MRC Events
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The McDowell Research Center for Global IT Management
MRC Working Papers
The following papers have been funded by the MRC. Abstracts are included.
2008 papers:
"Social Engineering Self-efficacy: Gateway to Empowerment in Information System Security" - Dr. Hamid Nemati, UNCG, & Dr. Simin Hall, UNCG
In this proposal, we present a research model, rooted in social cognitive theory, of factors that impact information security problems caused by social engineering and propose ways to mitigate them. In this proposal, we define Social Engineering self-efficacy (SESE) as an individual's confidence in his/her ability to effectively acquire and utilize cognitive and other resources to facilitate appropriate response to social engineering in the workplace to promote a positive climate that ensures security of information system. We propose to empirically test this model in a medical setting where the problem of social engineering is particularly prevalent and its consequences are potentially devastating.
"Process and Mechanisms of Institutional Changes in the Offshoring Sector of Emerging Economies" - Dr. Nir Kshetri, UNCG
Offshoring activities have transformed formal and informal institutions in emerging economies. An important but under-examined issue with respect to institutional theory and offshoring concerns institutional changes in these economies. The proposed research employs case study method to examine institutional changes in the Indian offshoring industry, which employs 1.6 million people. The findings are expected to help us better understand the phenomenon of offshoring that is becoming pervasive, and perhaps to find better ways of managing it. The insights are also expected to help developing countries learn from India's model, which arguably acts as a 'policy exemplar'.
"Promoting Social Inclusion Through a Nation-Wide ICT-in-Education Endeavor: Macedonia Connects" - Dr. Laura Hosman, University of California Berkeley, & Dr. Elizabeth Fife, University of Southern California
This article investigates the potential of ICT-in-education projects to promote social inclusion, particularly through the analysis of a nation-wide initiative in Macedonia to provide every school across the country with computers, Internet connections, and ICT training for teachers. Social inclusion and equality of opportunity were among the main considerations in the Macedonia Connects program, which, to our knowledge is the first nation-wide endeavor of its kind. The article includes a review of theory and empirical results regarding the use of ICT for social inclusion in schools, as well as a description and discussion of the Macedonia Connects project. The article finds that there is much promise in the use of new technologies for promoting interethnic communication and collaboration, although due to the lack of in-depth assessment of outcomes or follow-up evaluation, it is too soon to comment on the project’s long-term outcome. The value of the article consists in examining both a first-of-its-kind scaled ICT-in-education initiative, and the general possibility of such projects to promote social inclusion. The case offers a model for nation-wide ICT-in-education initiatives with best practices that are applicable both regionally and worldwide. The findings are of consequence for any society that faces ethnic, linguistic, religious, or other divisions, as well as for teachers and administrators charged with curriculum development for such projects.
"The Influence of Subgroup Dynamics on Knowledge Coordination in Dispersed Software Development Teams" - Yide Shen, Georgia State University, & Dr. Mike Gallivan, Georgia State University
In this proposal, we explain the importance of knowledge coordination in dispersed software development projects, and why inter-subgroup dynamics is a critical factor that impacts teams' knowledge coordination practices. We describe a field survey study that is in progress. The findings from this study will inform managers on how dispersed software development teams develop capabilities to perform successfully across temporal, geographic and cultural boundaries.
