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This paper proposes the adoption of Industry 4.0 (I4) technologies and lean techniques for improving operational performance in the healthcare sector.

The research adopted a systematic literature review and feedback of healthcare professionals to identify the inefficiencies in the current healthcare system. A questionnaire was used to get feedback from the patients and the hospital staff about the current practices and issues, and the expected impact of technology on existing practices. Data were analysed using descriptive statistics, correlation analysis and multiple regression analysis.

The results indicate that I4 technologies lead to the improvement of the operational performance, and the perceptions about I4 technologies are made through the pre-medical diagnosis. However, a weak correlation between lean practices and healthcare operational performance compared to that of I4 technologies and operational performance indicate that lean practices are not fully implemented in the Sri Lankan healthcare sector to their full potential.

This study is limited to two government hospitals, with insights from only the doctors and nurses in Sri Lanka. Furthermore, the study is limited to only selected aspects of I4 technologies (big data, cloud computing and IoT) and lean concepts (value stream mapping and 5S). Therefore, recommendations on the adoption of I4 technologies in the healthcare sector need to be made within the scope of the study investigation.

The implementation of I4 technologies needs careful consideration of process improvement as part of the overall plan for achieving the maximum benefits of technology adoption.

The findings of the research can be used as a benchmark/guide for other hospitals to explore the adoption of I4 technologies, and how process improvement from lean concepts could influence the overall operational performance.

This chapter presents an overview of our evaluation of the introduction of electronic medical records (EMR) in 20 nursing homes located in the New York City region. These organizations were part of an EMR demonstration project cosponsored by the for-profit segment of the nursing home industry in the region and 1199SEIU United Health Care Workers East, the union that represented frontline staff in these organizations. We report central lessons from our evaluation, which took place over the course of four years and included multiple data sources. The primary purpose of our research was to examine the effects of EMR adoption on employment and labor relations in the participating organizations. Findings are based on a longitudinal study of EMR adoption in 15 of the 20 organizations that received the EMR technology and five “control” organizations, which did not receive the technology, employing a mixed methodological design with both quantitative and qualitative data collection methods. Results from our research inform the existing EMR adoption discussion in two ways. First, we find mixed evidence associated with EMR implementation. The adoption of this new technology enhances certain organizational outcomes, but it seems to hinder others. Second, findings from our research highlight the importance of preexisting organizational factors as predictors of EMR-associated outcomes. EMR-associated outcomes, positive or negative, are likely to be contingent on key organizational characteristics and on managerial adoption strategies. Our study's findings imply that the meaningful use of EMR needs to take into account not only the technical specifications of EMR but also the organizational characteristics of the physician practices and healthcare facilities adopting the technology. Healthcare organizations vary in their capacity and ability to make optimal use of health information technology, which should be incorporated into public policy and organizational practices designed to increase adoption.

The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision‐making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn‐around‐times, enabling critical results to reach physicians rapidly for improved clinical outcomes.

Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations.

US hospitals are actively involved in laboratory systems planning to improve health service quality. Specifically, data show 76 new laboratory information systems are currently being installed in 2007 with another 399 under contract for future installation. As a result, increasing investment in laboratory information systems is providing state‐of‐the‐art clinical laboratory support, which enhances clinical care processes and improves quality. These state‐of‐the‐art Laboratory Information Systems, when linked with other clinical information systems such as Computerized Physician Order Entry and Electronic Medical Record, will support further healthcare quality improvement.

This article includes the most current information available on the US hospital laboratory information system applications.

The purpose of this paper is to explore the attitudes of nursing home administrators and key managerial staff toward health information technology (health IT).

This research is exploratory in nature, and applies qualitative case-study methodology to further understand health IT adoption by nursing homes through multiple in-depth semi-structured interviews of management, and direct observations of employee behavior at each participating facility. A modified Technology Acceptance Model is used to examine the attitudes and perceptions of administrators.

