Stagewise Overview of Issues Influencing Organizational Technology Adoption and Use

Enhancing the Implementation and Integration of mHealth Interventions in Resource-Limited Settings: A Scoping Review

Background

Although mobile health (mHealth) interventions have shown promise in improving health outcomes, most of them rarely translate to scale. Prevailing mHealth studies are largely small-sized, short-term and donor-funded pilot studies with limited evidence on their effectiveness. To facilitate scale-up, several frameworks have been proposed to enhance the generic implementation of health interventions. However, there is a lack of a specific focus on the implementation and integration of mHealth interventions in routine care in low-resource settings. Our scoping review aimed to synthesize and develop a framework that could guide the implementation and integration of mHealth interventions.

Methods

We searched the PubMed, Google Scholar, and ScienceDirect databases for published theories, models, and frameworks related to the implementation and integration of clinical interventions from 1st January 2000 to 31st December 2023. The data processing was guided by a scoping review methodology proposed by Arksey and O'Malley. Studies were included if they were i) peer-reviewed and published between 2000 and 2023, ii) explicitly described a framework for clinical intervention implementation and integration, or iii) available in full text and published in English. We integrated different domains and constructs from the reviewed frameworks to develop a new framework for implementing and integrating mHealth interventions.

Results

We identified eight eligible papers with eight frameworks composed of 102 implementation domains. None of the identified frameworks were specific to the integration of mHealth interventions in low-resource settings. Two constructs (skill impartation and intervention awareness) related to the training domain, four constructs (technical and logistical support, identifying committed staff, supervision, and redesigning) from the restructuring domain, two constructs (monetary incentives and nonmonetary incentives) from the incentivize domain, two constructs (organizational mandates and government mandates) from the mandate domain and two constructs (collaboration and routine workflows) from the integrate domain. Therefore, a new framework that outlines five main domains-train, restructure, incentivize, mandate, and integrate (TRIMI)-in relation to the integration and implementation of mHealth interventions in low-resource settings emerged.

Conclusion

The TRIMI framework presents a realistic and realizable solution for the implementation and integration deficits of mHealth interventions in low-resource settings.

Early Impressions and Adoption of the AtriAmp for Managing Arrhythmias Following Congenital Heart Surgery

AtriAmp is a new medical device that displays a continuous real-time atrial electrogram on telemetry using temporary atrial pacing leads. Our objective was to evaluate early adoption of this device into patient care within our pediatric intensive care unit (PICU). This is a qualitative study using inductive analysis of semi-structured interviews to identify dominant themes. The study was conducted in a single-center, tertiary, academic 21-bed mixed PICU. The subjects were PICU multidisciplinary team members (Pediatric Cardiac Intensivists, PICU Nurse Practitioners, PICU nurses and Pediatric Cardiologists) who were early adopters of the AtriAmp (n = 14). Three prominent themes emerged: (1) Accelerated time from arrhythmia event to diagnosis and treatment; (2) Increased confidence in the accuracy of providers' arrhythmia diagnosis; and (3) Improvement in the ability to educate providers about post-operative arrhythmias. Providers also noted some learning curves, but none compromised medical care or clinical workflow. Insights from early adopters of AtriAmp signal the need for simplicity and fidelity in new PICU technologies. Our research suggests that such technologies can be pivotal to the support and growth of multi-disciplinary teams, even among those who do not participate in early implementation. Further research is needed to understand when and why novel technology adoption becomes widespread in high-stakes settings.

Early Impressions and Adoption of the AtriAmp for Managing Arrhythmias Following Congenital Heart Surgery

Objective

AtriAmp is a new medical device that displays a continuous real-time atrial electrogram on telemetry using temporary atrial pacing leads. Our objective was to evaluate early adoption of this device into patient care, understand how it affected clinical workflow, and identify unforeseen benefits or limitations.

Design

Qualitative study using inductive analysis of semi-structured interviews to identify dominant themes.

Setting

Single center, tertiary, academic 21-bed mixed pediatric intensive care unit (PICU).

Subjects

PICU multidisciplinary team members (Pediatric intensivists, PICU Nurse Practitioners, PICU nurses and Pediatric Cardiologists) who were early adopters of the AtriAmp (n=14).

Results

Three prominent themes emerged from qualitative analysis of the early adopters' experiences. (1) Accelerated time from arrhythmia event to diagnosis, treatment, and determination of treatment effectiveness; (2) Increased confidence and security in the accuracy of providers' arrhythmia diagnosis; and (3) Improvement in the ability to educate providers about post-operative arrythmias where reliance on time consuming consultation is a default. Providers also noted some learning curves with the device; none of which compromised medical care or clinical workflow.

