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Case study
Publication date: 1 January 2024

John McVea, Daniel McLaughlin and Danielle Ailts Campeau

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and…

Abstract

Theoretical basis

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research methodology

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

Case overview/synopsis

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

Complexity academic level

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

Details

The CASE Journal, vol. ahead-of-print no. ahead-of-print
Type: Case Study
ISSN: 1544-9106

Keywords

Article
Publication date: 5 April 2024

Manoj Krishnan and Satish Krishnan

The study aims to drive conceptual clarity around resistance to information technology projects, integrating multiple facets of the phenomenon from earlier studies.

Abstract

Purpose

The study aims to drive conceptual clarity around resistance to information technology projects, integrating multiple facets of the phenomenon from earlier studies.

Design/methodology/approach

The study conducts a meta-synthesis of qualitative studies on resistance to technology projects; it analyzes those studies at a case-specific level, compares and contrasts emergent concepts against each other, and “translates” those to the rest of the studies. The study uses the seven-step meta-ethnography method by Noblit and Hare to reciprocally translate emergent concepts to construct the conceptual model.

Findings

Through meta-synthesis, the study derives a new conceptual model for resistance to information technology projects, exemplifying how the identified antecedents create user resistance and how the phenomenon progresses within organizations.

Research limitations/implications

This study enriches the observations and conclusions of past individual studies while explicating various facets of the mechanisms that generate and progress technology resistance within organizations. It offers fresh insights into the equivocal nature of the phenomenon and the distinctive ways it progresses from individual to group level.

Practical implications

Many ambitious and costly digital transformation efforts do not succeed due to user resistance. Understanding the mechanisms that create user resistance can help organizations manage technology projects better, thereby reducing the technology assimilation gap and protecting returns on related investments.

Originality/value

There have been extensive studies on technology acceptance (enablers) within organizations, while those relating to technology inhibitors are somewhat limited. However, the symmetry of understanding between enablers and inhibitors is vital for organizations to assimilate promising technologies and transform their business models. This model uses a new lens of sensemaking theory to explain how the antecedents trigger perceived threats and resistance behavior; it highlights the nuances around the development of resistance within individuals and its progression to groups. The resultant model offers better generalizability in organizational contexts.

Details

Information Technology & People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 8 August 2022

Williams E. Nwagwu and Omwoyo Bosire Onyancha

This paper aims to examine the global pattern of growth and development of eHealth research based on publication headcount, and analysis of the characteristics, of the keywords…

Abstract

Purpose

This paper aims to examine the global pattern of growth and development of eHealth research based on publication headcount, and analysis of the characteristics, of the keywords used by authors and indexers to represent their research content during 1945–2019.

Design/methodology/approach

This study adopted a bibliometric research design and a quantitative approach. The source of the data was Elsevier’s Scopus database. The search query involved multiple search terms because researchers’ choice of keywords varies very significantly. The search for eHealth research publications was limited to conference papers and research articles published before 2020.

Findings

eHealth originated in the late 1990s, but it has become an envelope term for describing much older terms such as telemedicine, and its variants that originated much earlier. The keywords were spread through the 27 Scopus Subject Areas, with medicine (44.04%), engineering (12.84%) and computer science (11.47%) leading, while by Scopus All Science Journal Classification Health Sciences accounted for 55.83% of the keywords. Physical sciences followed with 30.62%. The classifications social sciences and life sciences made only single-digit contributions. eHealth is about meeting health needs, but the work of engineers and computer scientists is very outstanding in achieving this goal.

Originality/value

This study demonstrates that eHealth is an unexplored aspect of health literature and highlights the nature of the accumulated literature in the area. It further demonstrates that eHealth is a multidisciplinary area that is attractive to researchers from all disciplines because of its sensitive focus on health, and therefore requires pooling and integration of human resources and expertise, methods and approaches.

Details

Global Knowledge, Memory and Communication, vol. 73 no. 3
Type: Research Article
ISSN: 2514-9342

Keywords

Article
Publication date: 11 April 2023

Hesham Metwalli Mousli, Iman El Sayed, Adel Zaki and Sherif Abdelmonem

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for…

Abstract

Purpose

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

Design/methodology/approach

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

Findings

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

Research limitations/implications

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Practical implications

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

Originality/value

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

Details

The TQM Journal, vol. 36 no. 2
Type: Research Article
ISSN: 1754-2731

Keywords

Content available

Abstract

Details

Knowledge Translation
Type: Book
ISBN: 978-1-80382-889-3

Article
Publication date: 6 February 2024

Somayeh Tamjid, Fatemeh Nooshinfard, Molouk Sadat Hosseini Beheshti, Nadjla Hariri and Fahimeh Babalhavaeji

The purpose of this study is to develop a domain independent, cost-effective, time-saving and semi-automated ontology generation framework that could extract taxonomic concepts…

Abstract

Purpose

The purpose of this study is to develop a domain independent, cost-effective, time-saving and semi-automated ontology generation framework that could extract taxonomic concepts from unstructured text corpus. In the human disease domain, ontologies are found to be extremely useful for managing the diversity of technical expressions in favour of information retrieval objectives. The boundaries of these domains are expanding so fast that it is essential to continuously develop new ontologies or upgrade available ones.

