Proceedings of the 51st Hawaii International Conference on System Sciences, 2018
Despite the widespread use of techniques and tools for causal analysis, existing methodologies st... more Despite the widespread use of techniques and tools for causal analysis, existing methodologies still fall short as they largely regard causal variables as independent elements, thereby failing to appreciate the significance of the interactions of causal variables. The prospect of inferring causal relationships from weaker structural assumptions compels for further research in this area. This study explores the effects of the interactions of variables in the context of causal analysis, and introduces new advancements to this area of research. In this study, we introduce a new approach for the causal complexity with the goal of making the solution set closer to deterministic by taking into consideration the underlying patterns embedded within a dataset; in particular, the interactions of causal variables. Our model follows the configurational approach, and as such, is able to account for the three major phenomena of conjunctural causation, equifinality, and causal asymmetry.
In the study of IT business value (ITBV), the notion of complementarities has been used to explai... more In the study of IT business value (ITBV), the notion of complementarities has been used to explain why firms with similar level of IT investments have received varying level of returns. Complementarities suggest that greater business value can be derived when IT investment is accompanied by other complementary organizational investments. This paper introduces a novel analytical approach called fuzzy set Qualitative Comparative Analysis (fsQCA). The method is based on principles of comparison used in the field of social and political science, and can be applied to explain the complex causality of IT business value. We have found that fsQCA was able to show that organizational factors in complex configurations may play different roles as core and periphery factors in affecting organizational performance. Such organizational practices have often been overlooked in many empirical studies but can play a non-trivial role in the organizational processes.
International Journal of Environmental Research and Public Health
Background: Standard precautions prevent the spread of infections in healthcare settings. Incompl... more Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the responde...
e19200 Background: While multidisciplinary teams (MDTs) are considered the “gold standard” of car... more e19200 Background: While multidisciplinary teams (MDTs) are considered the “gold standard” of care for cancer patients, their performance varies widely. This study aimed to develop a user friendly, reliable and valid self-assessment tool for MDTs to evaluate their performance and monitor improvement over time. Methods: Using maturity modelling methodology, key themes from the literature were developed into a 2-dimensional matrix comprising 17 indicators (within 6 components) across 5 levels of performance. A modified Delphi methodology (where 38 MDT members each assigned the contents to components and performance levels using card sorting software) was used to establish face and content validity. A 10 minute on-line version of the matrix was piloted across 11 MDTs. Each participant estimated where they thought the MDT performed for each indicator. Correlation and factor analyses examining convergent and discriminant validity were conducted using SPSS. Cronbach alpha was used to meas...
BACKGROUND Digital health is an important part of the future of health care, prevention and manag... more BACKGROUND Digital health is an important part of the future of health care, prevention and management of disease and innovative monitoring solutions. With an aging population and rising health related costs, digital health is an essential part of the solution, alongside the emerging big data and associated analytics. To varying extents, digital health and big data are present worldwide. However, consistency in terminology, regulation and implementation differ. As an international network of interdisciplinary experts we review and discuss the digital health and big data landscape. OBJECTIVE We firstly identify current challenges and solutions in digital health development, research, deployment in the management of non-communicable disease and regulation and then go on to establish an ongoing and international collaboration of multidisciplinary researchers and educators; creating opportunities for research and education. METHODS The Digital Health Research Network was established usi...
Background: Traditional implementations of electronic medication management (EMM) systems have in... more Background: Traditional implementations of electronic medication management (EMM) systems have involved two common formats – a ‘big bang’ approach on the day of go-live, or a phased ward-by-ward approach over months.Objective: To describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM.Method: This model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED). The tenet of ‘one patient, one chart’ was maintained with new patients commenced on EMM, while existing inpatients were maintained on paper charts until their discharge. In the second week, all other intake points commenced patients on EMM, and in the third week, all remaining patients were manually converted to EMM. The implementation was assessed with training completion rates, staff satisfaction surveys, focus group interviews and incident logs.Results: At go-live, 79% of doctors, ...
