Knowledge management systems success in healthcare: Leadership matters

If you build it, will they come? Exploring the success factors of knowledge management systems in the Malaysian public sector

The current study investigates the factors that influence the success of knowledge management systems in the public sector. This study integrates the DeLone and McLean Model with critical organizational factors. The model has been tested on the data collected from 158 employees in the public sector in Malaysia, the study found that knowledge content quality has a higher significant impact on the use of knowledge management systems than system quality. Perceived usefulness also has a greater impact than user satisfaction in determining the system's overall success. Among the organizational factors, leadership is the most significant determinant of success. However, the culture of sharing, perceived trust, and incentives do not significantly influence the use of knowledge management systems. The findings suggest that public sector organizations should focus on both system and organizational factors to implement successful knowledge management systems.

Knowledge transfer between physicians from different geographical regions in China's online health communities

Online Health Communities (OHCs) are a type of self-organizing platform that provide users with access to social support, information, and knowledge transfer opportunities. The medical expertise of registered physicians in OHCs plays a crucial role in maintaining the quality of online medical services. However, few studies have examined the effectiveness of OHCs in transferring knowledge between physicians and most do not distinguish between the explicit and tacit knowledge transferred between physicians. This study aims to demonstrate the cross-regional transfer characteristics of medical knowledge, especially tacit and explicit knowledge. Based on data collected from 4716 registered physicians on Lilac Garden (DXY.cn), a leading Chinese OHC, Exponential Random Graph Models are used to (1) examine the overall network and two subnets of tacit and explicit knowledge (i.e., clinical skills and medical information), and (2) identify patterns in the knowledge transferred between physicians, based on regional variations. Analysis of the network shows that physicians located in economically developed regions or regions with sufficient workforces are more likely to transfer medical knowledge to those from poorer regions. Analysis of the subnets demonstrate that only Gross Domestic Product (GDP) flows are supported in the clinical skill network since discussions around tacit knowledge are a direct manifestation of physicians' professional abilities. These findings extend current understanding about social value creation in OHCs by examining the medical knowledge flows generated by physicians between regions with different health resources. Moreover, this study demonstrates the cross-regional transfer characteristics of explicit and tacit knowledge to complement the literature on the effectiveness of OHCs to transfer different types of knowledge.

Leadership in the Context of Digital Health Services: A Concept Analysis

AIM

To define and clarify the concept of leadership in the context of digital health services using Walker's and Avant's concept analysis model.

BACKGROUND

Conceptualizing leadership in the context of digital health services is needed to deliver higher quality services and advance research.

METHOD

Searches were conducted of MEDLINE (Ovid), Scopus, CINAHL (EBSCO), and ProQuest (ABI/INFORM). Empirical articles were included if they reported attributes, antecedents, or consequences of leadership in the study context. A total of 4,037 references were identified; 23 were included.

RESULTS

Leadership attributes concerned leaders' behavior, roles, and qualities. Antecedents concerned informatics skills and competence, information and tools, understanding care systems and their complexity, and education. Consequences related to organization, professionals, and patient and care.

CONCLUSION

Based on our results, the term 'e-leadership' should be more widely utilized in nursing practice and research.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse leaders need to be strong leaders; they need to be visionary and use strategic thinking to develop existing and new digital solutions. By becoming e-leaders, nurse leaders may increase the successful development and implementation of eHealth, and benefit clinicians and patients.

The role of information communication technologies as a moderator of knowledge creation and knowledge sharing in improving the quality of healthcare services

This study examines the role of knowledge creation, knowledge sharing and information communication technologies, which are organizational factors that influence the quality of healthcare services. In today’s knowledge-intensive environment, understanding and gaining in-depth knowledge on how to improve the quality of healthcare services is gaining in importance and recognition. Quantitative data collected in 2019 with 151 respondents employed in healthcare organizations was used. Running a series of hierarchical linear regression models, we found a significant positive relationship between knowledge creation and quality of healthcare services, and a significant positive relationship between knowledge sharing and quality of healthcare services. Empirical data additionally provides support for information communication technologies that act as a moderator both in the relationship between knowledge creation and knowledge sharing with quality of healthcare services. With our data, we provide empirical backing for the impact of knowledge creation, knowledge sharing and information communication technologies on the quality of healthcare services that are provided by Montenegrin healthcare organizations. Our paper offers theoretical and practical implications derived from our research study.

