and optimism) positively affect perceived usefulness and ease of use, while negative TR factors (discomfort and insecurity) negatively impact perceived usefulness and ease of use. Furthermore, the result demonstrability and colleagues' opinions positively influence perceived usefulness, while the perception of external control and organizational support positively influence perceived ease of use. In addition, significant relationships between perceived ease of use and usefulness and adoption intention were identified.
Originality/value
This is the first study to apply the TRAM to understand physicians' adoption intentions to use EHR systems. Moreover, this study determined the different roles of positive and negative TR affecting physicians' cognition regarding using EHR systems.
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Jihane Sebai, Wendy Leslie and Jessica Lichy
In France, telemedicine was integrated into the Code of Public Health in 2009, but adoption and use were slow until the beginning of the COVID-19 health crisis, when telemedicine…
Abstract
Purpose
In France, telemedicine was integrated into the Code of Public Health in 2009, but adoption and use were slow until the beginning of the COVID-19 health crisis, when telemedicine arguably became the only way to ensure continuity of care for non-COVID patients, reduce viral transmission and streamline strained medical resources. Despite growing enthusiasm, criticism persists.
Design/methodology/approach
User satisfaction will be essential for the sustainability and development of telemedicine, yet this remains an under-researched area. Framed by the first lockdown in France (March–May 2020), this two-step mixed-methods study uses secondary quantitative data (n users = 2,511; n doctors = 254; n nurses = 248) and primary qualitative interviews (n = 5) among healthcare professionals and patients in France to analyse satisfaction levels among telemedicine users. Implementing an inductive approach, it identifies key themes in the adoption and use of telemedicine, the impact on user satisfaction and evolution in perceptions over time.
Findings
The findings contribute to the literature by identifying and explaining the shift in telemedicine practices and offering recommendations for addressing ongoing obstacles through pragmatic strategies.
Originality/value
This research addresses a gap in knowledge to examine the impact of the COVID-19 pandemic on the uptake, perception and satisfaction of telemedicine experienced by users. Recognising telemedicine as a complex innovation in conceptual and practical terms, this paper investigates the degree of acceptance among users and the process of assimilation in the system.
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Francis Kamewor Tetteh, Dennis Kwatia Amoako, Andrews Kyeremeh, Gabriel Atiki, Francisca Delali Degbe and Prince Elton Dion Nyame
The coronavirus disease 2019 (COVID-19) pandemic represents one of the most significant disruptions to supply chains (SCs), stimulating both practitioners and scholars to seek…
Abstract
Purpose
The coronavirus disease 2019 (COVID-19) pandemic represents one of the most significant disruptions to supply chains (SCs), stimulating both practitioners and scholars to seek ways to enhance supply chain performance (SCP). Recent advancements in technology, particularly supply chain analytics (SCA) technologies, offer promising avenues for mitigating risks associated with SC disruptions like those posed by the COVID-19 pandemic. However, the existing literature lacks a comprehensive analysis of the connection between SCA and healthcare SC (HSC) performance. To address this research gap, we employed the dynamic capability perspective to investigate the mediating roles of supply chain innovation (SCI), resilience (SCR) and flexibility (SCF) in the relationship between SCA and HSC performance. The study further examined the moderating role of a data-driven culture (DDC).
Design/methodology/approach
The proposed model was tested using survey data from 374 managers of healthcare facilities in Ghana. SPSS and Amos were used to analyze the data gathered.
Findings
The results showed that while SCA may drive HSC performance, the presence of SCI, SCR and SCF may serve as channels to drive enhanced HSC performance. Additionally, we also found that different levels of a DDC induce varying effects of SCA on SCI, SCR and SCF.
Research limitations/implications
The study’s results have theoretical and practical implications, offering valuable insights for the advancement of SCA in healthcare literature. They also deepen SC managers’ comprehension of how and when SCA can boost HSC performance. However, as the study was limited to healthcare facilities in Ghana, its findings may not be universally applicable.
Originality/value
This study contributes to the literature by demonstrating that SCI, SCR, SCF and a DDC could serve as transformative mechanisms to reap superior HSC outcomes. This study also offers contemporary guidance to managers regarding SCA investment decisions.
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Adetumilara Iyanuoluwa Adebo, Kehinde Aladelusi and Mustapha Mohammed
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…
Abstract
Purpose
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).
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
Research includes information relevant to access the impact of e-pharmacy services on healthcare accessibility, affordability and quality in developing countries.
Originality/value
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.
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