Exploring relationships between admission variables and outcome using regression models has been ... more Exploring relationships between admission variables and outcome using regression models has been the focus of Traumatic Brain Injury (TBI) research. Although practical and well established, these approaches do not evaluate interactions between predictors. We therefore applied a set-theoretic logical analysis to the Corticosteroid Randomization after Significant Head Injury (CRASH) trial database. Complete data analysis of 6945 patients demonstrated 9 different configurations of admission variables were sufficient for favorable outcome in 87.5% of all cases and explained 57% of favorable outcomes (moderate disability or good outcome). We also evaluated the contrasting configurations for unfavorable versus favorable outcome. Results are largely in line with findings of previous studies however the influence of age fell behind GCS components, which is unexpected. Specifying a combination of admission parameters that are likely to translate into a given clinical outcome is appealing fro...
Despite the shift towards collaborative healthcare and the increase in the use of eHealth technol... more Despite the shift towards collaborative healthcare and the increase in the use of eHealth technologies, there does not currently exist a model for the measurement of eHealth readiness in interdisciplinary healthcare teams. This research aims to address this gap in the literature through the development of a three phase methodology incorporating qualitative and quantitative methods. We propose a conceptual measurement model consisting of operationalized themes affecting readiness across four factors: (i) Organizational Capabilities, (ii) Team Capabilities, (iii) Patient Capabilities, and (iv) Technology Capabilities. The creation of this model will allow for the measurement of the readiness of interdisciplinary healthcare teams to use eHealth technologies to improve patient outcomes.
Studies in health technology and informatics, 2017
An aging population and the expectation of premium quality health services combined with the incr... more An aging population and the expectation of premium quality health services combined with the increasing economic burden of the healthcare system requires a paradigm shift toward patient oriented healthcare. The guardian angel theory described by Szolovits [1] explores the notion of enlisting patients as primary providers of information and motivation to patients with similar clinical history through social connections. In this study, an agent based model was developed to simulate to explore how individuals are affected through their levels of intrinsic positivity. Ring, point-to-point (paired buddy), and random networks were modelled, with individuals able to send messages to each other given their levels of variables positivity and motivation. Of the 3 modelled networks it is apparent that the ring network provides the most equal, collective improvement in positivity and motivation for all users. Further study into other network topologies should be undertaken in the future.
Studies in health technology and informatics, 2017
The use of information technology in the delivery of healthcare services is pervasive but faces m... more The use of information technology in the delivery of healthcare services is pervasive but faces many barriers. We propose a four-factor comprehensive conceptual model to provide a measure of interdisciplinary healthcare readiness to provide healthcare services using e-health. We incorporate factors from a series of focus group studies and the wider literature and construct a conceptual model. We utilise the Delphi method to establish content validity and use a series of Q sorts for initial construct validity. This model will improve patient outcomes through healthcare teams identifying barriers to using e-health effectively and efficiently.
Studies in health technology and informatics, 2017
The complex relations between Health Technologies and clinical practices have been the focus of i... more The complex relations between Health Technologies and clinical practices have been the focus of intensive research in recent years. This research represents a shift towards a holistic view where evaluation of health technologies is linked to organisational practices. In this paper, we address the gaps in existing literature regarding the holistic evaluation of e-health in clinical practice. We report the results from a qualitative study conducted to gain insight into e-health in practice within an interdisciplinary healthcare domain. Findings from this qualitative study, provides the foundation for the creation of a generic measurement model that allows for the comparative analysis of health technologies and assist in the decision-making of its stakeholders.
Studies in health technology and informatics, 2016
To develop and test an optimal ensemble configuration of two complementary probabilistic data mat... more To develop and test an optimal ensemble configuration of two complementary probabilistic data matching techniques namely Fellegi-Sunter (FS) and Jaro-Wrinkler (JW) with the goal of improving record matching accuracy. Experiments and comparative analyses were carried out to compare matching performance amongst the ensemble configurations combining FS and JW against the two techniques independently. Our results show that an improvement can be achieved when FS technique is applied to the remaining unsure and unmatched records after the JW technique has been applied. Whilst all data matching techniques rely on the quality of a diverse set of demographic data, FS technique focuses on the aggregating matching accuracy from a number of useful variables and JW looks closer into matching the data content (spelling in this case) of each field. Hence, these two techniques are shown to be complementary. In addition, the sequence of applying these two techniques is critical. We have demonstrated...
