The growth of e-health system has influenced the way health organizations conducttheir business. Communication between these systems is one of the most significantfactors since a more efficient communication system can improve an organizationperformance. Nowadays the health organizations make a lot of investments to deploya suitable information and communication technology to meet their goals.This study investigates the health information exchange within different healthinformation systems. We first carried out a theoretical study to find out the relevantconcepts by reviewing the related literature and analyzing them. As a result of ourtheoretical study we investigate and redesign the basic model of the “Super Clinic” asa new model for health information exchange system. Then we conducted anempirical study to validate the result from the theoretical study which helped us tonarrow down our research area. We revised our proposed theoretical model by thelesson learnt from our empirical study results. Three interviews were conducted withexperts and the outcomes were analyzed using comparative analysis. These interviewsallowed us to outline the most important factors of successful health informationexchange systems (i.e. “Super Clinic”).They also helped us to design a central hub (i.e. “health Hub”) for communicationand information exchange between different information systems. This revised modelof Super Clinic (with the central hub) could be going under more investigation infuture works. / Program: Masterutbildning i Informatik

This interactive session provides opportunities (1) to share ideas for infusing global perspectives and goals into CAPCSD projects, conferences, and the work of committees and task forces; (2) to discuss ways to collaborate in an ongoing global engagement projects and help include content for 2017 conference; and (3) to create how-to guides for ethical and culturally attuned translational research, and clinical education, and service learning.

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 clinical business managers in 2 successful small health care clinics located in the mid-Atlantic region of the United States. Data were collected from semistructured interviews with health care leaders and documents from the health care organization as a resource. Inductive analysis was guided by the Donabedian theory and sociotechnical system theory, and trustworthiness of interpretations was confirmed through member checking. Three themes emerged: standardizing data formats reduced medication errors and increased profits, adopting user-friendly HIE reduced medication errors and increase profits, and efficient communication reduced medication errors and increased profits. The findings of this study contribute to positive change through improved health care delivery to patients resulting in healthier communities.

In a context where technology is increasingly being incorporated into health care practice, many U.S. health care providers and organizations are finding it challenging to connect disparate electronic documentation systems to retrieve patient information when coordinating care across providers and heath care entities. Local and regional health information exchange (HIE) systems were created to facilitate collecting information into one integrated patient record to address information transfer between heath care providers. Yet, adoption and use of HIEs have been low. The purpose of this study was to review the predictive factors accounting for physicians' use of a HIE in the U.S. state of Hawaii. Key factors from the technology acceptance model were evaluated to determine the behavioral intention resulting in actual use of the Hawaii health information exchange (HHIE). Physician characteristics (medical specialty, age, and gender) and location characteristics were also assessed. The total population of the study contained 1034 Hawaii physicians who have signed up to use the HHIE. Linear and logistic regression models were structured to evaluate the predictive nature of (a) use to determine if a physician has ever logged into the HIE and (b) usage to evaluate the extent to which a physician is logging into the HIE. Findings from the study reveal a predictive relationship between the characteristic of medical specialty and HHIE use when comparing primary care and emergency department physicians to physician specialists. Using study results, health care leaders can improve physician outreach and review barriers when using the HIE systems to coordinate care. Policy implications include the possible formulation of future requirements surrounding HIE physician participation.

