Data-Driven Supply Chain Operations-The Pilot Case of Postal Logistics and the Cross-Border Optimization Potential

According to the defined challenge of cross-border delivery, a pilot experiment based on the integration of new digital technologies to assess process optimization potential in the postal sector was designed. The specifics were investigated with events processing based on digital representation. Different events were simulated with scenario analysis with the integration of the Cognitive Advisor and supported by the monitoring of KPIs. The business environment is forcing logistics companies to optimize their delivery processes, integrate new technologies, improve their performance metrics, and move towards Logistics 4.0. Their main goals are to simultaneously reduce costs, environmental impact, delivery times, and route length, as well as to increase customer satisfaction. This pilot experiment demonstrates the integration of new digital technologies for process optimization in real time to manage intraday changes. Postal operators can increase flexibility, introduce new services, improve utilization by up to 50%, and reduce costs and route length by 12.21%. The Cognitive Advisor has shown great potential for the future of logistics by enabling a dynamic approach to managing supply chain disruptions using sophisticated data analytics for process optimization based on the existing delivery infrastructure and improving business processes. Research originality is identified with a novel approach of real-time simulation based on the integration of the Cognitive Advisor in postal delivery.

Analyzing older users' home telehealth services acceptance behavior-applying an Extended UTAUT model

BACKGROUND

Although telehealth offers an improved approach to providing healthcare services, its adoption by end users remains slow. With an older population as the main target, these traditionally conservative users pose a big challenge to the successful implementation of innovative telehealth services.

OBJECTIVES

The objective of this study was to develop and empirically test a model for predicting the factors affecting older users' acceptance of Home Telehealth Services (HTS).

METHODS

A survey instrument was administered to 400 participants aged 50 years and above from both rural and urban environments in Slovenia. Structural equation modeling was applied to analyze the causal effect of seven hypothesized predicting factors. HTS were introduced as a bundle of functionalities, representing future services that currently do not exist. This enabled users' perceptions to be measured on the conceptual level, rather than attitudes to a specific technical solution.

RESULTS

Six relevant predictors were confirmed in older users' HTS acceptance behavior, with Performance Expectancy (r=0.30), Effort Expectancy (r=0.49), Facilitating Conditions (r=0.12), and Perceived Security (r=0.16) having a direct impact on behavioral intention to use HTS. In addition, Computer Anxiety is positioned as an antecedent of Effort Expectancy with a strong negative influence (r=-0.61), and Doctor's Opinion influence showed a strong impact on Performance Expectancy (r=0.31). The results also indicate Social Influence as an irrelevant predictor of acceptance behavior. The model of six predictors yielded 77% of the total variance explained in the final measured Behavioral Intention to Use HTS by older adults.

CONCLUSION

The level at which HTS are perceived as easy to use and manage is the leading acceptance predictor in older users' HTS acceptance. Together with Perceived Usefulness and Perceived Security, these three factors represent the key influence on older people's HTS acceptance behavior. When promoting HTS, interventions should focus to portray it as secure. Marketing interventions should focus also on promoting HTS among health professionals, using them as social agents to frame the services as useful and beneficial. The important role of computer anxiety may result in a need to use different equipment such as a tablet computer to access HTS. Finally, this paper introduces important methodological guidelines for measuring perceptions on a conceptual level of future services that currently do not exist.

Older adults' perceptions of home telehealth services

The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market.

Resuscitation of a micropremie: the case of MacDonald v. Milleville

One of the most unsettling experiences for a neonatologist is having an early gestational-age infant for whom resuscitation has been abandoned or not initiated subsequently begin breathing on his own. That was the experience of Gregory Milleville, MD when at 2:30 AM a nurse brought such an infant with a heart rate of 130 and a temperature of 91.2 degrees F to the neonatal intensive care unit (NICU).