This study builds on the theory of planned behavior, institutional and innovation diffusion theories to investigate physicians' responses to introduction of electronic medical records (EMR) in large healthcare organizations. Using a case study methodology, we show that physicians' attitudes towards using EMR are influenced by their perceptions of EMR complexity, relative advantage, compatibility with professional beliefs and individual predisposition to change. Specifically, we found that EMR usability characteristics such as system interface, "navigation," "search" and "speed" are major dimensions underlying physicians' perceptions of EMR complexity. To the extent that navigating and searching for clinical results are seen as difficult, physicians' perceptions of the complexity of using EMR are enhanced, with the result of physicians forming more negative attitudes towards EMR and using EMR less. Accessibility to EMR (i.e. logging in) and availability of hardware are two emergent constructs. These factors are immediate barriers for physicians not using EMR or using EMR minimally. At the same time, these barriers contribute to impacting physicians' perceptions that EMR is difficult to use and disadvantageous (i.e. time inefficient) compared to the paper chart. Results also show that most EMR usage at Alpha is rather "shallow." Physicians tend to use data-retrieval EMR minimally, mainly to supplement the paper chart. The availability of this "competing artifact," that is much easier to use and conveniently located near a patient's room limits the extent to which physicians use EMR at Alpha. Use of an imaging EMR system (EMR3) is more committed. EMR3 is used to replace the "old way" of accessing films. Lack of accessibility and hardware barriers, the relative advantage of EMR3 and other system usability considerations contribute to physicians using this system more faithfully. As regards the question "what do physicians want?" it seems that physicians want a system that that is easy to access and simple to use but most importantly, a system that they can directly identify with, an EMR that is personally relevant. In order to promote a "deeper" level of EMR usage, the benefits of EMR need to be emphasized to physicians while any potential costs or barriers reduced or eliminated.

The organizational consequences of information technology (IT) constitutes a core focus in information systems (IS) research. The relationship between organizations and IT has received considerable attention by IS researchers in order to develop knowledge related to how and why organizations and IT are related. While organizational use of IT continues to increase in practice, previous research has shown that the effects of IT at best are difficult to predict. Consequently, the adoption and assimilation of IT in organizational settings must be recognized as complex and challenging processes, which makes the production of knowledge related to such processes important and pressing.   This dissertation identifies, characterizes and explains a paradoxical outcome of the adoption and assimilation of an enterprise content management (ECM) system in a context of organizational information management. The outcome, labeled the duplicate systems paradox, is constituted by a situation in which an organization continuously allows multiple, overlapping, partially competing and largely incompatible information systems to persist and continue to evolve over time, despite continued awareness of the adverse consequences on organizational information management capabilities. A qualitative case study approach was used as the primary means for data collection. The case study was conducted in the administrative divisions of HealthOrg, a large organization in the medical- and health care sector. To this end, the main objective of this dissertation is to investigate how this paradox was formed, and furthermore, how and why it was able to persist. In order to do this, dialectical theory is combined with contextualism and theory on organizational information processing to form a comprehensive theoretical perspective used to inform the analytical efforts.   By using a dialectical approach, the analysis presents empirical evidence of the existence and composition of three overarching contradictions found to affect the formation and persistence of the duplicate systems paradox. More specifically, the resulting explanatory model demonstrates how three pairs of opposites, control versus support at the requirements level, options versus practices at the solutions level, and top-down versus bottom-up approaches at the transformations level, along with contextual tensions, were essential components in the formation and persistence of the paradox. Thus, the duplicate systems paradox could form and continue to evolve due to contradictory forces present at, and interconnected between, different vertical and horizontal levels within the organization. Through the identification and explanation of the duplicate systems paradox, this study provides a detailed example of how, and why, unintended consequences of IT in organizations may emerge and continue over time.   In terms of implications for research and practice, the findings of this dissertation point to six important observations. First, this research suggests that understanding and characterizing the context in which IT is to be implemented is crucial and challenging. Thus, organizations should pay careful attention to the practical side of context, rather than to the somewhat theoretical boundaries of organizations. It is suggested that the concepts of ‘inner’ and ‘outer’ context may be useful in analyzing and understanding context. Second, this research suggests that organizations should attempt to identify potentially conflicting requirements, and devise clear strategies to decide how to prioritize between such requirements as the identification and explication of requirements present at different levels in the organization may reveal problems that need to be considered when choosing information system (IS). Third, organizations need to pay careful attention to what the adoption of a new IS means in terms of adaptation and/or realignment, and to what extent organizational activities, technological functionalities, or both, should be adapted. Organizations should furthermore be aware that the adoption of systems that can also be used as development platforms may cause a cascade of effects and dependencies that are difficult to manage. Fourth, the findings of this research suggest that organizations faced with the challenge of adopting complex IT solutions need to take into account their previous strategies and planned new ones in order to devise a comprehensive strategic approach since the coexistence of radically different strategies may cause uncertainty and inertia within the overall assimilation process. Fifth, this research indicates that IT management and information management (IM) are highly interrelated activities, but are not mutually exclusive. Thus, organizations adopting technologies that are specifically focused on information management may benefit from developing distinct areas of responsibility and clear communication channels between the involved organizational units. Furthermore, these findings suggest that future research should pay careful attention to, and specifically investigate, the exact nature of the relationship between information management and IT management. Finally, this research demonstrates how a dialectical approach may be used to adequately investigate organizational information management, specifically in relation to the adoption and assimilation of IT.

