Research Topics
Strategy
My current research is summarized in a diagram I put together for a PhD Seminar at the USC Industrial and Systems Engineering Department. While my research is done at many levels of analysis (see figure), the underlying theme of my research are the process ramifications when information systems are introduced into an organization. These ramifications exist whether the analysis is done at the architecture or process level. Looking for a linkpin is moving me towards broader frameworks such as institutional theory.
E-prescribing
The current approach to e-prescribing has embedded many changes to people and process that have not been recognized.
UPDATE: I responded to AHRQ request for comments (due October 1) on a planned e-prescribing study: ‘‘Health IT Community Tracking Study 2009" (see pdf from Federal Register). Contact me if interested in seeing my response.
Work in Progress
I am digging deeper (e.g., routines) and wider (e.g., network relationships and relationship to other healthcare information systems) on this topic. I am exploring more holistic research methods to account for the diversity of studies and methods employed - the latest being interpretive synthesis.
Published Articles
In Journals
Azad B, King NE, "Enacting Computer Workarounds within a Medication Dispensing System." European Journal of Information Systems, Vol. 17, No. 3, June 2008, pp. 264-278 [2009 AMIA Diana Forsythe Award Finalist]
King NE, Christie T, Alami K, "Process Implications of E-Prescribing Information Integration Models: United States Versus a Middle East Approach", E-service Journal, Vol 5, No. 3, Summer 2007, pp. 15-37 - Healthcare Special Issue
Conferences
King NE, "E-Prescribing as a Micro-Organizational Network – In Search of an Analysis Framework", IWODE09 - International Workshop on Organizational Design and Engineering, December 2009
King NE, “An Initial Exploration of Stakeholder Benefit Dependencies in Ambulatory E-Prescribing",15th Americas Conference on Information Systems, 2009 (pdf)
King NE, “Availability of Prescription Information for Secondary Usage – Impact of Outpatient E-prescribing”, Presentation - Summer Institute in Nursing Informatics 2008 (pdf)
IBM Grant
The IBM study is intended for government decision makers. Derivative works from the data include: mapping technology to benefits accrued by stakeholders, population view of e-prescribing actors and more.
King NE, "Overcoming Ambulatory E-prescribing Adoption Challenges: Governments Shaping Innovation On Behalf Of Individual Stakeholders", Report, IBM Center for the Business of Government (unpublished manuscript). (pdf)
Here is proposal to the IBM Center for Business of Government (first manuscript due January 2008) built upon the E-service article.
Proposal Abstract
The push towards e-prescribing for efficiency and reducing adverse drug events will inevitably shift traditional prescribing roles while increasing the potential for unintended secondary use of prescription data. Accommodating these changes may obscure the real benefit of e-prescribing which is taking advantage of the end-to-end prescription information. Governments have an opportunity to go beyond merely anticipating these challenges but shaping the discussion of innovation enabled by e-prescribing (e.g., comparison shopping). The report builds upon e-prescribing adoption challenges identified by King et al (E-service Journal article) and identifies areas that governments could champion on behalf of healthcare stakeholders to take full advantage of this emerging technology.
IBM CBG E-Prescribing Executive Summary
Workarounds in Clinical Applications
Bijan Azad and I published "Enacting Computer Workarounds within a Medication Dispensing System" in the European Journal of Information Systems. We are working on a dual industry comparative study of workarounds.
Abstract Computer workarounds in health information systems (HIS) threaten the potential for gains in the efficiency of computerization aimed at reducing process variability. Eliminating such workarounds is desirable, but information system (IS) researchers tend to treat computer workarounds as black-boxes, while HIS researchers are primarily concerned with descriptive or prescriptive remedies. We propose to open the black-box of computer workarounds and study them as situated practices that consist of adjustments to existing computer-based procedures, which are enabled by the negotiated order of a hospital. This negotiative property of a hospital’s organizational environment allows for interpretive flexibility, in which physicians stretch certain rules in practice, while inducing others to cooperate in this. We illustrate this conceptual framework with a non-participant observer case study of a medication dispensing system used in a teaching hospital to support a prior-approval policy for anti-microbial drugs. Within these enacted workaround practices, we find significant variety in roles, timing and interactions, which boil down to a pattern of four practices revolving around one function of an HIS. Our research extends the literature on computer workarounds in IS and HIS by proposing a theoretical understanding of workaround practices based on a contextual healthcare study.
As of October 2010 Google Scholar shows seven citations (link to latest)
Stay tuned - several interesting pieces in progress.
Indoor Positioning Systems (RFID and more)
AMCIS 2007 Tutorial with Q Chung, "Positioning and Tracking Technologies in Healthcare: RFID and More"
Q Chung and I plan to write up the positioning taxonomy portion of this tutorial. Stay tuned ...
Hand-held Nursing Applications
I supervise nursing graduate students interested in informatics. The first student identified potential computerization opportunities and concluded a nursing assessment tool would be beneficial. Five paper forms are currently required which means the forms are not completed at bedside. A second nursing student working with two business undergraduates studied the assessment process and came up with user requirements for such a tool and user interface storyboards. The storyboard for the patient medication portion of this hand-held nursing assessment tool (for a PDA) is shown to the right. The hope is that a third nursing student can work with application developers to test a prototype that can be tested among nursing colleagues. A team of engineering seniors are working on the prototype for their final year project.
We presented a poster on the topic:
King NE, Abi Saad M, El Wazzi T, BBA, El Yafi T, Chedid R, Sayeh J, "Privacy and Security Considerations in a Loosely Coupled Wireless Hand-held Nursing Assessment Tool: Some Architectural Tradeoffs", Poster - Summer Institute in Nursing Informatics 2008
Clinical Image Storage Architectures
Clinical implementation work based on a data storage grid is on hold as there are insufficient computing and more importantly internet bandwidth limitations. The entire country of Lebanon has around 100 Mbps so I've been told (in 2005).
My previous work has been published in CAIS and a Top 10 Download from October 2008 to August 2009.
King, Nelson E. (2008) "Information Systems and Healthcare XVII: Operational Stakeholder Relationships in the Deployment of a Data Storage Grid for Clinical Image Backup and Recovery," The Communications of the Association for Information Systems: Vol. 23, Article 1.
Abstract - A data storage grid (DSG) is under development for a federation of clinical sites to provide a cost-effective backup and recovery solution for their clinical images. Geographic separation provides fault-tolerance against localized disasters. Pooling of storage resources across organizations utilizes economies of scale associated with storage area networks. However, the control and administration of a DSG is now spread across multiple organizations increasing the complexity of deployment. Socio-technical issues specific to a DSG arise as there are now multiple stakeholders linked together in a network of new relationships. Agreement upon every relationship is necessary to determine service level agreements, security, and liability such as in the event of a security breach. Implications of socio-technical networks and stakeholder analysis on the operators rather than the users of an inter-organizational DSG are discussed.
Do you see the similarity with Vendor Neutral Archives that hospitals began moving towards in 2009?
Ambiguity and Innovation
Follow-up of my dissertation research - see Education page or go to the Executive Summary. Several working papers are in progress.
* Effect on Innovation of Timely Ambiguity Mitigation
* Role of specific ambiguity types on virtual product definition teams
Sponsored ads test area: