Search results for: healthcare innovation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3309

Search results for: healthcare innovation

2859 Secure Data Sharing of Electronic Health Records With Blockchain

Authors: Kenneth Harper

Abstract:

The secure sharing of Electronic Health Records (EHRs) is a critical challenge in modern healthcare, demanding solutions to enhance interoperability, privacy, and data integrity. Traditional standards like Health Information Exchange (HIE) and HL7 have made significant strides in facilitating data exchange between healthcare entities. However, these approaches rely on centralized architectures that are often vulnerable to data breaches, lack sufficient privacy measures, and have scalability issues. This paper proposes a framework for secure, decentralized sharing of EHRs using blockchain technology, cryptographic tokens, and Non-Fungible Tokens (NFTs). The blockchain's immutable ledger, decentralized control, and inherent security mechanisms are leveraged to improve transparency, accountability, and auditability in healthcare data exchanges. Furthermore, we introduce the concept of tokenizing patient data through NFTs, creating unique digital identifiers for each record, which allows for granular data access controls and proof of data ownership. These NFTs can also be employed to grant access to authorized parties, establishing a secure and transparent data sharing model that empowers both healthcare providers and patients. The proposed approach addresses common privacy concerns by employing privacy-preserving techniques such as zero-knowledge proofs (ZKPs) and homomorphic encryption to ensure that sensitive patient information can be shared without exposing the actual content of the data. This ensures compliance with regulations like HIPAA and GDPR. Additionally, the integration of Fast Healthcare Interoperability Resources (FHIR) with blockchain technology allows for enhanced interoperability, enabling healthcare organizations to exchange data seamlessly and securely across various systems while maintaining data governance and regulatory compliance. Through real-world case studies and simulations, this paper demonstrates how blockchain-based EHR sharing can reduce operational costs, improve patient outcomes, and enhance the security and privacy of healthcare data. This decentralized framework holds great potential for revolutionizing healthcare information exchange, providing a transparent, scalable, and secure method for managing patient data in a highly regulated environment.

Keywords: blockchain, electronic health records (ehrs), fast healthcare interoperability resources (fhir), health information exchange (hie), hl7, interoperability, non-fungible tokens (nfts), privacy-preserving techniques, tokens, secure data sharing,

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2858 Is Swaziland on Track with the 2015 Millennium Development Goals?

Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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2857 Challenges for Adopting Circular Economy Toward Business Innovation and Supply Chain

Authors: Kapil Khanna, Swee Kuik, Joowon Ban

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The current linear economic system is unsustainable due to its dependence on the uncontrolled exploitation of diminishing natural resources. The integration of business innovation and supply chain management has brought about the redesign of business processes through the implementation of a closed-loop approach. The circular economy (CE) offers a sustainable solution to improve business opportunities in the near future by following the principles of rejuvenation and reuse inspired by nature. Those business owners start to rethink and consider using waste as raw material to make new products for consumers. The implementation of CE helps organisations to incorporate new strategic plans for decreasing the use of virgin materials and nature resources. Supply chain partners that are geographically dispersed rely heavily on innovative approaches to support supply chain management. Presently, numerous studies have attempted to establish the concept of supply chain management (SCM) by integrating CE principles, which are commonly denoted as circular SCM. While many scholars have recognised the challenges of transitioning to CE, there is still a lack of consensus on business best practices that can facilitate companies in embracing CE across the supply chain. Hence, this paper strives to scrutinize the SCM practices utilised for CE, identify the obstacles, and recommend best practices that can enhance a company's ability to incorporate CE principles toward business innovation and supply chain performance. Further, the paper proposes future research in the field of using specific technologies such as artificial intelligence, Internet of Things, and blockchain as business innovation tools for supply chain management and CE adoption.

Keywords: business innovation, challenges, circular supply chain, supply chain management, technology

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2856 A System Dynamics Model for Analyzing Customer Satisfaction in Healthcare Systems

Authors: Mahdi Bastan, Ali Mohammad Ahmadvand, Fatemeh Soltani Khamsehpour

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Health organizations’ sustainable development has nowadays become highly affected by customers’ satisfaction due to significant changes made in the business environment of the healthcare system and emerging of Competitiveness paradigm. In case we look at the hospitals and other health organizations as service providers concerning profit issues, the satisfaction of employees as interior customers, and patients as exterior customers would be of significant importance in health business success. Furthermore, satisfaction rate could be considered in performance assessment of healthcare organizations as a perceived quality measure. Several researches have been carried out in identification of effective factors on patients’ satisfaction in health organizations. However, considering a systemic view, the complex causal relations among many components of healthcare system would be an issue that its acquisition and sustainability requires an understanding of the dynamic complexity, an appropriate cognition of different components, and effective relationships among them resulting ultimately in identifying the generative structure of patients’ satisfaction. Hence, the presenting paper applies system dynamics approaches coherently and methodologically to represent the systemic structure of customers’ satisfaction of a health system involving the constituent components and interactions among them. Then, the results of different policies taken on the system are simulated via developing mathematical models, identifying leverage points, and using scenario making technique and then, the best solutions are presented to improve customers’ satisfaction of the services. The presenting approach supports taking advantage of decision support systems. Additionally, relying on understanding of system behavior Dynamics, the effective policies for improving the health system would be recognized.

Keywords: customer satisfaction, healthcare, scenario, simulation, system dynamics

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2855 An Empirical Analysis of the Determinants for Adopting Vocera Wireless Communication Systems

Authors: Patrick David Chirilele

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There are growing interests in improving service delivery in the healthcare sector through the adoption of emerging digital technologies, including the Vocera B3000n communication system badge. As a result, understanding the factors that impact the adoption of such digital technologies is becoming important. This study investigates the determinants of task-technology fit through the adoption of Vocera B3000n communication system badge in healthcare sector in South Africa. Statistical analyses are performed on the data collected from 143 healthcare workers including registered nurses and personal care workers at three hospitals in South Africa through survey to test the relationship between task characteristics, technology characteristics and user characteristics for better understanding the task-technology fit and the adoption of Vocera communication systems in South African hospitals. The result reveals that all three factors have a significant impact on task-technology fit through the adoption of Vocera B3000n communication system badge. Such findings are useful for healthcare sector in their adoption of digital technologies for improving service delivery through effective communication in their workplace.

Keywords: adoption, communication systems, task-technology fit, user characteristics, Vocera

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2854 Time, Uncertainty, and Technological Innovation

Authors: Xavier Everaert

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Ever since the publication of “The Problem of Social” cost, Coasean insights on externalities, transaction costs, and the reciprocal nature of harms, have been widely debated. What has been largely neglected however, is the role of technological innovation in the mitigation of negative externalities or transaction costs. Incorporating future uncertainty about negligence standards or expected restitution costs and the profit opportunities these uncertainties reveal to entrepreneurs, allow us to frame problems regarding social costs within the reality of rapid technological evolution.

Keywords: environmental law and economics, entrepreneurship, commons, pollution, wildlife

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2853 Teachers and Innovations in Information and Communication Technology

Authors: Martina Manenova, Lukas Cirus

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This article introduces research focused on elementary school teachers’ approach to innovations in ICT. The diffusion of innovations theory, which was written by E. M. Rogers, captures the processes of innovation adoption. The research method derived from this theory and the Rogers’ questionnaire focused on the diffusion of innovations was used as the basic research method. The research sample consisted of elementary school teachers. The comparison of results with the Rogers’ results shows that among the teachers in the research sample the so-called early majority, as well as the overall division of the data, was rather central (early adopter, early majority, and later majority). The teachers very rarely appeared on the edge positions (innovator, laggard). The obtained results can be applied to teaching practice and used especially in the implementation of new technologies and techniques into the educational process.

Keywords: innovation, diffusion of innovation, information and communication technology, teachers

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2852 Exploring the Healthcare Leader's Perception of Their Role and Leadership Behaviours - Looking Through an Adult Developmental Lens

Authors: Shannon Richards-Green, Suzanne Gough, Sharon Mickan

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Background: Healthcare leaders work in highly complex and rapidly changing environments. Consequently, they need both flexibility and the capacity to hold multiple perspectives simultaneously. My research explored how healthcare leaders understand and make sense (meaning) of their leadership experiences and how this understanding was manifested in their leadership behaviours. Methods: This grounded theory study was conducted via 2 x 1-hour interviews with healthcare leaders within acute care hospitals. A total of 33 hours of interviews were conducted with 17 participants. Participants were recruited using a combination of purposive and snowball sampling. Interviews were recorded, transcribed, and coded to explore emergent patterns and relationships within the data, utilising constant comparative analysis. Adult developmental stage was defined through a subject-object interview with each participant, in alignment with the tenets of constructive development theory. Findings: Participants from acute care hospitals within Australia have participated in the study, with the majority representing the executive leadership level. Broad categories emerging from the data include; Broadening perspectives and abilities as a leader, Dealing with and experiencing conflict within the workplace, Experiencing rewarding times as a leader, and Leading in alignment with a strong personal values system. Discussion: Successfully dealing with complex challenges requires an ability to engage with nuanced perspectives and responses, an integral part of adult developmental growth. In dealing with conflict, for example, leaders at various levels of adult development approached the situation quite differently. Understanding how healthcare leaders make sense of their experiences can assist in providing insights into the value of supporting adult developmental growth in healthcare leadership.

Keywords: leadership, adult development, complexity, growth

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2851 Electronic Health Record System: A Perspective to Improve the Value of Services Rendered to Patients in Healthcare Organization in Rwanda, Case of CHUB and Hopital De Nemba

Authors: Mugabe Nzarama Gabriel

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In Rwanda, many healthcare organizations are still using a paper based patients’ data record system although it still present weaknesses to share health patients’ information across different services when necessary. In developed countries, the EHR has been put in place to revolutionize the paper based record system but still the EHR has some challenges related to privacy, security, or interoperability. The purpose of this research was to assess the existing patients’ data record system in healthcare sector in Rwanda, see what an EHR can improve to the system in place and assess the acceptance of EHR as system which is interoperable, very secure and interoperable and see whether stakeholders are ready to adopt the system. The case based methodology was used and TAM theoretical framework to design the questionnaire for the survey. A judgmental sample across two cases, CHUB and Hopital de Nemba, has been selected and SPSS has been used for descriptive statistics. After a qualitative analysis, the findings showed that the paper based record is useful, gives complete information about the patient, protects the privacy of patients but it is still less secure and less interoperable. The respondents shown that they are ready to use the proposed EHR System and want it secure, capable of enforcing the privacy but still they are not all ready for the interoperability. A conclusion has been formulated; recommendations and further research have been proposed.

Keywords: EHR system, healthcare service, TAM, privacy, interoperability

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2850 Data Disorders in Healthcare Organizations: Symptoms, Diagnoses, and Treatments

Authors: Zakieh Piri, Shahla Damanabi, Peyman Rezaii Hachesoo

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Introduction: Healthcare organizations like other organizations suffer from a number of disorders such as Business Sponsor Disorder, Business Acceptance Disorder, Cultural/Political Disorder, Data Disorder, etc. As quality in healthcare care mostly depends on the quality of data, we aimed to identify data disorders and its symptoms in two teaching hospitals. Methods: Using a self-constructed questionnaire, we asked 20 questions in related to quality and usability of patient data stored in patient records. Research population consisted of 150 managers, physicians, nurses, medical record staff who were working at the time of study. We also asked their views about the symptoms and treatments for any data disorders they mentioned in the questionnaire. Using qualitative methods we analyzed the answers. Results: After classifying the answers, we found six main data disorders: incomplete data, missed data, late data, blurred data, manipulated data, illegible data. The majority of participants believed in their important roles in treatment of data disorders while others believed in health system problems. Discussion: As clinicians have important roles in producing of data, they can easily identify symptoms and disorders of patient data. Health information managers can also play important roles in early detection of data disorders by proactively monitoring and periodic check-ups of data.

Keywords: data disorders, quality, healthcare, treatment

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2849 Innovation Ecosystems in Construction Industry

Authors: Cansu Gülser, Tuğce Ercan

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The construction sector is a key driver of the global economy, contributing significantly to growth and employment through a diverse array of sub-sectors. However, it faces challenges due to its project-based nature, which often hampers long-term collaboration and broader incentives beyond individual projects. These limitations are frequently discussed in scientific literature as obstacles to innovation and industry-wide change. Traditional practices and unwritten rules further hinder the adoption of new processes within the construction industry. The disadvantages of the construction industry’s project-based structure in fostering innovation and long-term relationships include limited continuity, fragmented collaborations, and a focus on short-term goals, which collectively hinder the development of sustained partnerships, inhibit the sharing of knowledge and best practices, and reduce incentives for investing in innovative processes and technologies. This structure typically emphasizes specific projects, which restricts broader collaborations and incentives that extend beyond individual projects, thus impeding innovation and change. The temporal complexities inherent in project-based sectors like construction make it difficult to address societal challenges through collaborative efforts. Traditional management approaches are inadequate for scaling up innovations and adapting to significant changes. For systemic transformation in the construction sector, there is a need for more collaborative relationships and activities beyond traditional supply chains. This study delves into the concept of an innovation ecosystem within the construction sector, highlighting various research findings. It aims to explore key questions about the components that enhance innovation capacity, the relationship between a robust innovation ecosystem and this capacity, and the reasons why innovation is less prevalent and implemented in this sector compared to others. Additionally, it examines the main factors hindering innovation within companies and identifies strategies to improve these efforts, particularly in developing countries. The innovation ecosystem in the construction sector generates various outputs through interactions between business resources and external components. These outputs include innovative value creation, sustainable practices, robust collaborations, knowledge sharing, competitiveness, and advanced project management, all of which contribute significantly to company market performance and competitive advantage. This article offers insights and strategic recommendations for industry professionals, policymakers, and researchers interested in developing and sustaining innovation ecosystems in the construction sector. Future research should focus on broader samples for generalization, comparative sector analysis, and application-focused studies addressing real industry challenges. Additionally, studying the long-term impacts of innovation ecosystems, integrating advanced technologies like AI and machine learning into project management, and developing future application strategies and policies are also important.