A Systematic Approach to Healthcare Knowledge Management Systems in the Era of Big Data and Artificial Intelligence

Big data in healthcare contain a huge amount of tacit knowledge that brings great value to healthcare activities such as diagnosis, decision support, and treatment. However, effectively exploring and exploiting knowledge on such big data sources exposes many challenges for both managers and technologists. In this study, we therefore propose a healthcare knowledge management system that ensures the systematic knowledge development process on various data in hospitals. It leverages big data technologies to capture, organize, transfer, and manage large volumes of medical knowledge, which cannot be handled with traditional data-processing technologies. In addition, machine-learning algorithms are used to derive knowledge at a higher level in supporting diagnosis and treatment. The orchestration of a knowledge system, big data, and artificial intelligence brings many advances to healthcare. Our research results show that the system fully ensures the knowledge development process, serving for knowledge exploration and exploitation to improve decision-making in healthcare. The knowledge system is illustrated for the detection and classification of high blood pressure and brain hemorrhage in text and CT/MRI image formats, respectively, from medical records of hospitals. It can support doctors to accurately diagnose the diseases to give appropriate treatment regimens.

An Integrated Success Model of Internet of Things (IoT)-Based Services in Facilities Management for Public Sector

The rapid growth of the Internet of Things (IoT) has vigorously affected government by enhancing quality and efficiency of public services. However, the application of IoT-based services in public sectors is slow, despite its benefits to citizens. Research is needed to deepen understanding of the factors that influence the successful implementation of facilities management as the Internet-of-Things-based services in public sectors. An integrated model is developed and validated to extend the DeLone and McLean IS success model by including technology readiness and other identified factors which impact the use of facilities management of IoT-based services in public sectors from the perspective of employees. An online questionnaire was developed and distributed to employees from all local authorities throughout Malaysia, and 187 usable responses were collected. The partial least squares structural equation modelling approach was used to test the model, with 90.8% of the variance in IoT-based services, suggesting an acceptable model fit with seven out of nine hypotheses were supported. Thus, the empirical evidence exerts significant effects of technology readiness towards the success of IoT-based facility management in the public sector.

User Engagement and Abandonment of mHealth: A Cross-Sectional Survey

Mobile health (mHealth) apps have great potential to improve health outcomes. Given that mHealth apps have become ubiquitous, there is limited focus on their abandonment. Data concerning crucial metrics, including reasons for adoption and discontinued use, are limited. This study aims to gain broad insights into utilization of mHealth and game-like features promoting user engagement. We conducted a cross-sectional survey of 209 mHealth users worldwide. The 17-item survey assessed sociodemographics, as well as the key motivators for mHealth uptake and discontinued use. Our findings show that sports and fitness activity tracking were the most common categories of health apps, with most users engaging with them at least several times a week. Interestingly, the most downloaded mHealth apps among younger adults include MyFitnessPal, Fitbit, Nike Run Club, and Samsung Health. Critical drivers of abandonment of mHealth apps were amotivation, loss of interest, and experimenting with different apps to identify the most suitable tool. Additionally, the financial cost of mHealth apps is crucial, with most participants advocating for free or more affordable apps. The study findings suggest that while many individuals utilize mHealth, several factors drive their abandonment. Moreover, data indicate that mHealth developers need to consider gamification strategies to sustain user commitment, as well as psychological variables, such as intrinsic motivation.

Assessing the Success of the Perceived Usefulness for Knowledge Management Systems

Recently, Knowledge Management Systems (KMS) consider one of the major fields of study in educational institutions, caused by the necessity to identify their knowledge value and success. Hence, based on the updated DeLone and McLean’s Information Systems Success Model (DMISSM), this study set out to assess the success of the Perceived Usefulness of Knowledge Management Systems (PUKMS) in Iraqi universities. To achieve this objective, the quantitative method is selected as the research design. In total, 421 university administration staff members from 13 Iraqi private universities were conducted. This study highlights a number of significant results depending on structural equation modeling which confirms that system, information, and service quality play a fulfilling role in ensuring user satisfaction and the PUKMS.

Transformational leadership and work performance in health care: the mediating role of job satisfaction

PURPOSE

The purpose of this study is to investigate the relation among transformational leadership, job satisfaction and adaptive performance of health-care professionals and administrative personnel of Portuguese non-profit health-care organizations.