International business relationships have been widely researched over the last three decades. Themajor attention of these studies, no matter what their theoretical perspective, concerns the MNCs inthe less developing countries (LDCs). Studies that illustrate how firms in LDCs behave regardinginteraction with MNCs are slim. Therefore, this study focuses on firms in LDCs, namely Libyan firms,and their relationships with MNCs. The study reflects not only on the relationships between the localfirms with MNCs but also the impacts of other interrelated business and non-business units on theserelationships. The study employs business network theory for industrial marketing and develops amodel applicable for studying such a market.The empirical study employs a survey method which examines 60 Libyan firms’ relationships withforeign suppliers containing more than 300 questions. In the empirical part, the study shows that therelationships like technological adaptation, technological cooperation and information exchange wereawarded low values. The measures on the other hand show a high value of impact from the politicalactors and even activities in the contextual environment. The study shows in detail where and howthe political actions influence business relationships. These impacts from the local environment affectlocal firms more than the foreign suppliers, and thus have some bearing on the MNCs and local firms’relationship weaknesses and strengths.The thesis’ conceptual contribution stands on development of new notions in business network theoryby integration of the contextual environment, in other words, network environment, and examinationof their impact on the strength of the focal business relationship. The study further contributesknowledge, not only for firms and politicians in LDCs to understand the consequence of their actions,but also provides deep information for MNCs to understand issues like why firms in LDCs behave ina specific way. Such understandings facilitate the development of cooperation. The study providesinformation about a number of characteristics which are specific for the business networks of such amarket which is dependent on only one resource like oil. While most studies in the field ofinternational business regard the business activities of MNCs, more research is needed to also observethe behaviour of firms from LDCs to gain deeper knowledge on the relationship between the MNCsand local firms from LDCs. The role of political actors and the influence of dependency on one soletype of resources and aspects like change in the prices of this resource seem to be important, but arequite neglected in research in international business.

Since the mid-1990s, countries offering tax systems that facilitate international tax avoidance and evasion have been facing growing political pressure to comply with the internationally agreed standards of exchange of tax information. Using data of German investments in tax havens, we find evidence that the conclusion of a bilateral tax information exchange agreement (TIEA) is associated with fewer operations in tax havens and the number of German affiliates has on average decreased by 46% compared to a control group. This suggests that firms invest in tax havens not only for their low tax rates but also for the secrecy they offer. (authors' abstract) / Series: WU International Taxation Research Paper Series

Mechatronic systems encompass a wide range of disciplines, including mechanical and electrical engineering, and hence the development process for mechatronic system is collaborative in nature. Currently the collaborative development of mechatronic systems is inefficient and error-prone because contemporary design environments do not allow sufficient information flow of design and manufacturing data across different engineering domains. Mechatronic systems need to be designed in an integrated fashion allowing designers from multiple engineering domains to receive updates regarding design modifications throughout the design process. One approach to facilitate integrated design of mechatronic systems is to integrate mechanical with electrical engineering CAD systems. Currently there exist numerous techniques that were developed to support various levels of integration between CAD/CAE systems. Standardized data exchange formats, e.g., STEP and IGES, support information exchange between various different CAD and PDM systems. Multi-Representation Architecture (Peak et al.) supports the integration of geometric information in CAD tools with analysis information in CAE tools. Other integration techniques include the Core Product Model (developed at NIST), Active Semantic Networks (Roller et al.), Constraint Linking Bridge (Kleiner et al.), and others. All these techniques have their areas of focus as well as research gaps that need to be covered. One area that needs research attention is the information exchange between mechanical and electrical domains, which is the focus of this thesis. In this thesis, the information exchange between mechanical and electrical domains is explored from two perspectives: conceptual design perspective, in which constraint relationship between attributes of mechanical and electrical components is identified and classified based on the physical forms, functions, and behavior of the mechatronic system; system realization perspective, in which the identified constraints are modeled for propagation between MCAD and ECAD systems. SysML is used to model the constraints between mechanical and electrical components. By means of an illustrative example (a robot arm), the constraint modeling and propagation developed in my thesis are demonstrated and implemented utilizing a MCAD system (SolidWorks) and an ECAD system (EPLAN Electric P8).