For many years universities communicated generic graduate attributes (e.g. global citizenship) their students have acquired after studying. Graduate attributes are skills and competencies that are relevant for both employability and other aspects of life (Barrie, 2004). Over the past years and due to the Bologna Process, the focus on competencies has also found its way into universities' curricula. As a consequence, curricula were adapted in order to convey students both in-depth knowledge of a particular area as well as generic competences (Bologna Working Group on Qualifications Framework, 2005, Appendix 8). For example, students with a Master's degree should be able to “communicate their conclusions, and the knowledge and rationale underpinning these, to specialist and non-specialist audiences clearly and unambiguously” (p. 196). This shift has been supported by the demand of the labour market for students that have achieved social and personal competencies, in addition to in-depth knowledge (Heidenreich, 2011). On course level, this placed emphasis on collaborative learning, which had led to “greater autonomy for the learner, but also to greater emphasis on active learning, with creation, communication and participation” (Downes, 2005). The shift to collaborative learning has been supported by existing learning theories and models (Brown et al., 1989; Lave and Wenger, 1991; Vygotsky, 1978), which could explain the educational advantages. For example, collaborative learning has proved to promote critical thinking and communications skills (Johnson and Johnson, 1994; Laal and Ghodsi, 2012). As Haythornthwaite (2006) advocates: “collaborative learning holds the promise of active construction of knowledge, enhanced problem articulation, and benefits exploring and sharing information and knowledge gained from peer-to-peer communication” (p. 10). The term collaboration defies clear definition (Dillenbourg, 1999). In this article, cooperation is seen as the division of labour in tasks, which allows group members to work independently, whereas collaboration needs continuous synchronisation and coordination of labour (Dillenbourg et al., 1996; Haythornthwaite, 2006). Therefore, cooperation allows students to subdivide task assignments, work relatively independent, and to piece the results together to one final product. In contrast, collaboration is seen as a synchronous and coordinated effort of all students to accomplish their task assignment resulting in a final product where “no single hand is visible” (Haythornthwaite, 2006, p. 12). Due to the debate about digital natives (Prensky, 2001) and “students' heavy use of technology” in private life (Luo, 2010, p. 32), teachers have started to explore possible applications of modern technology in teaching and learning. Especially wikis have become popular and gained reasonable attention in higher education. Wikis have been used to support collaborative learning (e.g. Cress and Kimmerle, 2008), collaborative writing (e.g. Naismith et al., 2011), and student engagement (e.g. Neumann and Hood, 2009). A wiki is a “freely expandable collection of interlinked Web ‘pages’, a hypertext system for storing and modifying information - a database, where each page is easily editable by any user” (Leuf and Cunningham, 2001, p. 14; italics in original). Thereby, wikis enable the collaborative construction of knowledge (Alexander, 2006). With the intention to take advantage of the benefits connected with collaborative learning, this doctoral thesis focuses on the facilitation of collaboration in wikis to leverage collaborative learning. The doctoral thesis was founded on a constructivist understanding of reality. The research is associated with three different research areas: adoption of IT, computer-supported collaborative learning, and learning analytics. After reviewing existing literature, three focal points were identified that correspond to the research gaps in these research areas: factors influencing students' use of wikis, assessment of collaborative learning, and monitoring of collaboration. The aims of this doctoral thesis were (1) to investigate students' intentions to adopt and barriers to use wikis in higher education, (2) to develop and evaluate a method for assessing computer-supported collaborative learning, and (3) to map educational objectives onto learning-related data in order to establish indicators for collaboration. Based on the research aims, four studies were carried out. Each study raised unique research questions that has been addressed by different methods. Thereby, this doctoral thesis presents findings covering the complete process of the use of wikis to support collaboration and thus provides a holistic view on the use of wikis in higher education.