Keywords: construction industry, innovation ecosystem, innovation ecosystem components, project management

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2848 Low Back Pain-Related Absenteeism among Healthcare Workers in Kibuli Muslim Hospital, Kampala Uganda

Authors: Aremu Abdulmujeeb Babatunde

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Background: Low back pain was not only considered to be the most common reason for functional disability worldwide, but also estimated to have affected 90% of the universal population. This study aimed at determining the prevalence, consequences and socio-demographic factors associated with low back pain. Methods; A cross-sectional survey was employed and a total number of 150 self-structured questionnaire was distributed among healthcare workers and this was used to determine the prevalence of low back pain and work related absenteeism. Data was entered using Epi info soft-ware and analyzed using SPSS. Results; An overall response rate of 84% (n = 140) was achieved. The study established that majority (37%) of the respondents were in the age bracket of 20-39 years, 57% female (n=59) and 64% of them were married. the pint prevalence was 84%, 31% of the respondents took leave from work as a result of low back pain. There was high prevalence of sick leave among nursing staff 45.2%, Chi-square test shows that there was a statistically significant association between the respondents occupations and daily time spent during their work (P value 0.011 and 0.042) respectively. Socio-demographic factors like age, marital status and gender were not statistically significant at P<0.05. Conclusions; The medical and socio-professional consequences of low back pain among healthcare workers was as a result of their occupation designations and the daily time spent in carry out this occupations.

Keywords: low back pain, healthcare workers, prevalence, sick leave

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2847 Addressing Rural Health Challenges: A Flexible Modular Approach for Resilient Healthcare Services

Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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2846 Cryptocurrency Realities: Insights from Social and Economic Psychology

Authors: Sarah Marie

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In today's dynamic financial landscape, cryptocurrencies represent a paradigm shift characterized by innovation and intense debate. This study probes into their transformative potential and the challenges they present, offering a balanced perspective that recognizes both their promise and pitfalls. Emulating the engaging style of a TED Talk, this research goes beyond academic analysis, serving as a critical bridge to reconcile the perspectives of cryptocurrency skeptics and enthusiasts, fostering a well-informed dialogue. The study employs a mixed-method approach, analyzing current trends, regulatory landscapes, and public perceptions in the cryptocurrency domain. It distinguishes genuine innovators in this field from ostentatious opportunists, echoing the sentiment that real innovation should be separated from mere showmanship. If one is unfamiliar with who is being referenced, they can likely spot them leaning against their Lamborghinis outside "Crypto" conventions, looking greasy. Major findings reveal a complex scenario dominated by regulatory uncertainties, market volatility, and security issues, emphasizing the need for a coherent regulatory framework that balances innovation with risk management and sustainable practices. The study underscores the importance of transparency and consumer protection in fostering responsible growth within the cryptocurrency ecosystem. In conclusion, the research advocates for education, innovation, and ethical governance in the realm of cryptocurrencies. It calls for collaborative efforts to navigate the intricacies of this evolving landscape and to realize its full potential in a responsible, inclusive, and forward-thinking manner.

Keywords: financial landscape, innovation, public perception, transparency

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2845 Artificial Intelligence and Liability within Healthcare: A South African Analysis

Authors: M. Naidoo

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AI in healthcare can have a massive positive effect in low-resource states like South Africa, where patients outnumber personnel greatly. However, the complexity and ‘black box’ aspects of these technologies pose challenges for the liability regimes of states. This is currently being discussed at the international level. This research finds that within the South African medical negligence context, the current common law fault-based inquiry proves to be wholly inadequate for patient redress. As a solution to this, this research paper culminates in legal reform recommendations designed to solve these issues.

Keywords: artificial intelligence, law, liability, policy

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2844 Exploring the Cultural Values of Nursing Personnel Utilizing Hofstede's Cultural Dimensions

Authors: Ma Chu Jui

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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.

Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing

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2843 Understanding Tourism Innovation through Fuzzy Measures

Authors: Marcella De Filippo, Delio Colangelo, Luca Farnia

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In recent decades, the hyper-competition of tourism scenario has implicated the maturity of many businesses, attributing a central role to innovative processes and their dissemination in the economy of company management. At the same time, it has defined the need for monitoring the application of innovations, in order to govern and improve the performance of companies and destinations. The study aims to analyze and define the innovation in the tourism sector. The research actions have concerned, on the one hand, some in-depth interviews with experts, identifying innovation in terms of process and product, digitalization, sustainability policies and, on the other hand, to evaluate the interaction between these factors, in terms of substitutability and complementarity in management scenarios, in order to identify which one is essential to be competitive in the global scenario. Fuzzy measures and Choquet integral were used to elicit Experts’ preferences. This method allows not only to evaluate the relative importance of each pillar, but also and more interestingly, the level of interaction, ranging from complementarity to substitutability, between pairs of factors. The results of the survey are the following: in terms of Shapley values, Experts assert that Innovation is the most important factor (32.32), followed by digitalization (31.86), Network (20.57) and Sustainability (15.25). In terms of Interaction indices, given the low degree of consensus among experts, the interaction between couples of criteria on average could be ignored; however, it is worth to note that the factors innovations and digitalization are those in which experts express the highest degree of interaction. However for some of them, these factors have a moderate level of complementarity (with a pick of 57.14), and others consider them moderately substitutes (with a pick of -39.58). Another example, although outlier is the interaction between network and digitalization, in which an expert consider them markedly substitutes (-77.08).

Keywords: innovation, business model, tourism, fuzzy

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2842 An Entrepreneurial Culture Led by Creativity and Innovation: Challenges and Competencies for Sri Lanka as a Middle Income Country

Authors: Tissa Ravinda Perera

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An open economic policy was introduced by Sri Lanka in 1977, before many other countries in Asia to align her economy to world economic trends and it was affected indigenous businesses since they had to compete with foreign products, processes, technology, innovations and businesses. The year 2010 was a milestone in Sri Lankan history to achieve the developmental goals when Foxbuisness rated Sri Lanka as the best performing global economy. However, Sri Lanka missed her chances of achieving development with the political and social chaos, consequent the regime change in 2015. This paper argues that to support the development of the country, Sri Lanka must develop an entrepreneurial culture. In this endeavor, creativity and innovation will play a pivotal role to achieve the desired level of development. In this study, it was used secondary data from various local and international sources to understand and explore the existing scenario of Sri Lankan economy, state of entrepreneurial culture and innovation, and challenges and competencies for the development of an entrepreneurial culture in Sri Lanka. The data was collected from secondary sources were depicted in tables in this paper in a meaningful manner. Based on the tables many findings were aroused and conclusions were made to support the argument in this paper. This paper revealed that the development of an entrepreneurial culture has to be associated with creativity and innovation to gain a competitive advantage over the development strategies of other countries. It is exposed that an entrepreneurial culture will help minorities, women and underprivileged societies to empower themselves. This product will help to confront and manage youth unrest which has created anarchy in the country from time to time. Throughout this paper, it was highlighted the past, present and future scenario of Sri Lankan economy along with modification to be done to it through the development of an entrepreneur culture in light of innovation and creativity to achieve the desired level of development.

Keywords: economy, industry, creativity, innovation, entrepreneurship, entrepreneurial culture

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2841 Parents, Carers and Young Persons’ Views Regarding Nursing ‘Workarounds’ Within Clinical Electronic Patient Record Systems

Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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2840 The Moderating Impacts of Government Support on the Relationship Between Patient Acceptance and Telemedicine Adoption in Malaysia

Authors: Anyia Nduka, Aslan Bin Amad Senin, Ayu Azrin Binti Abdul Aziz

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Telemedicine is a rapidly developing discipline with enormous promise for better healthcare results for patients. To meet the demands of patients and the healthcare sector, medical providers must be proficient in telemedicine and also need government funding for infrastructure and core competencies. In this study, we surveyed general hospitals in Kuala Lumpur and Selangor to investigate patient’s impressions of both the positive and negative aspects of government funding for telemedicine and its level of acceptance. This survey was conducted in accordance with the Diffusion of Innovations (DOI) hypothesis; the survey instruments were designed through a Google Form and distributed to patients and every member of the medical team. The findings suggested a framework for categorizing patients' levels of technology use and acceptability, which provided practical consequences for healthcare. We therefore recommend the increase in technical assistance and government-backed funding of telemedicine by bolstering the entire system.

Keywords: technology acceptance, quality assurance, digital transformation, cost management.