This study finds that there are differences in the level of health IT adoption by nursing homes. While some administrators are aware of health IT and are implementing or updating their IT systems in a gradual but haphazard manner, others exhibited a lack of interest in implementing change. Overall, there is a lack of systematic planning and decision-making toward health IT adoption. Adoption is not evidence-based, instead driven primarily by real and perceived regulatory requirements combined with a lack of information about, or consideration of, the real costs and benefits of implementing health IT.

Including six in-depth case studies, the sample for this study is small for generalizing the findings. Yet, it contributes to the literature on the slow process of health IT adoption by nursing homes. Moreover, the findings provide guidelines for future research.

This study demonstrates that nursing home administrators must systematically plan the adoption of health IT, and such decision making should be evidenced-based and participatory so that employees can voice their opinions that could prevent future resistance.

This study is original and advances knowledge on the reasons for the slow adoption of health IT in nursing homes. It finds that lack of adequate information regarding the utility and benefits of health IT in management adoption decisions can result in haphazard implementation or no adoption at all. This finding has significant value for policy makers’ practitioners for improving accessibility of information regarding the use of health IT in nursing homes that could address the health IT adoption challenge in this industry.

The U.S. healthcare system is very complex and inundated with many challenges, ranging from escalating healthcare expenditure to increasing prevalence of medication errors. Emphasis on cost reduction and prevention of medication errors has given impetus to the development of computerized information technologies. Advanced technological innovation such as e-prescribing has the potential to improve quality of care, reduce costs and enhance patient satisfaction. Reaping these benefits is dependent on successful diffusion of innovation. This chapter summarizes the current literature covering diffusion of e-prescribing technology with an emphasis on the barriers and facilitators, and strategies to overcome these potential barriers.

The limited success of electronic health records (EHRs) implementation in the healthcare services in general, and a national EHR in particular, requires better understand and documentation of the current drivers and inhibitors of EHR adoption, together with a definition of a national EHR. This paper aims to address these issues.

Factors affecting EHR adoptions are elicited from extant literature and the stakeholder/actor framework is used as the theoretical framework. The multiple case study approach is used as the research method, and data are collected in Ireland and Israel by interviews and analysed using text coding methods.

Factors elicited in the literature are generally corroborated, yet the salient factor on the localized perspective appears to be the degree of centralization of the healthcare services; while different factors affect the national perspective. In summary, it seems that Israel is more ready for national EHR implementation than Ireland due to the high level of computerization and high levels of integration of primary and secondary care patient data.

Contribution to research is in the definition of a national EHR, the illustration of various levels of analysis and their relative impacts on EHR adoption, the analysis framework, and by showing that EHR adoption is a top‐down, change management process.

EHR adoption should be driven by a powerful actor in the healthcare sector addressing the need for a high level of integration within and between care levels, while focusing on clinicians' requirements. Technological and legislative infrastructures are mandatory for establishing a national EHR.

Data for this study are collected in two countries that represent different healthcare structures, one being highly centralized while the other is just the opposite. These differences provide an additional interesting lens through which factors affecting EHR adoption can be assessed. As far as we know, not many previous studies have compared EHR adoption across two diverse healthcare systems.

Health-care knowledge is dispersed among different departments in a health care organization, which makes it difficult at times to provide quality care services to patients. Therefore, this study aims to identify the main challenges in adopting health information technology (HIT).

This study surveyed 148 stakeholders in 4 key categories [patients, health-care providers, United Arab Emirates (UAE) citizens and foresight experts] to identify the challenges they face in adopting health care technologies. Responses were analyzed using exploratory (EFA) and confirmatory factor analysis (CFA).

EFA revealed four key latent factors predicting resistance to HIT adoption, namely, organizational strategy (ORGS); technical barriers; readiness for big data and the internet of things (IoT); and orientation (ORI). ORGS accounted for the greatest amount of variance. CFA indicated that readiness for big data and the IoT was only moderately correlated with HIT adoption, but the other three factors were strongly correlated. Specific items relating to cost, the effectiveness and usability of the technology and the organization were strongly correlated with HIT adoption. These results indicate that, in addition to financial considerations, effective HIT adoption requires ensuring that technologies will be easy to implement to ensure their long-term use.

The results indicate that readiness for big data and the IoT-related infrastructure poses a challenge to HIT adoption in the UAE context. Respondents believed that the infrastructure of big data can be helpful in more efficiently storing and sharing health-care information. On the technological side, respondents felt that they may experience a steep learning curve. Regarding ORI, stakeholders expected many more such initiatives from health-care providers to make it more knowledge-specific and proactive.

This study has implications for knowledge management in the health -care sector for information technologies. The HIT can help firms in creating a knowledge eco-system, which is not possible in a dispersed knowledge environment. The utilization of the knowledge base that emerged from the practices and data can help the health care sector to set new standards of information flow and other clinical services such as monitoring the self-health condition. The HIT can further influence the actions of the pharmaceutical and medical device industry.

This paper highlights the challenges in HIT adoption and the most prominent factors. The conceptual model was empirically tested after the collection of primary data from the UAE using stakeholder theory.

This paper aims to review the healthcare supply chain (HSC) literature along various areas and to find out the gap in it.

In total, 143 research papers were reviewed during 1996-2017. A critical review was carried out in various dimensions such as research methodologies/data collection method (empirical, case study and literature review) and inquiry mode of research methodology (qualitative, quantitative and mixed), country-specific, targeted area, research aim and year of publication.

Supply chain (SC) operations, performance measurement, inventory management, lean and agile operation, and use of information technology were well studied and analyzed, however, employee and customer training, tracking and visibility of medicines, cold chain management, human resource practices, risk management and waste management are felt to be important areas but not much attention were made in this direction.

Mainly drug and vaccine SC were considered in current study of HSC while SC along healthcare equipment and machine, hospitality and drug manufacturing related papers were excluded in this study.

This literature review has recognized and analyzed various issues relevant to HSC and shows the direction for future research to develop an efficient and effective HSC.

The insight of various aspects of HSC was explored in general for better and deeper understanding of it for designing of an efficient and competent HSC. The outcomes of the study may form a basis to decide direction of future research.

Warren Buffett asserted that the greatest issue confronting American business and the economy is rising health-care costs, which have risen to 17% of gross domestic product. Public policymakers, health-care providers and other stakeholders grapple with cost-containment and increased health-care delivery efficiencies. There exists a paucity of theory-driven research addressing how information technology vis-à-vis electronic health records (EHR) may supply a managerial mechanism for increasing bottom-line hospital performance, thereby attaining competitive advantage.

A systematic interdisciplinary literature review motivated by resource advantage theory (RAT) offers a conceptual foundation for analyzing the financial, informational and physical workflows that are core elements of supply chain management in a hospital.

RAT links how EHR impacts profitability, competitive advantage and macromarketing factors in hospital supply chains. The literature review provides a research synthesis of the implementation and adoption of EHR to reveal its impact on a hospital’s competitive advantage. Although legislative initiatives like the 2009 Health Information Technology for Economic and Clinical Health Act and the Affordable Care Act encourage EHR adoption, there remains a reluctance for hospitals to do so.

The extant literature precedes the relevant legislation, has incomplete data or focuses solely on patient outcomes.

This chapter discusses the potential role of geographic information systems (GIS) for infection control within the hospital system. The chapter provides a brief overview of the role of GIS in public health and reviews current work applying these methods to the hospital setting. Finally, it outlines the potential opportunities and challenges for adapting GIS for use in the hospital setting for infection prevention. A targeted literature review is used to illustrate current use of GIS in the hospital setting. The discussion of complexity was compiled using the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework. Challenges and opportunities were then extracted from this exercise by the authors. There are multiple challenges to implementation of a Hospital GIS for infection prevention, mainly involving the domains of technology, organization, and adaptation. Use of a transdisciplinary approach can address many of these challenges. More research, specifically prospective, reproducible clinical trials, needs to be done to better assess the potential impact and effectiveness of a Hospital GIS in real-world settings. This chapter highlights a powerful but rarely used tool for infection prevention within the hospital. Given the importance of reducing hospital-acquired infection rates, it is vital to identify relevant methods from other fields that could be translated into the field of hospital epidemiology.