DESIGN/METHODOLOGY/APPROACH

This study collects data using an online survey sent to a nationwide database. This study uses a structural equation modeling approach to specify and estimate models of linear relations among the variables. This study tests the direct and mediated effects proposed by the hypotheses using a sample of non-profit 192 health-care organizations.

FINDINGS

The results show (regardless of being direct health-care professionals or employees performing support functions) that job satisfaction fully mediates the relation between transformational leadership and adaptive performance. Transformational leadership alone and directly seems to have no effect on adaptive performance.

RESEARCH LIMITATIONS/IMPLICATIONS

The theoretical implications of this study concern the influence that transformational leadership has on job satisfaction and the consequent indirect influence on performance regardless of being direct health-care professionals or employees performing support functions.

PRACTICAL IMPLICATIONS

The main managerial contribution of the study regards how health-care organizations' leaders may contribute to increase employees' performance by ensuring job satisfaction.

ORIGINALITY/VALUE

Despite the numerous studies that relate transformational leadership to job satisfaction and performance, there is a gap on research run in health care settings involving both health care and administrative personnel. Transformational leadership can increase the satisfaction of health-care professional and consequently job satisfaction has a positive influence on employees' adaptive performance.

Psychosocial antecedents of knowledge sharing in healthcare research centers: a mixed-methods approach

PURPOSE

Literature addressing psychosocial factors' relation with knowledge sharing in healthcare organizations is still scarce, being of extreme shortage in specific environments, such as healthcare research centers. This paper investigates the impact of psychosocial factors as antecedents of knowledge sharing between healthcare research peers in such environments.

DESIGN/METHODOLOGY/APPROACH

By expanding on the theory of reasoned action (TRA), the authors follow a mixed-methods design to study the relation between perceptions of psychosocial factors and knowledge sharing in healthcare researchers. A quantitative approach uses a structural equation modeling (SEM) to test the links in an original model. A fuzzy-set qualitative comparative analysis (fsQCA) identifies alternative configurations that lead knowledge sharing intention and its absence as well as the knowledge sharing behavior and its absence considering additional sample characteristics.

FINDINGS

Findings show evidence of the proposed psychosocial antecedents' effect on knowledge sharing. Additional configurations of causal conditions that lead to the presence or absence of the intention and knowledge sharing behavior are discussed, with emphasis on both psychosocial antecedent configuration and sample characteristics.

ORIGINALITY/VALUE

This study identifies the influence of both psychosocial and team characteristic aspects leading to knowledge sharing behavior between healthcare researchers. The importance of a rich social network lying on trust is vital for a sharing environment inside research environments. Given the complex nature of behavioral intentionality, additional findings allow an articulation between individual characteristics, substantiating the proposition of complex configurations between antecedents that hints for team configuration strategies and managerial practices in healthcare research teams.

A systematic review exploring the impact of focal leader behaviours on health care team performance

AIM

The aim of this study is to understand how the behaviour of focal leaders impacts health care team performance and effectiveness.

BACKGROUND

Despite recent shifts towards more collectivistic leadership approaches, hierarchical structures that emphasize the role of an individual focal leader (i.e., the formal appointed leader) are still the norm in health care. Our understanding of the effect of focal leader behaviours on health care team performance remains unclear.

EVALUATION

A systematic review was conducted. Five electronic databases were searched using key terms. One thousand forty-seven records were retrieved. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

KEY ISSUES

Fifty papers met the criteria for inclusion, were reviewed and synthesized under the following categories: task-focused leadership, directive leadership, empowering leadership and relational focused leadership.

CONCLUSIONS

Categories are discussed in relation to team performance outcomes, safety specific outcomes, individual-level outcomes and outcomes related to interpersonal dynamics. Emerging themes are explored to examine and reflect on how leadership is enacted in health care, to catalogue best practices and to cascade these leadership practices broadly.

IMPLICATIONS FOR NURSING MANAGEMENT

Empowering and relational leadership styles were associated with positive outcomes for nursing team performance. This underscores the importance of training and encouraging nursing leaders to engage in more collaborative leadership behaviours.

Why online medical teams disband? The role of team diversity and leadership type

Purpose

Online medical teams (MTs), involving collaboration between remote healthcare workers, can provide comprehensive and rapid healthcare to patients. The growth in MTs is continuing, with popularity growing among doctors and patients, but some MTs disband, which could break the continuity of healthcare services provided. We aim to address this pressing issue by exploring the effects of team diversity and leadership types on team status (i.e. team disbandment (TD)). This paper systematically investigates the influences of team diversity, including separation, variety and disparity diversity and the effects of leadership types, including strong, equal and weak types.