Abstract Purpose: The construction industry's productivity in Sweden is low and one of the major causes of this is the lack of work preparation. A study showed that 45 percent of the fault causes could be linked to work preparation and accounted for up to 30 percent of the error costs. Work preparation is a tool for efficient and safe execution of work, but despite good foundation, the use of it does not work at present. The lack of use of work preparation is to a large extent a result of poor communication and information exchange between production management and occupational workers in production. The aim of the work is to investigate communication and information exchange between production management and occupational workers in the production. Identifying deficiencies in communication and information exchange, how they can be rectified. As well as provide improvement suggestions for the use of work preparation as a tool between production management and occupational workers. Method: To achieve the goal, a qualitative case study on three building projects has been carried out. The methodology has been semi structured interviews with team members involved in the work preparation, observation of meetings, document analysis of the organization's work preparation and a literature study to gain knowledge of the factors that cause deficiencies in communication and information exchange of the team members involved in the work preparation. Findings: The identified underlying causes of communication and information exchange failures are too little information about work preparation, unclear how to implement it and too few tools. Production management does not realize the value of work preparation, which means that the time required for a good work preparation is not set aside. Implications: An adequate work preparation is an important factor in increasing the productivity of construction projects. In order to achieve an adequate workforce the organization must have stronger guidelines and more tools to streamline it and appoint the responsible party to implement them. Production management needs to realize the value of a work preparation and set aside the time required for it to be beneficial. Limitations: The limitations on the work have been a requirement based on the time perspective of the work. The work is considered despite the limitation to Peabs office in Jönköping applicable to other projects. The work has not had the purpose of changing the work preparation but focuses on the use of it, how it is worked and used. Reflecting that work preparation is a general term not only used in the construction industry, the result is generalizable to not only building projects but in all areas of work that require a comprehensive work preparation in an efficient and flexible manner. / Sammanfattning Syfte: Byggbranschens produktivitet i Sverige är låg och en av de större felorsakerna till detta är bristande arbetsberedning. I en studie påvisades det att 45 procent av felorsakerna kunde kopplas till arbetsberedning och att det stod för upp till 30 procent av felkostnaderna. Arbetsberedning är ett verktyg för ett effektivt och säkert utförande av arbetsmoment, men trots bra underlag fungerar inte användningen i dagens läge. Den bristande användningen av arbetsberedning är till större del ett resultat av undermålig kommunikation och informationsöverföring mellan produktionsledning och yrkesarbetare i produktionen. Målet med arbetet är att undersöka kommunikation och informationsöverföring mellan produktionsledning och yrkesarbetare inom produktionsmomentet arbetsberedning. Att identifiera brister i kommunikation och informationsöverföringen, hur de kan avhjälpas. Samt ge förbättringsförslag på användningen av arbetsberedning som verktyg mellan produktionsledning och yrkesarbetare. Metod: För att nå målet har en kvalitativ fallstudie på tre byggnadsprojekt utförts. Metodvalen har varit semistrukturerade intervjuer med involverade parter i arbetsberedningen, en innehållsanalys av organisationens arbetsberedning samt en litteraturstudie för att få kunskap om de underliggande orsakerna till brister i kommunikation och informationsöverföring mellan produktionsledning och yrkesarbetare. Resultat: De identifierade underliggande orsakerna till brister i kommunikation och informationsöverföring är för lite information om arbetsberedning, oklart hur den ska genomföras samt för få hjälpmedel. Produktionsledning inser inte värdet av arbetsberedningar vilket gör att tiden som krävs för en god arbetsberedning inte avsätts. Konsekvenser: En adekvat arbetsberedning är en viktig faktor för att öka produktiviteten i byggprojekt. För att uppnå en adekvat arbetsberedning måste organisationen ha starkare riktlinjer och mer hjälpmedel för att effektivisera den och utse ansvarig part som genomför dem. Produktionsledning behöver inse värdet av en arbetsberedning och lägga den tid som krävs för att den ska bli gynnsam. Begränsningar: Begränsningarna i arbetet har varit ett krav utifrån tidsperspektivet för arbetet. Arbetet anses trots avgränsning mot enbart Peabs kontor i Jönköping applicerbart mot andra projekt. Arbetet har inte haft som syfte att ändra på arbetsberedningen utan har fokus på användningen av arbetsmomentet, hur det arbetas med och används. Reflekterande på att arbetsberedningen är en generell term som inte bara används inom byggindustrin så är resultatet generaliserbart och kan användas inom alla områden med arbetsmoment som kräver en arbetsberedning.

