Search results

Purpose – This chapter argues that health care is best conceptualized as a complex adaptive system. Sustainable health care depends on harnessing the complexity of the system by building aligned purpose, flexible pathways to connect people, knowledge and resources, and the capacity for self-organization.

Design/methodology/approach – The case study of the Southern California Region of Kaiser Permanente is based on three years of interviews and archival data collection examining the system's transformational change that began in 2004 and has been aimed at building a sustainable health care system with the guiding principles of value and prevention. The case focuses primarily on the medical care delivery system designed by the Southern California Permanente Medical Group, the capabilities that have been built into the system to continually improve the quality of care and the outcomes of the system, and the results that have been achieved.

Findings – During the period from 2004 to 2011, the region improved significantly in slowing cost acceleration by significantly improving medical care. The implementation of an electronic medical records system and its integration with other clinical information technology systems have enabled: (1) truly integrated, well defined, and easily navigated care delivery systems that are based on evidence; (2) upstream focus on prevention, disease control, patient education, and population health; and (3) management accountability and organizational improvement systems based on transparency of data and feedback. Physician leadership and partnering with the region's administrative and hospital leadership have been critical change enablers.

Originality/value – Embracing the complexity of the system has led to the crafting of pathways and linkages that enable patients to move through the system to flexibly and efficiently connect to the knowledge and resources required to optimize their health. This requires continual self-organization based on well-defined roles and connections. Previous health care improvement approaches have stressed initiatives and organizational changes that may further fragment the health care system.

This chapter proposes a new architecture to address challenges to security and the privacy in e-healthcare under Industry 5.0. With the growing needs for high-quality medical treatment and the continuously growing costs of treating global medical problems, systems and web-based medical care are regarded as innovative solutions. In particular, the new progress in Internet of Things (IoT) has led to the development of Internet of Medical Things (IoMT). The patient history data is handled and processed remotely in real-time rather than visiting any clinic and then having that data transferred for subsequent use to third parties, such as data that gets saved in the cloud. This patient data faced security threats and it is observed as major limitations of using such systems in Industry 5.0. This chapter analyzes the security and secrecy challenges, together with the necessities, the danger involved and proposed secured blockchain-based framework which is capable of future research scope in Industry 5.0. The study has described an Eye Hospital case study that stores the eye donors’ details. With such critical scenario, this study addresses healthcare scenario with poverty-led agenda and social developmental features.

Purpose – The paper explains how internal reporting systems, as embedded practices informing organizational actions and “know-how”, contributed to the inertia in implementing a corporate form of governance in a transitional public organization in a developing country – Egypt.

Design/methodology/approach – The paper synthesizes an institutional theory framework in order to capture the case study mixed results. Drawing on DiMaggio and Powell's (1983) notions of isomorphic mechanisms, Ocasio (1999) and Burns and Scapens’ (2000) notions of organizations’ memory, history, cumulative actions and routines, Brunsson's (1994) notion of organizational institutional confusion as well as Carruthers's (1995) notion of “symbolic window-dressing” adoption of new practices, the paper explores the dynamic of a public hospital corporatization processes. Data collection methods include semi-structured interviews, documentary evidence and direct observation.

Findings – The case study evidence shows that the interplay between the new form of “corporate” governance and the intra-organizational power, routines and “know-how” created internal organizational confusion and changed organizational members’ narrative of risk and uncertainties.

Research limitations/implications – The paper does not reveal the role of reformers involved in the public sector “governance” reform in developing countries. Exploring such a role goes beyond the scope of this paper and represents an area of future research.

Originality/value – The paper provides a comprehensive account of public sector “governance” reform in a developing nation, while exploring the role of management accounting and costing systems in facilitating or otherwise that reform processes.

Purpose — Since a couple of years, we are confronted with the phenomenon of information overload. In particular, the web provides a rich source of a variety of information mainly in textual, i.e. unstructured form. Thus, web search faces new challenges that are how to make the user aware of the variety of content available and how to satisfy users best with such manifold content.

Methodology — This variety of content is considered as diversity, i.e. the reflection of a result set's coverage of multiple interpretations of a query. Diversification within web search aims on the one hand at adapting the ranking in a way that the top results are diverse. Increasingly important becomes on the other hand the organization and classification of content within diversification.

Findings — Various approaches to diversification are available or currently focus on research activities. They range from an adapted ranking by means of similarity measures or diversity scores to a comprehensive diversity analysis which determines topics and classifies text according to opinions etc.

Implications — Given the high diversity of web content, approaches for diversification are extremely important. Web search tries to address this problem from different perspectives. For the future, combination with image search result diversification is important. Further, benchmarks and standard data sets for evaluations need to be established to ensure comparability of results from various approaches.

Originality/value — This chapter provides an overview on diversity in web search from two directions: (a) Diversity is introduced with its notions and dimensions. (b) Methods to assess diversity within web search are presented.

The response of governments to the health crisis caused by COVID-19 has been different in each country. This chapter analyzes the reaction that the Mexican government had to the health crisis. At first, the context in which the pandemic occurs is described, characterized by high social and political polarization, a process of centralization of authority, a precarious health sector with limited institutional capacities, and government communication characterized by ambiguous and confusing messages. Subsequently, we discuss the tensions and limitations of state autonomy and the coordination mechanisms, such as the National Health Council. We also present the policies portfolio developed and implemented to address the health crisis, like the national healthy distance program, hospital reconversion, and the national vaccination program. Finally, we identify a series of challenges and learnings offered by the Mexican case to improve health crisis management in the future.

This chapter will initially review some health care system issues with a focus on the US health care system. It will then review some of the sociological literature about race/ethnicity, immigration, socioeconomic status (SES) and gender and how these factors link to health and health care. In addition, the chapter will serve as an introduction to the volume and will briefly review the contents of the other sections and chapters in this volume.