Conclusions

Insights from early adopters of AtriAmp signal the need for simplicity and fidelity in new technologies within the PICU. Further research in the qualitative and observational sphere is needed to understand how technologies, such as AtriAmp, find expanded use in the PICU environment. Our research suggests that such technologies can be pivotal to the support and growth of multi-disciplinary teams, even among those who do not participate in early implementation.

Co-working with robotic and automation technologies: technology anxiety of frontline workers in organisations

Purpose

The advent of robotics and automation technologies was augmenting firm initiatives to attain competitive advantage. From a resource-based view perspective, human-led capabilities were important to operate with technology resource base of an organisation. This was evident for both manufacturing as well as services firms. However, employees as an individual confronted technology anxiety (TA) when they were working with new technologies like robotics and automation technologies. Thus, the purpose of this paper was to examine the factors causing TA.

Design/methodology/approach

Given the novelty of this research study context a qualitative exploratory method was designed. For this research study, the data collected was through in-depth interviews conducted through open-ended semi-structured questionnaire. The data was collected from 62 frontline employees who were working with robotics and automation-based technologies in manufacturing firms. The authors applied thematic content analysis on collected data for analysis.

Findings

Technology anxieties ranged from fear of complete inability to learn new technologies, failure to learn new technologies properly, incapability to implement the learned skills and job loss to younger technology savvy employees. Finally, there was anxiety over job loss as automation and robotic technologies over the years was expected to erode the employment of human workforce altogether.

Research limitations/implications

The author undertook the research study based upon the TA perspective advocated by Meuter et al. (2003) and Yang and Forney (2013). Furthermore, this research study in the context of robotics and automation-based technologies in the manufacturing sector applied the mental accounting theory (Thaler, 1999) and technology self-efficacy perspective (Huffman et al., 2013).

Practical implications

Managers involved in the implementation of robotics and automation-based technologies were required to address TA of employees. Fear of job loss had to be addressed specially in a country like India. Anxiety regarding the ability to learn to work with robotics and automation technologies also was needed to be addressed by managers through adequate training and time for preparation. The benefits of robotics and automation-based technologies for employees as well as organisations have to be ascertained through open communication between the management and the frontline employees.

Originality/value

To the best of the authors’ knowledge, this was one of the first empirical research studies which deliberated regarding TA in the context of frontline workers working with robotics and automation-based technologies in the manufacturing sector. This research study was based upon a combination of varied perspectives ranging from micro foundations theory, TA, mental accounting theory and technology self-efficacy perspective.

Organizational Challenges of Development and Implementation of Virtual Reality Solution for Industrial Operation

This research investigated the organizational challenges related to the development and implementation of virtual reality (VR) technology for operation in a conservative heavy machinery industry. The incorporation of a VR solution for heavy machinery equipment enhanced the safety and convenience of operation under dangerous work conditions. However, the development and implementation processes faced challenges. Furthermore, the adoption of the solution by users was perceived to be slower than anticipated. We aimed to explore the main challenges that the developer organization faced and how it also influenced user organizations. Due to the exploratory nature of the research, qualitative analysis was chosen, interviews were conducted, and thematic analysis was applied. The themes and subthemes were identified and discussed. The results showed the existence of challenges related to technology maturity, managerial challenges regarding communication and support coordination, workload, and multiple stakeholder management. The findings emphasize the importance of attending to the existing and potential organizational challenges before and throughout technological innovation. Theoretical and managerial implications are discussed, and a future research agenda is suggested.

The Assessment of Big Data Adoption Readiness with a Technology–Organization–Environment Framework: A Perspective towards Healthcare Employees

Big data is rapidly being seen as a new frontier for improving organizational performance. However, it is still in its early phases of implementation in developing countries’ healthcare organizations. As data-driven insights become critical competitive advantages, it is critical to ascertain which elements influence an organization’s decision to adopt big data. The aim of this study is to propose and empirically test a theoretical framework based on technology–organization–environment (TOE) factors to identify the level of readiness of big data adoption in developing countries’ healthcare organizations. The framework empirically tested 302 Malaysian healthcare employees. The structural equation modeling was used to analyze the collected data. The results of the study demonstrated that technology, organization, and environment factors can significantly contribute towards big data adoption in healthcare organizations. However, the complexity of technology factors has shown less support for the notion. For technology practitioners, this study showed how to enhance big data adoption in healthcare organizations through TOE factors.