Proceedings of the 51st Hawaii International Conference on System Sciences, 2018
Despite the widespread use of techniques and tools for causal analysis, existing methodologies st... more Despite the widespread use of techniques and tools for causal analysis, existing methodologies still fall short as they largely regard causal variables as independent elements, thereby failing to appreciate the significance of the interactions of causal variables. The prospect of inferring causal relationships from weaker structural assumptions compels for further research in this area. This study explores the effects of the interactions of variables in the context of causal analysis, and introduces new advancements to this area of research. In this study, we introduce a new approach for the causal complexity with the goal of making the solution set closer to deterministic by taking into consideration the underlying patterns embedded within a dataset; in particular, the interactions of causal variables. Our model follows the configurational approach, and as such, is able to account for the three major phenomena of conjunctural causation, equifinality, and causal asymmetry.
In the study of IT business value (ITBV), the notion of complementarities has been used to explai... more In the study of IT business value (ITBV), the notion of complementarities has been used to explain why firms with similar level of IT investments have received varying level of returns. Complementarities suggest that greater business value can be derived when IT investment is accompanied by other complementary organizational investments. This paper introduces a novel analytical approach called fuzzy set Qualitative Comparative Analysis (fsQCA). The method is based on principles of comparison used in the field of social and political science, and can be applied to explain the complex causality of IT business value. We have found that fsQCA was able to show that organizational factors in complex configurations may play different roles as core and periphery factors in affecting organizational performance. Such organizational practices have often been overlooked in many empirical studies but can play a non-trivial role in the organizational processes.
International Journal of Environmental Research and Public Health
Background: Standard precautions prevent the spread of infections in healthcare settings. Incompl... more Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the responde...
e19200 Background: While multidisciplinary teams (MDTs) are considered the “gold standard” of car... more e19200 Background: While multidisciplinary teams (MDTs) are considered the “gold standard” of care for cancer patients, their performance varies widely. This study aimed to develop a user friendly, reliable and valid self-assessment tool for MDTs to evaluate their performance and monitor improvement over time. Methods: Using maturity modelling methodology, key themes from the literature were developed into a 2-dimensional matrix comprising 17 indicators (within 6 components) across 5 levels of performance. A modified Delphi methodology (where 38 MDT members each assigned the contents to components and performance levels using card sorting software) was used to establish face and content validity. A 10 minute on-line version of the matrix was piloted across 11 MDTs. Each participant estimated where they thought the MDT performed for each indicator. Correlation and factor analyses examining convergent and discriminant validity were conducted using SPSS. Cronbach alpha was used to meas...
BACKGROUND Digital health is an important part of the future of health care, prevention and manag... more BACKGROUND Digital health is an important part of the future of health care, prevention and management of disease and innovative monitoring solutions. With an aging population and rising health related costs, digital health is an essential part of the solution, alongside the emerging big data and associated analytics. To varying extents, digital health and big data are present worldwide. However, consistency in terminology, regulation and implementation differ. As an international network of interdisciplinary experts we review and discuss the digital health and big data landscape. OBJECTIVE We firstly identify current challenges and solutions in digital health development, research, deployment in the management of non-communicable disease and regulation and then go on to establish an ongoing and international collaboration of multidisciplinary researchers and educators; creating opportunities for research and education. METHODS The Digital Health Research Network was established usi...
Background: Traditional implementations of electronic medication management (EMM) systems have in... more Background: Traditional implementations of electronic medication management (EMM) systems have involved two common formats – a ‘big bang’ approach on the day of go-live, or a phased ward-by-ward approach over months.Objective: To describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM.Method: This model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED). The tenet of ‘one patient, one chart’ was maintained with new patients commenced on EMM, while existing inpatients were maintained on paper charts until their discharge. In the second week, all other intake points commenced patients on EMM, and in the third week, all remaining patients were manually converted to EMM. The implementation was assessed with training completion rates, staff satisfaction surveys, focus group interviews and incident logs.Results: At go-live, 79% of doctors, ...