This project started with the assumption that some people do not continue to perform their exercises independently after they have visited the physiotherapist. Through the application of different service design methods, the underlying problem was explored and new service solutions were developed and presented with a prototype and scenario. The project was limited to the user group of patients with osteoarthritis who are being treated through physical activity. Osteoarthritis is a very common joint disease in Sweden which affects the cartilage and causing pain. Observations and interviews were directly conducted at the physiotherapists to gain insights on what supports, encourages and prevents the patient to perform their exercise independently. Research was done on the entire journey of the patient, starting when they seek help and ending when they are to manage the treatment on their own. All the steps were presented in a Customer Journey. The insights from the research were presented with key insight, two personas called Gunilla and Bosse representing different types of patients and an Emotional Journey showing their experience of their journey. The ultimate problem definition was done collaboratively with physiotherapists and patients by discussing their unique experiences and frustrations. A key pattern among the problems was information exchange so the ultimate problem was defined: “When, where and how should the information exchange take form so that the patients understand the support, the importance of exercise and are presented with individual adjusted exercises?” It was answered by patients using an Information Journey and giving data to the final solution. The new service solution aims at improving the information exchange between the physiotherapist and the patient, as a step to encourage the patient to perform their exercises. The project also presents a better understanding for the patients experience when meeting with the healthcare. The project was done in cooperation with Experio Lab in Karlstad, with Olga Sabirova Höjerström as supervisor. Experio Lab is a section of County Council of Värmland and works with service design within the healthcare. This project is the degree project of the Bachelor of Science in Innovation and Design engineering at Karlstad University. The project covers 22,5 ECTS credits and extends from January to June in 2018. The supervising teacher is Postdoctoral Researcher Jakob Trischler and examiner of the course is Professor Leo de Vin. / Projektet startade i problematiken kring att patienter inte utför sina ordinerade övningar efter besök hos fysioterapeut. Genom tillämpningen av olika tjänstedesign metoder undersöktes orsakerna och en lösning utvecklades som presenterades med en prototyp samt ett scenario. Projektet begränsades till målgruppen patienter med artros som behandlas genom fysisk aktivitet. Artros är en väldigt vanlig ledsjukdom som påverkar brosket i knät och ger upphov till smärtor i leden. Genom observation och intervju på Fysioterapimottagningen i Kristinehamn samlades data in kring vad som ger stöd och uppmuntrar eller förhindrar patienten att göra sina övningar. Hela patientens resa undersöktes, från att de söker hjälp till att de fortsätter sin behandling på egen hand. Alla steg i resan redovisades i en Costumer Journey. Insikterna från undersökningen presenterades genom viktiga insikter. Två persona, namngivna Gunilla och Bosse, som representerade två olika patienttyper och en Emotional Journey som visade deras upplevelse av sina respektive resor. Den slutgiltiga problemdefinitionen fastslogs tillsammans med fysioterapeuter genom diskussion av deras erfarenhet kring erfarna problem och patienternas upplevelser. Ett genomgående mönster bland problemen var informationsutbyte så den slutgiltiga problemdefinitionen löd: ”När, var och hur ska informationsutbytet vara så att patienten förstår stödet, vikten av träning och är erbjudna en individuell anpassad träning?” Den var besvarad av patienter genom en Information Journey vilket gav data till den slutgiltiga lösningen. Den nya tjänsten är skapad för att förbättra informationsutbytet mellan fysioterapeut och patient, som ett steg i att uppmuntra patienten att utföra sin träning. Projektet presenterar även en större förståelse för patientens upplevelse i deras möte med sjukvården. Projektet utfördes tillsammans med Experio Lab med Olga Sabirova Höjerström som handledare. Experio Lab är en del av utvecklingsenheten på Landstinget i Värmland och tillämpar tjänstedesign inom vården. Arbetet har gjorts i kursen Examensarbete för högskoleingenjörsexamen i Innovationsteknik och design (MSGC12) på Karlstads universitet. Projektet innefattade 22,5 hp och varade från januari till juni, 2018. Projektet har handletts av Jakob Trischler och professor Leo de Vin har varit examinator.

