Search results
21 – 30 of over 5000Kaija Collin, Sanna Herranen, Ulla Maija Valleala and Susanna Paloniemi
The purpose of this paper is to explore interprofessional collaboration during ward rounds on a Finnish emergency and infection ward from the viewpoint of three central…
Abstract
Purpose
The purpose of this paper is to explore interprofessional collaboration during ward rounds on a Finnish emergency and infection ward from the viewpoint of three central professional groups: physicians, nurses and secretaries.
Design/methodology/approach
The authors utilise an ethnographically informed approach, with observations and interviews as the data collection devices. The data comprise ten interviews with staff members and ten hours of observations. The data were analysed using qualitative thematic analysis.
Findings
The ward rounds were found to be rather physician- and medicine-centred, and mostly not interprofessional. Nurses and secretaries in particular expressed dissatisfaction with many of the current ward rounds work practices. Ward rounds are an essential part of collaboration in implementing the emergency-natured operational aim of the ward, yet we found that the ward rounds are complicated by diverging professional views and expectations, variable work practices and interactional inequality.
Originality/value
This study makes a contribution to the research of collaboration in emergency care and ward rounds, both of which are little-studied fields. Further, context-specific studies of collaboration have been called for in order to eventually create a model of shared expertise. The findings of this study can be utilised in studying and developing emergency care contexts.
Details
Keywords
Kudret Demirli, Abdulqader Al Kaf, Mecit Can Emre Simsekler, Raja Jayaraman, Mumtaz Jamshed Khan and E. Murat Tuzcu
Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The purpose…
Abstract
Purpose
Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The purpose of this study is to identify opportunities to reduce waiting time using lean techniques and discrete-event simulation (DES).
Design/methodology/approach
A five-step procedure is proposed to facilitate the effective utilization of lean and DES to improve the performance of the Otolaryngology Head and Neck Surgery Outpatient Clinic at Cleveland Clinic Abu Dhabi. While lean techniques were applied to reduce the potential sources of waste by aligning processes, a DES model was developed to validate the proposed solutions and plan patient arrivals under dynamic conditions and different scenarios.
Findings
Aligning processes resulted in an efficient patient flow reducing both waiting times. DES played a complementary role in verifying lean solutions under dynamic conditions, helping to plan the patient arrivals and striking a balance between the waiting times. The proposed solutions offered flexibility to improve the clinic capacity from the current 176 patients up to 479 (without violating the 30 min waiting time policy) or to reduce the patient waiting time during the visit from the current 33 min to 4.5 min (without violating the capacity goal of 333 patients).
Research limitations/implications
Proposing and validating lean solutions require reliable data to be collected from the clinic and such a process could be laborious as data collection require patient and resource tracing without interfering with the regular functions of the clinic.
Practical implications
The work enables health-care managers to conveniently conduct a trade-off analysis and choose a suitable inter-arrival time – for every physician – that would satisfy their objectives between resource utilization (clinic capacity) and average patient waiting time.
Social implications
Successful implementation of lean requires a supportive and cooperative culture from all stakeholders involved.
Originality/value
This study presents an original and detailed application of lean techniques with DES to reduce patient waiting times. The adopted approach in this study could be generalized to other health-care settings with similar objectives.
Details
Keywords
Vaidik Bhatt and Samyadip Chakraborty
The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to…
Abstract
Purpose
The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition.
Design/methodology/approach
The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process.
Findings
This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery.
Research limitations/implications
The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest.
Practical implications
The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory.
Originality/value
The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.
Details
Keywords
To sustain competitive advantage, it is necessary to understand consumers and their psychological fears and deliver them a service solution which is best under existing conditions…
Abstract
Purpose
To sustain competitive advantage, it is necessary to understand consumers and their psychological fears and deliver them a service solution which is best under existing conditions so as to ensure consumer loyalty and retention. This paper seeks to conceptualise and operationalise customer relationship management (CRM) through two component model (operational CRM (OCRM) and analytical CRM (ACRM)), particularly in the healthcare sector.
Design/methodology/approach
The relationship between OCRM, based on three patient‐staff constructs (physicians, nurses and support staff) and ACRM based on four constructs (satisfaction, repatronization, recommendation and organizational performance) was analysed using confirmatory factor analysis (AMOS). The data for the model were collected from 306 indoor patients of three large public hospitals who have been associated with the hospital for at least five years.
Findings
The model portraying service quality as an antecedent to OCRM is found to be acceptable whereas the other two models, namely, service quality as the moderating variable in explaining OCRM and ACRM relationship effectively and direct relationship between OCRM (service quality implicit) and OCRM) were rejected. Characteristics, primarily caring attitude, friendliness, helpfulness, response to queries, expertise and effective treatment are found to be significant for OCRM from physicians, nurses and support staff perspectives that can impact the four ACRM dimensions – satisfaction, repatronization, recommendation and organizational performance.