Exploring relationships between admission variables and outcome using regression models has been ... more Exploring relationships between admission variables and outcome using regression models has been the focus of Traumatic Brain Injury (TBI) research. Although practical and well established, these approaches do not evaluate interactions between predictors. We therefore applied a set-theoretic logical analysis to the Corticosteroid Randomization after Significant Head Injury (CRASH) trial database. Complete data analysis of 6945 patients demonstrated 9 different configurations of admission variables were sufficient for favorable outcome in 87.5% of all cases and explained 57% of favorable outcomes (moderate disability or good outcome). We also evaluated the contrasting configurations for unfavorable versus favorable outcome. Results are largely in line with findings of previous studies however the influence of age fell behind GCS components, which is unexpected. Specifying a combination of admission parameters that are likely to translate into a given clinical outcome is appealing fro...
Despite the shift towards collaborative healthcare and the increase in the use of eHealth technol... more Despite the shift towards collaborative healthcare and the increase in the use of eHealth technologies, there does not currently exist a model for the measurement of eHealth readiness in interdisciplinary healthcare teams. This research aims to address this gap in the literature through the development of a three phase methodology incorporating qualitative and quantitative methods. We propose a conceptual measurement model consisting of operationalized themes affecting readiness across four factors: (i) Organizational Capabilities, (ii) Team Capabilities, (iii) Patient Capabilities, and (iv) Technology Capabilities. The creation of this model will allow for the measurement of the readiness of interdisciplinary healthcare teams to use eHealth technologies to improve patient outcomes.
Studies in health technology and informatics, 2017
An aging population and the expectation of premium quality health services combined with the incr... more An aging population and the expectation of premium quality health services combined with the increasing economic burden of the healthcare system requires a paradigm shift toward patient oriented healthcare. The guardian angel theory described by Szolovits [1] explores the notion of enlisting patients as primary providers of information and motivation to patients with similar clinical history through social connections. In this study, an agent based model was developed to simulate to explore how individuals are affected through their levels of intrinsic positivity. Ring, point-to-point (paired buddy), and random networks were modelled, with individuals able to send messages to each other given their levels of variables positivity and motivation. Of the 3 modelled networks it is apparent that the ring network provides the most equal, collective improvement in positivity and motivation for all users. Further study into other network topologies should be undertaken in the future.
Studies in health technology and informatics, 2017
The use of information technology in the delivery of healthcare services is pervasive but faces m... more The use of information technology in the delivery of healthcare services is pervasive but faces many barriers. We propose a four-factor comprehensive conceptual model to provide a measure of interdisciplinary healthcare readiness to provide healthcare services using e-health. We incorporate factors from a series of focus group studies and the wider literature and construct a conceptual model. We utilise the Delphi method to establish content validity and use a series of Q sorts for initial construct validity. This model will improve patient outcomes through healthcare teams identifying barriers to using e-health effectively and efficiently.
Studies in health technology and informatics, 2017
The complex relations between Health Technologies and clinical practices have been the focus of i... more The complex relations between Health Technologies and clinical practices have been the focus of intensive research in recent years. This research represents a shift towards a holistic view where evaluation of health technologies is linked to organisational practices. In this paper, we address the gaps in existing literature regarding the holistic evaluation of e-health in clinical practice. We report the results from a qualitative study conducted to gain insight into e-health in practice within an interdisciplinary healthcare domain. Findings from this qualitative study, provides the foundation for the creation of a generic measurement model that allows for the comparative analysis of health technologies and assist in the decision-making of its stakeholders.
Studies in health technology and informatics, 2016
To develop and test an optimal ensemble configuration of two complementary probabilistic data mat... more To develop and test an optimal ensemble configuration of two complementary probabilistic data matching techniques namely Fellegi-Sunter (FS) and Jaro-Wrinkler (JW) with the goal of improving record matching accuracy. Experiments and comparative analyses were carried out to compare matching performance amongst the ensemble configurations combining FS and JW against the two techniques independently. Our results show that an improvement can be achieved when FS technique is applied to the remaining unsure and unmatched records after the JW technique has been applied. Whilst all data matching techniques rely on the quality of a diverse set of demographic data, FS technique focuses on the aggregating matching accuracy from a number of useful variables and JW looks closer into matching the data content (spelling in this case) of each field. Hence, these two techniques are shown to be complementary. In addition, the sequence of applying these two techniques is critical. We have demonstrated...
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