International Journal of Healthcare Technology and Management (8 papers in press)
Emerging product-process archetypes in oncology: informing the sustainable provision of next-generation medicines
by Tomás S. Harrington, Jagjit Singh Srai, Ismail Najim
Abstract: The emergence of more targeted molecular therapies has contributed to accelerated growth within the oncology market, with forecast spends expected to be in the range of $74-84 billion by 2018. Coupled with its many specificities around pricing, insurance implications, and ethics, we argue that the oncology segment may best inform future pharmaceutical value network design characteristics. Through exploration of future state scenarios and opportunity areas, driven by the adoption of emerging process and digital technologies, a base framework is extended to enable a systematic assessment of candidates representative of the wider oncology market. These include niche, low volume drugs on-patent, through to higher volume generics with a history of supply shortages. Oncology archetypes are proposed classified as New Niche, Old Niche and Established Generics matching emerging process capabilities to future adaptive supply requirements, informing the potential for economies of drug repurposing, and associated models for reconfiguration based on benefits clustering.
Keywords: pharmaceuticals; oncology; value networks; sustainable industrial systems; futures.
Enhancing healthcare value by applying proactive measures: the role for business analytics and intelligence
by Nilmini Wickramasinghe, Jonathan Schaffer
Abstract: Healthcare is one of the most data-rich and data-generating industries. Yet, these data tend to be discontinuous, incomplete, lacking standardisation, or even erroneous and unusable. Pressure is increasing for healthcare organisations to provide increased value by improving health outcomes at a lower cost. In order to address these challenges, business analytics and intelligence (BA/BI) are critical strategic tools used to methodically analyse the wealth of seemingly disparate healthcare data sets and provide enhancement of healthcares overall performance through data-driven decision making. For acute and chronic oncology care processes, these pressures are mounting given the rising costs and increasingly complicated processes under the rising numbers and ages of the population. Given these pressures to improve healthcare value, this study proposes a systematic framework for the application of business analytics at one of the largest tertiary hospitals in Melbourne, Australia, in the quest for optimising healthcare.
Keywords: business analytics; business intelligence; clinical decision making; real-time analytics; evidence-based decisions; cancer treatment; oncology; action research methodology.
Rescheduling nursing staff with information technologybased staffing solutions: a scoping review
by Outi Tuominen, Sirkku Boucht, Helja Lundgren-laine, Mervi Flinkman, Sanna Salantera
Abstract: Rescheduling to cover the sudden absences of nursing staff members is a time-consuming part of a nurse managers daily work. The use of information technology-based (IT-based) staffing solutions is a potential solution to this issue. In order to address this challenge and improve the rescheduling process, this scoping review was created to identify, describe and analyse published papers focused on nursing staff rescheduling. The papers were analysed from the perspectives of nursing staff, patient care and organisational outcomes in hospital settings. The results showed that using IT-based staffing solutions for rescheduling can reduce both organisations staffing costs and nurse managers work tasks. Patient care consequences related to such solutions were not described in the reviewed papers. However, floating may also have an impact on the quality of patient care owing to the mixing of nursing staff members professional roles and skills. There is also a need for additional information about the usability of IT-based staffing solutions.
Keywords: personnel staffing and scheduling; rescheduling; nursing staff; management; hospital; rescheduling outcomes; information technology-based staffing solutions; scoping review.
The role of internet-based healthcare services in the healthcare process: the example of a Hungarian health portal
by Attila Bán, Viktor Pál, György Vida, Gábor Dudás
Abstract: E-health plays an increasingly important role in healthcare since it can improve the access to health information. In this article, we are seeking to answer the following questions with respect to online health services: To what extent can they reduce the workload of healthcare professionals in the healthcare system? What kind of health benefits can e-health produce for patients? In our study, we conducted a content analysis based on the doctor answers columns of a Hungarian online health portal. We examined the direct and indirect references to two indicators (seeing the doctor, therapeutic advice) in the responses in relation to 10 disease groups. Our results suggest that online health portals can moderately reduce the workload of healthcare professionals and at the same time they can produce considerable health gain for patients.
Keywords: e-health; cross-tabulation analysis; content analysis; health portal; website of WEBBeteg.