Originality/value
The study contributes to the current understanding of CRM in particular and consumer behaviour in general, in the context of the healthcare sector. The role of service quality in influencing patient‐staff interaction and CRM linkage with the service dominant concept has added more strength to the conceptual development of TCRM.
Details
Keywords
With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to grow…
Abstract
With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to grow, prescription drugs will continue to be a critical part of the larger health care industry. This chapter presents a survey on the economics of the US pharmaceutical industry, with a focus on the role of R&D and marketing, the determinants (and complications) of prescription drug pricing, and various aspects of consumer behavior specific to this industry, such as prescription drug regulation, the patient's interaction with the physician, and insurance coverage. This chapter also provides background in areas not often considered in the economics literature, such as the role of pharmacy benefit managers in prescription drug prices and the differentiation between alternative measures of prescription drug prices.
Details
Keywords
- Abbreviated New Drug Application (ANDA)
- Average Manufacturer Price (AMP)
- Average Wholesale Price (AWP)
- Bayh-Dole Act
- Bioequivalence
- Brand name drug
- Center for Medicare and Medicaid Services (CMS)
- Chain pharmacy
- Clinical trials
- Closed formulary
- Coinsurance
- Compliance
- Co-payment
- Cost controls
- Cost sharing
- Detailing
- Direct-to-consumer Advertising (DTC Advertising)
- Disease management
- Drug manufacturers
- Drug prices
- Drug–product substitution
- Experience goods
- Fee-for-service (FFS)
- First-mover advantage
- Food and Drug Administration (FDA)
- Formulary
- Generic drug
- Good Manufacturing Processes (GMP)
- Hatch-Waxman Act
- Health plan
- Insurance
- Investigational New Drug Application (IND)
- Mail-order pharmacy
- Mail-order prescription drugs
- Medicaid
- Medicare
- Medicare+Choice (M+C)
- Medicare Advantage
- Medicare Modernization Act (MMA)
- Medicare Part D
- Moral hazard
- Negative goods
- New Drug Application (NDA)
- Non-retail pharmacy
- Original Medicare
- Out-of-pocket
- Paid search advertising
- Patent
- Patient
- Pharmaceutical
- Pharmacy
- Pharmacy benefit manager (PBM)
- Physician
- Prescription drugs
- Product differentiation
- Rebate
- Reimbursement
- Research and development (R&D)
- Retail pharmacy
- Search costs
- Switching costs
- Therapeutic class
- Third-party insurance
- Tiered formulary
- Wholesale Acquisition Price (WAC)
- Wholesaler
Peng Ouyang, Jian-Jun Wang and Usman Ali
Gamification has been widely implemented to improve user engagement in the online health community (OHC). While its effect on the physicians' engagement has recently been…
Abstract
Purpose
Gamification has been widely implemented to improve user engagement in the online health community (OHC). While its effect on the physicians' engagement has recently been documented, whether and how gamification influences the patients' engagement in the OHC remains an untapped research area. The purpose of this study is to fill this dearth by encompassing the gamification strategy of Haodf.com, which awards the “Annual Physician” badges to the physicians, to analyze how this gamification approach motivates patients’ engagement in the OHC.
Design/methodology/approach
Real-world data are leveraged from the OHC. The Tobit model is employed for modeling the gamification-patient's engagement nexus in an OHC. Robust findings are obtained by incorporating different measures of a dependent variable, a set of control variables about the physician's characteristics and hospital's features, and alternative estimation techniques.
Findings
The results reveal that a patient's engagement in the OHC in the form of appointments and review-posting behavior is enhanced by the gamification strategy. Besides, the positive influence of gamification on the patient's engagement is further strengthened by the physician's professional capital. It is basically obtained that the gamification is an efficacious tool to accelerate not only the physicians' engagement but also of the patients in the OHC platform.
Originality/value
The study provides both theoretical and empirical discussion to enrich the understanding on how OHCs enhance patients' engagement by developing gamification techniques. The findings guide the practitioners of OHC to better understand the implications of their gamification design to optimize user engagement.
Details
Keywords
Faleh Alshameri, Debra Hockenberry and Robert B. Doll
This paper aims to, by looking at the electronic medical record (EMR) from three points of view, bring light to the dynamics that are essential and are currently missing in the…
Abstract
Purpose
This paper aims to, by looking at the electronic medical record (EMR) from three points of view, bring light to the dynamics that are essential and are currently missing in the USA. The traditional paper medical record has worked for physicians, management and patients since the beginning of practice. Yet the development of the EMR did not begin with all the essential elements of the traditional record that were working, but instead shreds out important aspects of the patient.