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2839 Inputs and Outputs of Innovation Processes in the Colombian Services Sector

Authors: Álvaro Turriago-Hoyos

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Most research tends to see innovation as an explanatory factor in achieving high levels of competitiveness and productivity. More recent studies have begun to analyze the determinants of innovation in the services sector as opposed to the much-discussed industrial sector of a country’s economy. This research paper focuses on the services sector in Colombia, one of Latin America’s fastest growing and biggest economies. Over the past decade, much of Colombia’s economic expansion has relied on commodity exports (mainly oil and coffee) whilst the industrial sector has performed relatively poorly. Such developments highlight the potential of the innovative role played by the services sector of the Colombian economy and its future growth prospects. This research paper analyzes the relationship between inputs, which at the same time are internal sources of innovation (such as R&D activities), and external sources that are improved by technology acquisition. The outputs are basically the four kinds of innovation that the OECD Oslo Manual recognizes: product, process, marketing and organizational innovations. The instrument used to measure this input-output relationship is based on Knowledge Production Function approaches. We run Probit models in order to identify the existing relationships between the above inputs and outputs, but also to identify spill-overs derived from interactions of the components of the value chain of the services firms analyzed: customers, suppliers, competitors, and complementary firms. Data are obtained from the Colombian National Administrative Department of Statistics for the period 2008 to 2013 published in the II and III Colombian National Innovation Survey. A short summary of the results obtained lead to conclude that firm size and a firm’s level of technological development turn out to be important discriminating factors for the description of the innovative process at the firm level. The model’s outcomes show a positive impact on the probability of introducing any kind of innovation both on R&D and Technology Acquisition investment. Also, cooperation agreements with customers, research institutes, competitors, and the suppliers are significant. Belonging to a particular industrial group is an important determinant but only to product and organizational innovation. It is possible to establish that Health Services, Education, Computer, Wholesale trade, and Financial Intermediation are the ISIC sectors, which report the highest number of frequencies of the considered set of firms. Those five sectors of the sixteen considered, in all cases, explained more than half of the total of all kinds of innovations. Product Innovation, which is followed by Marketing Innovation, gets the highest results. Displaying the same set of firms distinguishing by size, and belonging to high and low tech services sector shows that the larger the firms the larger a number of innovations, but also that always high-tech firms show a better innovation performance.

Keywords: Colombia, determinants of innovation, innovation, services sector

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2838 Research on Innovation Service based on Science and Technology Resources in Beijing-Tianjin-Hebei

Authors: Runlian Miao, Wei Xie, Hong Zhang

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In China, Beijing-Tianjin-Hebei is regarded as a strategically important region because itenjoys highest development in economic development, opening up, innovative capacity and andpopulation. Integrated development of Beijing-Tianjin-Hebei region is increasingly emphasized by the government recently years. In 2014, it has ascended to one of the national great development strategies by Chinese central government. In 2015, Coordinated Development Planning Compendium for Beijing-Tianjin-Hebei Region was approved. Such decisions signify Beijing-Tianjin-Hebei region would lead innovation-driven economic development in China. As an essential factor to achieve national innovation-driven development and significant part of regional industry chain, the optimization of science and technology resources allocation will exert great influence to regional economic transformation and upgrading and innovation-driven development. However, unbalanced distribution, poor sharing of resources and existence of information isolated islands have contributed to different interior innovation capability, vitality and efficiency, which impeded innovation and growth of the whole region. Under such a background, to integrate and vitalize regional science and technology resources and then establish high-end, fast-responding and precise innovation service system basing on regional resources, would be of great significance for integrated development of Beijing-Tianjin-Hebei region and even handling of unbalanced and insufficient development problem in China. This research uses the method of literature review and field investigation and applies related theories prevailing home and abroad, centering service path of science and technology resources for innovation. Based on the status quo and problems of regional development of Beijing-Tianjin-Hebei, theoretically, the author proposed to combine regional economics and new economic geography to explore solution to problem of low resource allocation efficiency. Further, the author puts forward to applying digital map into resource management and building a platform for information co-building and sharing. At last, the author presents the thought to establish a specific service mode of ‘science and technology plus digital map plus intelligence research plus platform service’ and suggestion on co-building and sharing mechanism of 3 (Beijing, Tianjin and Hebei ) plus 11 (important cities in Hebei Province).