"The Impact of Web-Based Health Risk Communication On Information Processing and Risk Perceptions" - Christopher Harle, Carnegie Mellon University, Dr. Rema Padman, Carnegie Mellon University, & Dr. Julie Downs, Carnegie Mellon University
The demand for online consumer health information has seen enormous growth in recent years. In response, government organizations, insurers, online health information providers and charitable organizations are vying for consumer attention in order to deliver messages about health awareness, disease prevention and other wellness goals. As web technologies have become more sophisticated and household Internet connections faster, organizations have begun to deliver personalized and interactive feedback about various health conditions. On WebMD.com alone, there are more than a dozen calculation tools that accept user-entered health information to predict measures such as stroke risk, stress levels, and fertility. We refer to thse personalized and interactive applications as risk calculators. The goal of the proposed study is to combine theory and methods from behavioral decision making and information systems and apply them to study how consumers of health information are influenced by two features that are common in health risk calculators: (1) personalized risk estimates and (2) interactive feedback about these risks. Assuming the goal of web-based health information is to improve awareness and education, we will examine how personalization and interactive feedback affect consumer engagement, information processing and accuracy of health risk perceptions. We will also examine how user characteristics, including prior risk perceptions and confidence in those perceptions, may moderate these effects. An experimental study of adult participants will be carried out in the context of an important health topic, risk of developing type 2 diabetes. Using an experimental risk calculator application that we developed, we will manipulate the presence of personalized risk information as well as the ability of users to interactively see how their risk would change if they altered their existing health situation. The results of this study have the potential to improve understanding of the descriptive and normative implications for website usage, information processing and health risk perceptions when personalized and interactive content is accessed by Internet users. These findings may inform the design and implementation of online health information services.
"Information and Process Quality Issues in IT-Supported Health Care" - Dr. Janis Gogan, Bentley College, Dr. Monica Garfield, Bentley College, & Dr. Ryan Baxter, Bentley College
Health care leaders continue to struggle to establish financially viable business models for telemedicine services provided by specialists at hub hospitals for generalist clinicians at spoke community hospitals, clinics, nursing homes, and other settings. Based on interviews conducted at seven hospitals, we examine business models in four medical domains: dermatology, psychiatry, acute stroke services, and critical-care pediatrics. While past studies identified licensure and reimbursement issues as the main obstacles to financial viability, our study uncovers additional dimensions, including the clinical domain, external legislation that can serve as a catalyst for the provision of specific medical services, scheduled versus unscheduled medical care, treatment urgency, and alignment of various pricing schemes with conventional reimbursement practices.
2009 papers:
“An In-Depth Case Study of Successful vs. Unsuccessful EMR Implementations: Mis-alignments vs. Organizational Change” – Dr. Mary Sumner, Southern Illinois University, Edwardsville.”
The use of IT in making clinical health care more efficient and effective is well known (Dick and Steen, 1991). The adoption of electronic medical records is a strategy for improving health care in the United States, and there are national efforts to provide funding for the initial purchase of EMR systems (Institute of Medicine, 2001). But recent articles in the healthcare domain indicate that 20 to 30% of electronic medical record (EMR) systems fail within a year of implementation (Chin, 2006). This study will examine the tensions between actual work processes and the best practices supported by IT-based EMR systems in two hospital settings: one in which the EMR implementation is a success and the other in which the EMR implementation is unsuccessful. The findings will provide strategies for the successful implementation of EMR systems at a time when EMR implementation is of strategic importance to the healthcare profession and to the general community.
“Electronic Medical Records on the Front Lines: Post Adoption Task and Business Process Performance” – Dr. Virginia Ilie, University of Kansas.
The current study focuses on investigating various influence tactics hospital administrators could use in order to influence physicians to make use of complex technologies such as EMR. We ground our study in the theory of interpersonal influence and leadership. We chose this theoretical lens as it provides us with important insights into influence mechanisms and leadership tactics that could be used in a healthcare setting in order to impact physicians’ attitudes and behavior towards EMR. Several social influence tactics have been defined in leadership theories as being important in influencing behavior, especially in situations where managers have little or formal authority over employees, which is the case in a healthcare environment. An influence tactic is defined as “a type of behavior one person (e.g. agent) uses to influence the attitudes and behavior of another person (e.g. the target)”. Various tactics such as pressure and legitimating (hard tactics), consultation, collaboration, coalition and apprising (soft tactics) and rational persuasion have been proposed in the leadership literature. Over time, depending on the tactics used, we anticipate changes in EMR innovation effectiveness as evidenced by changes from compliant to committed use or from resistance to compliant use or other combinations thereof.
“Reliability and Validity of Articulation Assessment by Telepractice” – Michael Campbell, M.S., MBA, CCC-SLP, Director of Speech & Hearing Program, UNCG.