Food waste in hospitals: a review
by Fadhel Alshqaqeeq, Janet Twomey, Michael Overcash
Abstract: Uneaten food, whether by patients or unserved, is considered food waste. Plate waste is the remaining, uneaten food after being served to patients in the hospital. The uneaten food has a cascading environmental impact on increasing the amount of food grown or raised, energy in transport of food to hospitals, and impact of methane and carbon dioxide from landfilling the uneaten food. Food waste has been measured either by weight or visual estimation. About 500 hospitals world-wide have had food waste studies and about half are in Europe. This study is the first to quantify the limited data on different strategies for improving food waste results. There were 92 studies that documented improvement of food waste, with the single biggest change being tailoring the food choice to the individual patient's desire for food. Unserved food waste was not considered in this review.
Keywords: hospitals; food waste; plate waste; food system improvement.
Service quality in private hospitals of Jammu and Kashmir: an empirical assessment from the district of Srinagar
by Shahid Hamid Raina, R.L. Bhat, Khursheed Hussain Dar
Abstract: The growing middle class, increased health consciousness and inadequate public health facilities have led to an enormous growth of the private healthcare sector in India. There is a general notion that private hospitals provide better service quality than public hospitals, which has also been upheld by various studies across the globe. However, given the poor condition of public hospitals in India, their service quality cannot serve as a benchmark for private hospitals. The aim of the present study is to evaluate the service quality of private hospitals in Srinagar District of India from the perspective of outpatients. The study has used the SERVQUAL model to determine the overall service quality and gaps between perceptions and expectations of outpatients regarding service quality attributes in sample private hospitals. A cross-sectional study has been done during December 2015 in Srinagar District of India. The sample consisted of 100 outpatients selected purposively from six private hospitals. The gaps in service quality were determined by subtracting the expectations of outpatients from their perceptions. The statistical significance of differences in mean perceptions and mean expectations of sample outpatients was tested by employing a dependent sample t-test. The results revealed that there existed a statistically significant difference between total mean perceptions and total mean expectations of patients across all the dimensions and variables of healthcare service quality (p<0.05) except for three variables (hospital being visually appealing; floor being clean; and, the hospital having regular water supply). The overall service quality of -1.22 implies that the private hospitals in Srinagar District are far from meeting the expectations of patients. Also, the difference between mean expectations and perceptions regarding service quality across gender and education levels was found to be statistically significant (p<0.05). The limitations of the present study include a smaller sample size; only one type of patients (outpatients) as respondents; and, consideration of functional service quality only.
Keywords: healthcare; SERVQUAL; private hospitals; service quality; expectations; perceptions; gap scores.
Stakeholder identification and salience in purchasing: an empirical study from UK hospitals
by Christos Papanagnou, Pearce Madhlambudzi
Abstract: The lack of systematic processes for stakeholder identification and the omission of key stakeholders in UK hospitals cause significant delays in purchasing processes. This is reinforced by the strict tender processes that follow in making their purchases as a matter of assurance of fairness and competition. This paper presents a descriptive analysis of decision-making processes when the public hospitals purchase diagnostic equipment and discovers how the hospitals use stakeholder identification and salience during the purchase of diagnostic equipment. With the aid of purposeful case studies and semi-structured interviews, we explore how stakeholder salience is concentrated on the administrative personnel who have the role to implement organisational policy, and technical experts who make sure that the right equipment is bought. Lastly, this study provides an insight into how stakeholder groups share the premises of the public hospitals decision-making processes by considering the attributes of power, urgency, legitimacy, and proximity.
Keywords: purchasing; procurement; stakeholder identification; stakeholder salience; United Kingdom; healthcare economics and management; NHS Trust; hospital management; decision-making; diagnostic equipment; semi-structured interviews.
Physicians' perceptions of electronic medical records: the impact of system service quality, and generation/experience gaps
by Shin-Yuan Hung, Makoto Nakayama, Charlie Chen, Fang-Lan Tsai
Abstract: Electronic Medical Record (EMR) systems are complex, organisation-wide information systems involving stakeholders in various medical fields and responsibilities. Assessing the usefulness of EMR, therefore, is not straightforward. Using SERVQUAL, this study assesses the relationship between perceived EMR service quality and the perceived usefulness (subjective belief), expectation (judgment), and satisfaction (affect) of EMR systems. Data were obtained from 338 physicians in 10 medical centres and 15 regional hospitals in Taiwan. The results show that physicians perceived EMR service quality has a much stronger effect on non-affect outcomes than on an affect-based antecedent like satisfaction. Owing to the complexity of EMRs, a beneficial assessment of EMRs requires the clinical experience of individual physicians and an organisational perspective on how EMRs facilitate their tasks.
Keywords: electronic medical record systems; SERVQUAL; continuance intention; beneficial assessment of EMRs; subjective belief; non-affect outcomes.