Whilst scholarship addressing the social and cultural issues surrounding enterprise resource planning (ERP) systems is blossoming, many of the studies, framed within well established modes of research, and constrained within particular loci, timeframes, disciplinary perspectives and concerns, are producing unhelpful readings of the characteristics of these systems and their implications for organizations. In particular research on particular socially and temporally bounded locales – the typical ERP implementation case study – has become the norm and given undue emphasis within Information Systems (IS) scholarship. Often influenced by constructivist frameworks and qualitative methodologies - including Actor Network Theory (ANT) and ethnography - scholars have developed actor centered analysis and rich local pictures of the immediate response by organizations and users to these systems. However we are skeptical that the most useful way to study ERP is solely at the place where the user encounters it. One implication of focusing only on certain locales or moments (like implementation) is that important influences from other levels and timeframes are missed from analysis. Lest we forget, ERP is typically a generic and global technologies designed at some remove from the place and time where it is used. It is also often instantiated at multiple sites and across distributed contexts. After setting out what we think are the limitations of current approaches we propose an alternative research approach - the emerging ‘Biography of Artefacts Framework’ - that attempts to take seriously the multiple locations and different timeframes in which ERP systems operate and evolve. We argue that if IS researchers our to fully understand these and related organizational systems they need more adequate spatial metaphors to understand the influence of technology supply and of the broader historical setting on the unfolding of ERP as well as approaches able to track both the trajectory of these artefacts over time. The framework developed is based on a review of relevant scholarship from Science & Technology Studies, Organization Studies, Cultural Psychology and IS research.
Forensic science has become increasingly important within contemporary criminal justice, from criminal investigation through to courtroom deliberations, and an increasing number of agencies and individuals are having to engage with its contribution to contemporary justice. This Handbook aims to provide an authoritative map of the landscape of forensic science within the criminal justice system of the UK. It sets out the essential features of the subject, covering the disciplinary, technological, organizational and legislative resources that are brought together to make up contemporary forensic science practice. It is the first full-length publication which reviews forensic science in a wider political, economic, social, technological and legal context, identifying emerging themes on the current status and potential future of forensic science as part of the criminal justice system. With contributions from many of the leading authorities in the field it will be essential reading for both students and practitioners
Background There is a need to identify approaches to reduce medication errors. Interest has converged on ePrescribing systems that incorporate computerised provider order entry and clinical decision support functionality. Objectives We sought to describe the procurement, implementation and adoption of basic and advanced ePrescribing systems; to estimate their effectiveness and cost-effectiveness; and to develop a toolkit for system integration into hospitals incorporating implications for practice from our research. Design We undertook a theoretically informed, mixed-methods, context-rich, naturalistic evaluation. Setting We undertook six longitudinal case studies in four hospitals (sites C, E, J and K) that did not have ePrescribing systems at the start of the programme (three of which went live and one that never went live) and two hospitals (sites A and D) with embedded systems. In the three hospitals that implemented systems, we conducted interviews pre implementation, shortly after roll-out and at 1 year post implementation. In the hospitals that had embedded systems, we conducted two rounds of interviews, 18 months apart. We undertook a three-round eDelphi exercise involving 20 experts to identify 80 clinically important prescribing errors, which were developed into the Investigate Medication Prescribing Accuracy for Critical error Types (IMPACT) tool. We elicited the cost of an ePrescribing system at one (non-study) site and compared this with the calculated ‘headroom’ (the upper limit that the decision-maker should pay) for the systems (sites J, K and S) for which effectiveness estimates were available. We organised four national conferences and five expert round-table discussions to contextualise and disseminate our findings. Intervention The implementation of ePrescribing systems with either computerised provider order entry or clinical decision support functionality. Main outcome measures Error rates were calculated using the IMPACT tool, with changes over time represented as ratios of error rates (as a proportion of opportunities for errors) using Poisson regression analyses. Results We conducted 242 interviews and 32.5 hours of observations and collected 55 documents across six case studies. Implementation was difficult, particularly in relation to integration and interfacing between systems. Much of the clinical decision support functionality in embedded sites remained switched off because of concerns about over alerting. Getting systems operational meant that little attention was devoted to system optimisation or secondary uses of data. The prescriptions of 1244 patients were audited pre computerised provider order entry and 1178 post computerised provider order entry implementation of system A at sites J and K, and system B at site S. A total of 21,138 opportunities for error were identified from 28,526 prescriptions. Across the three sites, for those prescriptions for which opportunities for error were identified, the error rate was found to reduce significantly post computerised provider order entry implementation, from 5.0% to 4.0% ( p < 0.001). Post implementation, the overall proportion of errors (per opportunity) decreased significantly in sites J and S, but remained similar in site K, as follows: 4.3% to 2.8%, 7.4% to 4.4% and 4.0% to 4.4%, respectively. Clinical decision support implementation by error type was found to differ significantly between sites, ranging from 0% to 88% across clinical contraindication, dose/frequency, drug interactions and other error types ( p < 0.001). Overall, 43 out of 78 (55%) of the errors had some degree of clinical decision support implemented in at least one of the hospitals. For the site in which no improvement was detected in prescribing errors (i.e. site K), the ePrescribing system represented a cost to the service for no countervailing benefit. Cost-effectiveness rose in proportion to reductions in error rates observed in the other sites (i.e. sites J and S). When a threshold value of £20,000 was used to define the opportunity cost, the system would need to cost less than £4.31 per patient per year, even in site S, where effectiveness was greatest. We produced an ePrescribing toolkit (now recommended for use by NHS England) that spans the ePrescribing life cycle from conception to system optimisation. Limitations Implementation delays meant that we were unable to employ the planned stepped-wedge design and that the assessment of longer-term consequences of ePrescribing systems was impaired. We planned to identify the complexity of ePrescribing implementation in a number of contrasting environments, but the small number of sites means that we have to infer findings from this programme with considerable care. The lack of transparency regarding system costs is a limitation of our method. As with all health economic analyses, our analysis is subject to modelling assumptions. The research was undertaken in a modest number of early adopters, concentrated on high-risk prescribing errors and may not be generalisable to other hospitals. Conclusions The implementation of ePrescribing systems was challenging. However, when fully implemented the ePrescribing systems were associated with a reduction in clinically important prescribing errors and our model suggests that such an effect is likely to be more cost-effective when clinical decision support is available. Careful system configuration considering clinical processes and workflows is important to achieving these potential benefits and, therefore, our findings may not be generalisable to all system implementations. Future work Formative and summative evaluations of efforts will be central to promote learning across settings. Other priorities emerging from this work include the possibility of learning from international experiences and the commercial sector. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research ; Vol. 10, No. 7. See the NIHR Journals Library website for further project information.
There is a growing global interest in integrating health and care through digitalisation. However, many ambitious digitalisation initiatives in the healthcare sector fail to achieve their intended outcomes. One contributing factor is the failure to apply lessons learned from past endeavours. We here leverage the experiences gained from large-scale digitalisation efforts within the National Health Service (NHS) in England to distil valuable insights for strategic decision-makers who are embarking on the development and implementation of initiatives aimed at integrating health and social care through digitalisation. While not exhaustive, our compilation of eight key lessons serves as a foundational resource to inform such initiatives, seeking ultimately to contribute to realising maximum benefits for health and care organisations and service users.
For RFID technology (radio frequency identification), the forms of the standardisation processes are co-evolving with the technology and are being shaped by the technology itself and by the needs of users. However, the engagement of the large majority of end-users in standards development is at best limited. Based on semi-structured interviews with key actors in the automotive industry, the chapter discusses the role that RFID standards play in shaping the adoption of RFID systems in the automotive supply chain.
Despite being a source of significant change, there has been little focus on how and why industry analysts constantly launch, adjust and abandon market-defining categories. To address this issue, we investigate the Big Three industry analyst firms and find that they promote categories clients find valuable and adjust or abandon those no longer attracting attention. Bringing together insights from information systems research and category scholarship, we show that industry analysts ensure their expertise is seen as relevant to clients through material and visual processes theorised as category-work, figuring-work, and client-mapping, which together create client-induced categories'. This novel theorisation throws light on the processes market intermediaries use to align categories with client concerns and how incorporating categories in graphical figurations can intensify the cycle of category creation and abandonment. It also enhances understanding of the dynamics surrounding transitory terminologies and opens up new research opportunities for studying IT markets.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