Speech and language disorders affect one’s ability to talk, understand, read, and write. A speech disorder can reduce speech intelligibility, which may have a significant impact on an individual’s ability to communicate in social and vocational contexts and, hence, impact quality of life. Speech-language pathologists (SLPs) evaluate, diagnose, and treat communication and swallowing disorders in individuals of all ages, from infants to the elderly. The American Speech-Language-Hearing Association (ASHA) is the professional, scientific, and credentialing association for more than 130,000 SLPs, audiologists, and speech, language, and hearing scientists in the United States and internationally. Telepractice is the application of telecommunications technology to deliver professional services at a distance by linking clinician to client, or clinician to clinician for assessment, intervention, and/or consultation.ASHA’s position is that telepractice or telehealth is an appropriate model of service delivery for the profession of speech-language pathology, and may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or subspecialists, and impaired mobility (ASHA Position Statement, 2006). According to a review of the literature, clinicians from across the globe are exploring the possibility of using telehealth to diagnose, assess and provide treatment to individuals with communication and swallowing disorders who otherwise may not have access to these services.
Since March 2008 the UNCG Speech and Hearing Program, located at the Gateway University Research Park, has been providing a pilot telepractice treatment program to a rural school in Washington County. The TeleSpeech Therapy program was established by the Speech and Hearing Program to address the shortage of SLPs in rural North Carolina and to demonstrate the possible effectiveness of using telepractice to evaluate and treat communication disorders. Several studies have demonstrated that videoconferencing is a viable and effective method for providing SLP services at-a-distance. Technology used for telehealth SLP sessions should not distort or interfere with communication, or must do so only in a minimal way, since the quality of signals must support assessment and treatment of communication disorders. Our TeleSpeech Therapy program uses quality videoconferencing equipment, a personal computer, a document camera (ELMO), and a digital video recorder. Additionally we have adequate bandwidth connection to ensure optimal audio and visual quality for clinical decision making.
The objective of this study is to examine the effectiveness of using synchronous transmission for ”real-time” two-way interactive videoconferencing to assess the articulation skills of children. The UNCG IRB has given the research protocol entitled “Reliability and Validity of Articulation Assessment by Telepractice” (IRB No. 089045) an expedited approval (see attached IRB approval letter, consent and assent form).
“Health Information Technology Adoptions Strategies Impacts on Productivity” – Dr. Eric Ford, UNCG, Dr. Timothy Huerrta, Texas Tech University & Dr. Nir Menachemi, University of Alabama, Birmingham.
U.S. hospitals are under continual pressure to increase productivity while simultaneously improving quality. In order to achieve those dual aims, hospitals are adopting Health Information Technologies (HITs) throughout the enterprise. Research evidence has linked HIT usage in hospitals to improved outcomes [1-4]. Enticed by the promise for better operational and clinical performance, hospital adoption of HIT systems has increased [5, 6]. However, there have also been several well-publicized HIT implementation failures [7]. Further, the potential negative impacts of such systems on productivity [8] and quality [9] continue to be major concerns. Therefore, health systems and hospitals are adopting a variety of strategies to mitigate the risks from undesirable side effects of HIT implementation and promote swifter, more complete adoption by end-users. HIT adoption strategies range from a ‘best-of-breed’ (BoB) approach, where every HIT application is selected on based on its own merit, to single vendor ‘enterprise resource planning’ (ERP) where all applications are provided by a single firm [10] . Each approach has advantages and disadvantages that may make it attractive to a given organization. Recently, hospitals have begun to adopt a ‘best-of-suite’ (BoS) strategy, a hybrid approach addressing some of the limitations of the other two extremes, which has caused other challenges in managing HIT implementations and application portfolios. The overarching purpose of this study is to identify and document best-demonstrated practices in HIT adoption related to these three common strategies. This research will use both quantitative and qualitative methods to assess HIT adoption strategies in relationship to organizational productivity and quality metrics. Deliverables will focus on the development and publication of a ‘Guide to Best Practices for HIT Adoption and Implementation’ and publication of the ‘High Performance Health Facility Index’. Additionally, the study will support the development of both peer-reviewed publications and case studies. The specific aims and deliverables are discussed next.