Design/methodology/approach

A data set consisting 1,071 online MTs was collected from the Good Doctor website, a leading Chinese online health community (OHC), on January 10, 2018. The data captured included 206 teams which disbanded after 3 months collaboration. Logistic regression and maximum likelihood estimation (MLE) were used to examine their effects.

Findings

The results show that variety diversity, related to departments, positively affects TD, but disparity diversity, referring to clinician titles, negatively affects TD. Separation diversity, in terms of team member attitudes, exerts a negligible influence on disbandment. Although strong and equal leadership types negatively influence TD, they are seen to strengthen the positive effect of variety diversity, suggesting stable structure combinations of strong or equal-type leadership and low department diversity, as well as the match of weak-type leadership and high department diversity.

Originality/value

This paper extends the current understanding of virtual teams and OHCs by examining the role of leadership types and team diversity, and their influencing role on team status. The pairwise combinations are obtained to effectively reduce the disbandment probability of medical teams operating in OHCs, which could help platform managers, team founders and those connected with MTs deal with the team-disbandment crisis, providing both theoretical and practical implications to healthcare providers and researchers alike.

The influence of machine learning-based knowledge management model on enterprise organizational capability innovation and industrial development

The aims are to explore the construction of the knowledge management model for engineering cost consulting enterprises, and to expand the application of data mining techniques and machine learning methods in constructing knowledge management model. Through a questionnaire survey, the construction of the knowledge management model of construction-related enterprises and engineering cost consulting enterprises is discussed. First, through the analysis and discussion of ontology-based data mining (OBDM) algorithm and association analysis (Apriori) algorithm, a data mining algorithm (ML-AR algorithm) on account of ontology-based multilayer association and machine learning is proposed. The performance of the various algorithms is compared and analyzed. Second, based on the knowledge management level, analysis and statistics are conducted on the levels of knowledge acquisition, sharing, storage, and innovation. Finally, according to the foregoing, the knowledge management model based on engineering cost consulting enterprises is built and analyzed. The results show that the reliability coefficient of this questionnaire is above 0.8, and the average extracted value is above 0.7, verifying excellent reliability and validity. The efficiency of the ML-AR algorithm at both the number of transactions and the support level is better than the other two algorithms, which is expected to be applied to the enterprise knowledge management model. There is a positive correlation between each level of knowledge management; among them, the positive correlation between knowledge acquisition and knowledge sharing is the strongest. The enterprise knowledge management model has a positive impact on promoting organizational innovation capability and industrial development. The research work provides a direction for the development of enterprise knowledge management and the improvement of innovation ability.

Reaching out to stakeholders: The use of knowledge terminology on the websites of Australian public hospitals

Background

The objective of the study described in this article was to examine whether, and to what extent, Australian public hospitals use knowledge terminology, i.e. a body of knowledge-related terms, on their websites. The paper also discusses the difference in the level of such communication between large and small hospitals, the factors affecting the use of the knowledge-related terms in the communication and the similarities/differences between the use of knowledge terms in Australian public hospitals and large/small companies in Australia.

Methods

151 Australian public hospitals were included in the research sample: 51 large and 100 small hospitals. Using the method of content analysis, websites mentioning knowledge creation, knowledge sharing, knowledge implementation, and knowledge retention were identified, along with the number of these mentions. Descriptive statistics and chi square test of independence were used to provide answers to four research questions.

Results

Of the 151 hospitals included in the sample, 30 had no website and 62 (50 small and 12 large) had a single page website. The study found that there are differences between Australian public hospitals regarding the level of their knowledge communication on their websites, both between small and large hospitals and between the individual hospitals within the large and small hospital groups.

Conclusions

A well-known saying goes “For the mouth speaks what the heart is full of”. Effective communication of knowledge-related terminologies to both internal and external stakeholders, i.e. the parties who access the websites, is therefore an indication of a knowledge focus in the public hospitals. Large hospitals are generally more active in communicating knowledge terms, although there are some exceptions. Some of the small hospitals can lead by example, but most of them do not include knowledge terminology in their communication on websites.

Information technology and knowledge sharing for better health care: an emerging economy context

Purpose

The present study aims to explore “what” type of knowledge is shared, “how” it is shared and what information and communication tools are used to share knowledge among health-care professionals in the context of emerging “digital laggard” country in the South-Eastern European region (i.e. Bosnia and Herzegovina [B&H]).