Det är inte längre enskilda företag som konkurrerar mot varandra utan snarare hela försörjningskedjor och detta påstående har varit utgångspunkten för den här studien. I takt med att handeln blir mer global, ställs företag inför utmaningar kring hur internationella relationer ska hanteras. En viktig fråga för konkurrenskraften är hur inköp ska struktureras i praktiken. Företag behöver göra en avvägning i val av försörjningsstrategi som berör frågor kring grad av samverkan och integrering till sina leverantörer. Denna studie är ett illustrerande exempel på hur leverantörsrelationer och försörjningskedjor organiseras i praktiken. Syftet är att skapa en fördjupad förståelse för hur relationer i försörjningskedjor kan utformas, där fokus ligger på informationsutbyte och integrering mellan parterna. För att empiriskt undersöka detta har en kvalitativ fallstudie genomförts hos det svenska detaljhandelsföretaget Rusta. De har fått agera som exempel för att belysa hur företag inom den handelsintensiva sektorn arbetar med frågor kring leverantörsrelationer och global försörjning. Till studien har ett ramverk tagits fram som bygger på tidigare forskning och teorier kring transaktionskostnader, kontrakt och kontroll samt leverantörsrelationer, information och integrering. Dessa ämnen har legat till grund för datainsamlingen. Studiens empiri bygger på insamling av data via intervjuer, dokumentgranskningar och en observation. De resultat som framkommit visar att det är många dimensioner som spelar in vid utformandet av leverantörsrelationer. Rusta har inköpskontor i Asien för att komma närmare sina leverantörer och skapa trygghet i affärsuppgörelserna. I vissa fall arbetar Rusta i närmare relation med sina leverantörer och i andra fall är handelsutbytet av mer transaktionell karaktär. Det framkommer att Rusta delar stora mängder information till sina leverantörer och att detta görs på daglig basis. Integrering framgår ske på olika sätt men något delat affärssystem mellan Rusta och deras leverantörer finns inte. Sammanfattningsvis visar studien på att ju mer komplex en produkt är, desto mer komplex blir relationen och en slutsats som dras är att det inte finns någon generell relation som passar alla affärsuppgörelser. / It is no longer individual companies competing against each other but rather supply chains and this assertion has been the starting point for this study. As trade becomes globalized, companies are faced with challenges about how international relations are to be managed. Companies need to make a consideration in the choice of supply strategy with decisions regarding what degree of cooperation and integration they should have with their suppliers. This study is intended as an illustrative example of how supplier relationships and supply chains are organized in practice, with the purpose to provide in-depth understanding of how relationships in supply chains can be designed. The focus in the study lies on information exchange and integration between the parties. To investigate this, a qualitative case study has been conducted at the Swedish retail company Rusta. They act as an example to help illustrate how companies in trade-intensive sectors work with issues related to supplier relationships and global sourcing. For the study, a framework has been designed based on previous research and theories about transaction costs, contract and control, supplier relations, information and integration. These topics have been the basis for data sample. The study is based on data collected through interviews, document examinations and one observation. The results found show that there are many dimensions in the design of supplier relationships. Rusta has purchasing offices in Asia to be closer to its suppliers and create a more secure business environment for trade. In some cases, Rusta works in close relations with their suppliers and in others on a transactional basis. We see that Rusta shares a large amount of information with their suppliers on a daily basis. Integration is evident in various ways, yet there is no shared business system operating between Rusta and their suppliers. In conclusion, the study shows that the more complex a product is, the more complex the relationship becomes. Another conclusion is that there is no general type of relationship that suits all business transactions.