Design/methodology/approach
Triangulation between three studies – medical, information technology and management studies.
Findings
An efficient EMR has to take into consideration more than just one area of study. The dynamics between departments and users of the EMR need an integrated process that includes the necessary pieces of all involved. This hole has not been addressed in academic literature.
Research limitations/implications
The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.
Practical implications
There is a depth, space and volume crucial to the comprehensive nature of medicine. With a perspective or dimension, necessary dialogues can be addressed and more intuitive tacit knowledge from medical expertise can be made available. A prototype, filling the holes of the observed elements in this paper, is possible by using digital objects and including more information than the data of the day. Bringing accountability to the patient, more expertise to the fingertips of the physician and available data for management purposes area are the key ingredients for an effective EMR.
Social implications
With a comprehensive EMR that works more effectively for those who input the data, the patient’s story can be documented with more detailed efficiency. Filling the holes of the observed elements in this paper all support better healthcare and long-term results for the health of society.
Originality/value
The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.
Details
Keywords
Vinayak Ram Tripathi, Manish Popli, Swati Ghulyani, Shrey Desai and Ajai Gaur
This paper aims to examine the role of information and communication technology (ICT) in the knowledge creation practices adopted by a health care organization. The organization…
Abstract
Purpose
This paper aims to examine the role of information and communication technology (ICT) in the knowledge creation practices adopted by a health care organization. The organization is delivering care to patients of a genetic disorder, called the sickle cell, in tribal communities. The paper identifies how ICT intermediates knowledge creation practices across the organizational boundaries wherein tribal patients, front-line counselors and expert physicians interact, which then produces context-specific, evidence-based medicine (EBM).
Design/methodology/approach
The knowledge-in-practice approach is adopted to conduct an ethnographic study of sickle cell care practices in a non-profit health care organization in Western India. The analysis focuses on ICT-mediated interactional practices among the physicians, front-line counselors, tribal patients and their families, for more than a year-long observation. These are supplemented with informal and formal interviews, archival records and vignettes based on several episodes to explicate the key knowledge creation practices.
Findings
Technology-mediated informative interactions at organizational boundaries can bridge socio-linguistic and interpretive barriers between actors, while also providing a generative structure that leads to the creation of longitudinal clinical evidence about a rare genetic disorder. Three specific ICT-entwined knowledge creation practices emerge, namely, knowing the community, increasing interactional engagement and constructing gradients of socio-clinical history. These practices generate organization-wide knowledge about the social and clinical dimensions of the genetic disorder. The findings are presented through vignettes and a novel conceptual framework.
Research limitations/implications
This study identifies various useful knowledge creation practices in health care delivery for resource-constrained emerging economy contexts. Further, the study suggests that the involvement of local front-line actors and ICT can become important resources in the delivery of health care in these settings.
Originality/value
A novel framework is developed which demonstrates knowledge creation at organizational boundaries wherein the actors use ICT-based practices for effective delivery of health care. The proposed framework may be used by health care organizations in similar contexts providing care to marginalized communities.
Details
Keywords
The significance of physician-user interaction has been widely acknowledged in offline and online healthcare consultation. However, limited attempts have been made to explore the…
Abstract
Purpose
The significance of physician-user interaction has been widely acknowledged in offline and online healthcare consultation. However, limited attempts have been made to explore the influence of physician-user interaction on users' perceived service quality (PSQ) in the mobile context. Based on the literature on physician-user interaction and media synchronicity theory, this study proposes a theoretical model where the interactive factors common across the offline, online and mobile context, i.e. physicians' informational support and emotional support, the interactive factors unique in the mobile context, i.e. physicians' response speed and voice service, and the interaction between the two categories of interactive factors predict users' PSQ in mobile consultation.
Design/methodology/approach
This study collects consultation records between 25,225 users and 738 physicians from a leading Chinese mobile consultation application, and employs linear regression to verify the proposed theoretical model.
Findings
Physicians' informational, emotional support, response speed and voice service are found to have significant positive impacts on users' PSQ. Besides, physicians' response speed strengthens the positive impacts of physicians' informational and emotional support on users' PSQ, while physicians' voice service weakens the positive link between physicians' informational support on users' PSQ.
Originality/value
This study contributes to the antecedents for users' PSQ in mobile consultation by identifying unique interactive factors in the mobile context, and highlighting the individual and interaction effects of different physician-user interactive factors. Besides, this study employs novel methods, which leverages text classification and text pattern recognition to more accurately depict physicians' online behaviors based on objective communication records.
Details