Design/methodology/approach

This study applies the qualitative research methodology and thematic analysis for collecting, analysing and interpreting data. Primary data is collected using semi-structured interviews (n = 9). Key informants are employees of the main primary health-care institution in the capital of B&H.

Findings

The results indicate that knowledge sharing among primary health-care practitioners is the interplay of formal and informal exchange of knowledge, facilitated by both traditional communication media (face-to-face interaction) and ICT-based tools. In regards to ICT tools, our findings suggest that instant messing applications (predominantly Viber) are viewed as common media for sharing tacit knowledge within a community of practice.

Research limitations/implications

This study is limited to one emerging digital laggard country; thus, future research regarding ICT-based knowledge sharing in other emerging digital laggard countries is welcomed.

Originality/value

In the context of “digital laggard”, societies, informal, spontaneous and dynamic system of social interactions can be a successful substitute for ICT-based formalised and structured system of knowledge sharing.

How professional capital and team heterogeneity affect the demands of online team-based medical service

BACKGROUND

The provision of medical services by Medical Teams (MT) on Online Healthcare Communities (OHCs) is a novel method employed by geographically-dispersed healthcare professionals to serve one patient simultaneously, allowing patients to receive more specific, targeted and comprehensive advice. As a relatively new method of service delivery, little attention has been paid to identifying the determinants of Team-based Service Demands (TSD). Based on Upper Echelons Theory and Social Exchange Theory, this study examines the impact of both professional capital (status capital and decisional capital) and team heterogeneity (team size and dispersion) on TSD.

METHODS

This study uses data collected from 890 MTs, employing 3994 team members, operating on haodf.com , a Chinese OHC, to examine effects of both leader and team characteristics on TSD.

RESULTS

Our findings suggest that a MT's characteristics have a significant impact on TSD. Firstly, the decisional capital of both leaders and teams were positively related with TSD, while only the status capital of leaders saw a positive impact. Secondly, team heterogeneity influenced TSD in two ways: (1) provided a direct negative impact and (2) positively moderated the relationship between professional capital and TSD.

CONCLUSION

This paper comprehensively studies the impact of TSD from the perspectives of professional capital and team heterogeneity, expanding current theoretical understanding of team heterogeneity and social capital in OHCs. Further, it provides practical suggestions for platform development and team leaders managing MTs in online environments.

Knowledge content quality, perceived usefulness, KMS use for sharing and retrieval

Purpose

Flock leadership theory explores how different collective learning capacities emerge when interacting individuals work through challenges. While research has link other leadership styles with knowledge management systems (KMS), studies examining flock leadership and KMS are largely lacking. This paper aims to investigate the nexus between flock leadership, knowledge content quality, perceived usefulness of KMS, KMS use for sharing and KMS use for retrieval.

Design/methodology/approach

Using survey data (n = 442) from health-care establishments in Jordan, the authors apply structural equation modeling (SEM).

Findings

The results show the following: flock leadership influences knowledge content quality; knowledge content quality influences perceived usefulness of KMS; perceived usefulness of KMS influences KMS use for sharing and retrieval; and knowledge content quality and perceived usefulness of KMS mediates the link between flock leadership and KMS use for sharing and retrieval.

Originality/value

Existing research considered KMS through a narrow lens, without consideration of the social context (collective capacities) that surrounds knowledge workers. This study responds to call for research concerning the motion that says technical and adaptive capacity are the underlying norm that configures flock behaviors. Implications for research and practice are discussed.

Securing electronic medical record in Near Field Communication using Advanced Encryption Standard (AES)

Doctors usually require patients' medical records before medical examinations. Nevertheless, obtaining such records may take time. Hence, Near Field Communication (NFC) could be used to store and send medical records between doctors and patients. Another issue is that there could be a threat such as, Man In The Middle Attack and eavesdropping, thus, a security method is required to secure the data. Furthermore, the information regarding the key and initialisation vector in NFC cannot be sent using one data package, hence, the data transmission should be done several times. Therefore, the initialisation vector that changed in each transmission is implemented, and the key utilised is based on the component agreed by both parties. This study aims at applying the cryptography process that does disturb and hinder the speed of data transmission. The result demonstrated that the data transmitted could be secured and the encryption process did not hinder data exchange. Also, different number of characters in plaintexts required different amount of time for encryption and decryption. It could be affected by the specifications of the devices used and the processes happening in the devices.