Keywords: Beijing-Tianjin-Hebei, science and technology resources, innovation service, digital platform

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2837 Conceptualization of Value Co-Creation for Shrimp Products in Bangladesh

Authors: Subarna Ferdous, Mitsuru Ikeda

Abstract:

For the shrimp companies to remain relevant to its local and international consumers, they must offer new shrimp product and services. It must work actively not just to create value for the consumer, but to involve the consumer in co-creating value for shrimp product innovation in the market. In this theoretical work, we conceptualize the business concept of value co-creation in the context of shrimp products, and propose a framework of value co-creation for shrimp product innovation in shrimp industries. With guidance on value co-creation in in shrimp industry, and shrimp value chain actors mapped to the co-creation cycle, companies can use the framework to offer new shrimp product to consumer communities. Although customer co-creation is known approach in the world, it is not commonly used by the companies in Bangladesh. This paper makes an original contribution by conceptualizing co-creation and set the examples of best co-creation practices in food sector. The results of the study provide management with guidelines for successful co-creation projects with an innovation- and market-oriented approach. The framework also provides a basis for further research in this area.

Keywords: bangladesh, shrimp industry, value co-creation, shrimp product

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2836 Healthcare Professionals' Perspectives on Warfarin Therapy at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR

Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

Abstract:

In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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2835 Innovation Eco-Systems and Cities: Sustainable Innovation and Urban Form

Authors: Claudia Trillo

Abstract:

Regional innovation eco-ecosystems are composed of a variety of interconnected urban innovation eco-systems, mutually reinforcing each other and making the whole territorial system successful. Combining principles drawn from the new economic growth theory and from the socio-constructivist approach to the economic growth, with the new geography of innovation emerging from the networked nature of innovation districts, this paper explores the spatial configuration of urban innovation districts, with the aim of unveiling replicable spatial patterns and transferable portfolios of urban policies. While some authors suggest that cities should be considered ideal natural clusters, supporting cross-fertilization and innovation thanks to the physical setting they provide to the construction of collective knowledge, still a considerable distance persists between regional development strategies and urban policies. Moreover, while public and private policies supporting entrepreneurship normally consider innovation as the cornerstone of any action aimed at uplifting the competitiveness and economic success of a certain area, a growing body of literature suggests that innovation is non-neutral, hence, it should be constantly assessed against equity and social inclusion. This paper draws from a robust qualitative empirical dataset gathered through 4-years research conducted in Boston to provide readers with an evidence-based set of recommendations drawn from the lessons learned through the investigation of the chosen innovation districts in the Boston area. The evaluative framework used for assessing the overall performance of the chosen case studies stems from the Habitat III Sustainable Development Goals rationale. The concept of inclusive growth has been considered essential to assess the social innovation domain in each of the chosen cases. The key success factors for the development of the Boston innovation ecosystem can be generalized as follows: 1) a quadruple helix model embedded in the physical structure of the two cities (Boston and Cambridge), in which anchor Higher Education (HE) institutions continuously nurture the Entrepreneurial Environment. 2) an entrepreneurial approach emerging from the local governments, eliciting risk-taking and bottom-up civic participation in tackling key issues in the city. 3) a networking structure of some intermediary actors supporting entrepreneurial collaboration, cross-fertilization and co-creation, which collaborate at multiple-scales thus enabling positive spillovers from the stronger to the weaker contexts. 4) awareness of the socio-economic value of the built environment as enabler of cognitive networks allowing activation of the collective intelligence. 5) creation of civic-led spaces enabling grassroot collaboration and cooperation. Evidence shows that there is not a single magic recipe for the successful implementation of place-based and social innovation-driven strategies. On the contrary, the variety of place-grounded combinations of micro and macro initiatives, embedded in the social and spatial fine grain of places and encompassing a diversity of actors, can create the conditions enabling places to thrive and local economic activities to grow in a sustainable way.

Keywords: innovation-driven sustainable Eco-systems , place-based sustainable urban development, sustainable innovation districts, social innovation, urban policie

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2834 Enabling Rather Than Managing: Organizational and Cultural Innovation Mechanisms in a Heterarchical Organization

