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Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

The study aims to explain the process of management accounting practices and organizational change aspects in the public sector’s response to environmental pressures. Specifically, it discusses the interaction process between management accounting practices from one side and culture, leadership and decentralization from the other side.

This study adopts qualitative research approach and an interpretive case study. The study uses the triangulation method of data collection, including interviews, annual reports, documents and archival records. A theoretical lens informs it of the contextual/processual approach for interpreting interaction processes between management accounting and organizational change aspects, including culture, leadership and decentralization.

The findings confirm that a change in organizational culture has an important impact on accounting change, which has played a central role in the desire to initiate and accept such changes by the organizational members. Similarly, the new leadership style created a unique culture that was considered a solid platform to introduce new accounting systems by enhancing the trust between IT staff and management accountants and their trust in themselves to accept the change. The paper concludes that the relationships between the change aspects at the organizational level, and accounting practices at the inherent organizational and accounting levels are both recursive and two way, with the two concepts inextricably interwoven.

The study has some limitations as the data is limited to only a single country – more explanation for Jordanian Customs Organization quantitative understandings of governance improvement. The study has important implications for practitioners and customs officials by showing that different government regulations and customs reforms have varied influences on the public sector. These reforms have included most modifications to the accounting and organizational configurations. This study contributes to institutional theory development and refinement by exploring the interface between external influences and internal origins in the accounting change process.

This study uses a categorical association between organizational changes and accounting in the public sector as most prior studies have been conducted on the private sector due to competitive and technical pressures. It also contributes to organizational change and accounting literature by discussing the relationship between accounting from one side and culture and leadership from another side.