For many years universities communicated generic graduate attributes (e.g. global citizenship) their students have acquired after studying. Graduate attributes are skills and competencies that are relevant for both employability and other aspects of life (Barrie, 2004). Over the past years and due to the Bologna Process, the focus on competencies has also found its way into universities' curricula. As a consequence, curricula were adapted in order to convey students both in-depth knowledge of a particular area as well as generic competences (Bologna Working Group on Qualifications Framework, 2005, Appendix 8). For example, students with a Master's degree should be able to “communicate their conclusions, and the knowledge and rationale underpinning these, to specialist and non-specialist audiences clearly and unambiguously” (p. 196). This shift has been supported by the demand of the labour market for students that have achieved social and personal competencies, in addition to in-depth knowledge (Heidenreich, 2011). On course level, this placed emphasis on collaborative learning, which had led to “greater autonomy for the learner, but also to greater emphasis on active learning, with creation, communication and participation” (Downes, 2005). The shift to collaborative learning has been supported by existing learning theories and models (Brown et al., 1989; Lave and Wenger, 1991; Vygotsky, 1978), which could explain the educational advantages. For example, collaborative learning has proved to promote critical thinking and communications skills (Johnson and Johnson, 1994; Laal and Ghodsi, 2012). As Haythornthwaite (2006) advocates: “collaborative learning holds the promise of active construction of knowledge, enhanced problem articulation, and benefits exploring and sharing information and knowledge gained from peer-to-peer communication” (p. 10). The term collaboration defies clear definition (Dillenbourg, 1999). In this article, cooperation is seen as the division of labour in tasks, which allows group members to work independently, whereas collaboration needs continuous synchronisation and coordination of labour (Dillenbourg et al., 1996; Haythornthwaite, 2006). Therefore, cooperation allows students to subdivide task assignments, work relatively independent, and to piece the results together to one final product. In contrast, collaboration is seen as a synchronous and coordinated effort of all students to accomplish their task assignment resulting in a final product where “no single hand is visible” (Haythornthwaite, 2006, p. 12). Due to the debate about digital natives (Prensky, 2001) and “students' heavy use of technology” in private life (Luo, 2010, p. 32), teachers have started to explore possible applications of modern technology in teaching and learning. Especially wikis have become popular and gained reasonable attention in higher education. Wikis have been used to support collaborative learning (e.g. Cress and Kimmerle, 2008), collaborative writing (e.g. Naismith et al., 2011), and student engagement (e.g. Neumann and Hood, 2009). A wiki is a “freely expandable collection of interlinked Web ‘pages’, a hypertext system for storing and modifying information - a database, where each page is easily editable by any user” (Leuf and Cunningham, 2001, p. 14; italics in original). Thereby, wikis enable the collaborative construction of knowledge (Alexander, 2006). With the intention to take advantage of the benefits connected with collaborative learning, this doctoral thesis focuses on the facilitation of collaboration in wikis to leverage collaborative learning. The doctoral thesis was founded on a constructivist understanding of reality. The research is associated with three different research areas: adoption of IT, computer-supported collaborative learning, and learning analytics. After reviewing existing literature, three focal points were identified that correspond to the research gaps in these research areas: factors influencing students' use of wikis, assessment of collaborative learning, and monitoring of collaboration. The aims of this doctoral thesis were (1) to investigate students' intentions to adopt and barriers to use wikis in higher education, (2) to develop and evaluate a method for assessing computer-supported collaborative learning, and (3) to map educational objectives onto learning-related data in order to establish indicators for collaboration. Based on the research aims, four studies were carried out. Each study raised unique research questions that has been addressed by different methods. Thereby, this doctoral thesis presents findings covering the complete process of the use of wikis to support collaboration and thus provides a holistic view on the use of wikis in higher education.:Introduction Theoretical foundation Research areas and focal points Research aims and questions Methods Findings Conclusions References Essay 1: Factors influencing wiki collaboration in higher education Essay 2: Students' intentions to use wikis in higher education Essay 3: Facilitating collaboration in wikis Essay 4: Using fsQCA to identify indicators for wiki collaboration