Design/methodology/approach

This paper proposes a semi-automated approach that extracts entities/relations via text mining of scientific publications. Text mining-based ontology (TmbOnt)-named code is generated to assist a user in capturing, processing and establishing ontology elements. This code takes a pile of unstructured text files as input and projects them into high-valued entities or relations as output. As a semi-automated approach, a user supervises the process, filters meaningful predecessor/successor phrases and finalizes the demanded ontology-taxonomy. To verify the practical capabilities of the scheme, a case study was performed to drive glaucoma ontology-taxonomy. For this purpose, text files containing 10,000 records were collected from PubMed.

Findings

The proposed approach processed over 3.8 million tokenized terms of those records and yielded the resultant glaucoma ontology-taxonomy. Compared with two famous disease ontologies, TmbOnt-driven taxonomy demonstrated a 60%–100% coverage ratio against famous medical thesauruses and ontology taxonomies, such as Human Disease Ontology, Medical Subject Headings and National Cancer Institute Thesaurus, with an average of 70% additional terms recommended for ontology development.

Originality/value

According to the literature, the proposed scheme demonstrated novel capability in expanding the ontology-taxonomy structure with a semi-automated text mining approach, aiming for future fully-automated approaches.

Details

The Electronic Library , vol. 42 no. 2
Type: Research Article
ISSN: 0264-0473

Keywords

Article
Publication date: 23 December 2021

Manaf Al-Okaily

This study aims to evaluate the Accounting Information Systems (AIS) effectiveness on the organizational level by extending DeLone and McLean success model in developing countries…

1347

Abstract

Purpose

This study aims to evaluate the Accounting Information Systems (AIS) effectiveness on the organizational level by extending DeLone and McLean success model in developing countries like Jordan. Unlike other studies, this study investigates the effects of system quality, information quality, process quality, collaboration quality, service quality, individual performance and workgroup performance toward organizational performance during the period of the COVID-19 pandemic outbreak.

Design/methodology/approach

A self-administrated survey was used to collect data from 104 accounting managers operating in listed Jordanian firms in the Amman Stock Exchange (ASE). The partial least squares-structural equation modeling method was used for data analysis.

Findings

Eight relationships were tested, whereby six were supported as was expected. Particularly, the empirical results reveal that individual performance is positively and significantly influenced by information quality, process quality and service quality. Furthermore, workgroup performance is positively and significantly influenced by individual performance. The results also show that organizational performance is impacted by individual performance and workgroup performance.

Originality/value

The current study is among the first empirical studies that has extended the information systems success model to evaluate AIS success during COVID-19 pandemic. This study also offers insights into the importance of AIS success among listed Jordanian firms in ASE.

Details

VINE Journal of Information and Knowledge Management Systems, vol. 54 no. 1
Type: Research Article
ISSN: 2059-5891

Keywords

Article
Publication date: 11 March 2024

Zhen Xu, Ruohong Hao, Xuanxuan Lyu and Jiang Jiang

Knowledge sharing in online health communities (OHCs) disrupts consumers' health information-seeking behavior patterns such as seeking health information and consulting. Based on…

Abstract

Purpose

Knowledge sharing in online health communities (OHCs) disrupts consumers' health information-seeking behavior patterns such as seeking health information and consulting. Based on social exchange theory, this study explores how the two dimensions of experts' free knowledge sharing (general and specific) affect customer transactional and nontransactional engagement behavior and how the quality of experts' free knowledge sharing moderates the above relationships.

Design/methodology/approach

We adopted negative binomial regression models using homepage data of 2,982 experts crawled from Haodf.com using Python.

Findings

The results show that experts' free general knowledge sharing and free specific knowledge sharing positively facilitate both transactional and nontransactional engagement of consumers. The results also demonstrate that experts' efforts in knowledge-sharing quality weaken the positive effect of their knowledge-sharing quantity on customer engagement.

Originality/value

This study provides new insights into the importance of experts' free knowledge sharing in OHCs. This study also revealed a “trade-off” between experts' knowledge-sharing quality and quantity. These findings could help OHCs managers optimize knowledge-sharing recommendation mechanisms to encourage experts to share more health knowledge voluntarily and improve the efficiency of healthcare information dissemination to promote customer engagement.

Details

Kybernetes, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0368-492X

Keywords

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