Authors: Sarah M. Schoellhammer, Stephen Gibb

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Bureaucracy, in particular, its core element, a formal and stable hierarchy of authority, is proving less and less appropriate under the conditions of today’s knowledge economy. Centralization and formalization were consistently found to hinder innovation, undermining cross-functional collaboration, personal responsibility, and flexibility. With its focus on systematical planning, controlling and monitoring the development of new or improved solutions for customers, even innovation management as a discipline is to a significant extent based on a mechanistic understanding of organizations. The most important drivers of innovation, human creativity, and initiative, however, can be more hindered than supported by central elements of classic innovation management, such as predefined innovation strategies, rigid stage gate processes, and decisions made in management gate meetings. Heterarchy, as an alternative network form of organization, is essentially characterized by its dynamic influence structures, whereby the biggest influence is allocated by the collective to the persons perceived the most competent in a certain issue. Theoretical arguments that the non-hierarchical concept better supports innovation than bureaucracy have been supported by empirical research. These prior studies either focus on the structure and general functioning of non-hierarchical organizations or on their innovativeness, that means innovation as an outcome. Complementing classic innovation management approaches, this work aims to shed light on how innovations are initiated and realized in heterarchies in order to identify alternative solutions practiced under conditions of the post-bureaucratic organization. Through an initial individual case study, which is part of a multiple-case project, the innovation practices of an innovative and highly heterarchical medium-sized company in the German fire engineering industry are investigated. In a pragmatic mixed methods approach media resonance, company documents, and workspace architecture are analyzed, in addition to qualitative interviews with the CEO and employees of the case company, as well as a quantitative survey aiming to characterize the company along five scaled dimensions of a heterarchy spectrum. The analysis reveals some similarities and striking differences to approaches suggested by classic innovation management. The studied heterarchy has no predefined innovation strategy guiding new product and service development. Instead, strategic direction is provided by the CEO, described as visionary and creative. Procedures for innovation are hardly formalized, with new product ideas being evaluated on the basis of gut feeling and flexible, rather general criteria. Employees still being hesitant to take responsibility and make decisions, hierarchical influence is still prominent. Described as open-minded and collaborative, culture and leadership were found largely congruent with definitions of innovation culture. Overall, innovation efforts at the case company tend to be coordinated more through cultural than through formal organizational mechanisms. To better enable innovation in mainstream organizations, responsible practitioners are recommended not to limit changes to reducing the central elements of the bureaucratic organization, formalization, and centralization. The freedoms this entails need to be sustained through cultural coordination mechanisms, with personal initiative and responsibility by employees as well as common innovation-supportive norms and values. These allow to integrate diverse competencies, opinions, and activities and, thus, to guide innovation efforts.

Keywords: bureaucracy, heterarchy, innovation management, values

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2833 Knowledge Sharing Practices in the Healthcare Sector: Evidences from Primary Health Care Organizations in Indonesia

Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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2832 Impact of Reverse Technology Transfer on Innovation Capabilities: An Econometric Analysis for Mexican Transnational Corporations

Authors: Lissette Alejandra Lara, Mario Gomez, Jose Carlos Rodriguez

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ransnational corporations (TNCs) as units in which it is possible technology and knowledge transfer across borders and the potential for generating innovation and contributing in economic development both in home and host countries have been widely acknowledged in the foreign direct investment (FDI) literature. Particularly, the accelerated expansion of emerging countries TNCs in the last decades has guided an uprising research stream that measure the presence of reverse technology transfer, defined as the extent to which emerging countries’ TNCs use outward FDI in a host country through certain mechanisms to absorb and transfer knowledge thus improving its technological capabilities in the home country. The objective of this paper is to test empirically the presence of reverse technology transfer and its impact on the innovation capabilities in Mexican transnational corporations (MXTNCs) as a part of the emerging countries TNCs that have successfully entered to industrialized markets. Using a panel dataset of 22 MXTNCs over the period 1994-2015, the results of the econometric model demonstrate that the amount of Mexican outward FDI and the research and development (R&D) expenditure in host developed countries had a positive impact on the innovation capabilities at the firm and industry level. There is also evidence that management of acquired brands and the organizational structure of Mexican subsidiaries improved these capabilities. Implications for internationalization strategies of emerging countries corporations and future research guidelines are discussed.

Keywords: emerging countries, foreign direct investment, innovation capabilities, Mexican transnational corporations, reverse technology transfer

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2831 Exploring Management of the Fuzzy Front End of Innovation in a Product Driven Startup Company

Authors: Dmitry K. Shaytan, Georgy D. Laptev

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In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management

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2830 Challenges to Tuberculosis Control in Angola: The Narrative of Medical Professionals

Authors: Domingos Vita, Patrick Brady

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Background: There is a tuberculosis (TB) epidemic in Angola that has been getting worse for more than a decade despite the active implementation of the DOTS strategy. The aim of this study was to directly interrogate healthcare workers involved in TB control on what they consider to be the drivers of the TB epidemic in Angola. Methods: Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. Results: The healthcare professionals see the migrant working poor as a particular problem for the control of TB. These migrants are constructed as ‘Rural People’ and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. Conclusions: The local narrative is in contrast to previous explanations used elsewhere in the developing world. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.

Keywords: Africa, Angola, migrants, qualitative, research, tuberculosis

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