Involving customers in the creation and design process of new products and services has been dis-cussed in practice and research since the early 1980’s. As one of the first researchers, von Hippel (1986) shed light on the concept of Lead Users, a group of users who are able to provide most accu-rate data on future needs for organizations. Subsequently, many scholars emphasized different areas of contribution for customers and how they provide assistance to the process of innovation. First of all, customers may contribute to product innovation (Cooper & Kleinschmidt, 1987; Driessen & Hillebrand, 2013; Füller & Matzler, 2007; Gruner & Homburg, 2000; Sawhney, Verona, & Prandelli, 2005; Snow, Fjeldstad, Lettl, & Miles, 2011; Yang & Rui, 2009) and service innovation (Abecassis-Moedas, Ben Mahmoud-Jouini, Dell’Era, Manceau, & Verganti, 2012; Alam, 2002; Chesbrough, 2011; Larbig-Wüst, 2010; Magnusson, 2003; Paton & Mclaughlin, 2008; Shang, Lin, & Wu, 2009; Silpakit & Fisk, 1985), e.g., by co-creating values (Prahalad & Ramaswamy, 2004), such as concepts or designs as well as reviewing and testing them throughout the stages of the process of innovation. From the customers’ point of view, being involved in innovation processes and becoming a part of the organ-ization is a desire of an increasing number of them. Customers are demanding more individual and more tailored products. They are increasingly knowledgeable and capable of designing and produc-ing their own products and services. Due to the fact that their influence on product development is positively related to the quality of the new product (Sethi, 2000), more and more organizations appreciate them as innovation actors and are willing to pay them for their input. Today, customers are not only involved in the qualification of products (Callon, Méadel, & Rabeharisoa, 2002; Callon & Muniesa, 2005; Grabher, Ibert, & Flohr, 2009) but also allowed to customize and evaluate them on the path to innovation (Franke & Piller, 2004; Piller & Walcher, 2006; von Hippel & Katz, 2002; von Hippel, 2001). Moreover, there is an abundance of studies that stress the customers’ influence on effectiveness (de Luca & Atuahene-Gima, 2007; Kleinschmidt & Cooper, 1991; Kristensson, Matthing, & Johansson, 2008; Still, Huhtamäki, Isomursu, Lahti, & Koskela-Huotari, 2012) and risk (Bayer & Maier, 2006; Enkel, Kausch, & Gassmann, 2005; Enkel, Perez-Freije, & Gassmann, 2005). While the latter comprises the risk of customer integration as well as the customers’ influence on market risks, e.g., during new product development, studies on effectiveness are mostly concerned with customer-orientation and products/services in line with customers’ expectations (Atuahene-Gima, 1996, 2003; Fuchs & Schreier, 2011). The accompanying change in understanding became known as open innovation (OI; first coined by Chesbrough in 2003) and represents a paradigm shift, where organizations switch their focus from internally generated innovation (i.e., ideation, in-house R&D, etc.) toward external knowledge and open innovation processes, thus, allowing them to integrate external ideas and actors, i.e. custom-ers (Chesbrough, 2006) and other external stakeholders (Laursen & Salter, 2006). Since then, OI has been identified as a success factor for increasing customer satisfaction (Füller, Hutter, & Faullant, 2011; Greer & Lei, 2012) and growing revenues (Faems, De Visser, Andries, & van Looy, 2010; Mette, Moser, & Fridgen, 2013; Spithoven, Frantzen, & Clarysse, 2010). In addition to that, by open-ing their doors to external experts and knowledge workers (Kang & Kang, 2009), organizations cope with shorter innovation cycles, rising R&D costs, and the shortage of resources (Gassmann & Enkel, 2004). Parallel to the paradigm shift in innovation, another shift has taken place in information and com-munication technologies (Kietzmann, Hermkens, McCarthy, & Silvestre, 2011). Only a few years ago, when customer integration was still very costly, companies had to fly in customers, provide facilities onsite, permanently assign employees to such activities, and incentivise each task execut-ed by customers. Today, emerging technologies (subsumed under the term ‘social software’) help integrating customers or other external stakeholders, who are increasingly familiar with the such technologies from personal usage experience (Cook, 2008), and grant them access from all over the world in a 24/7 fashion. Examples include blogging tools, social networking systems, or wikis. These technologies help organizations to access customer knowledge, facilitate the collaboration with customers (Culnan, McHugh, & Zubillaga, 2010; Piller & Vossen, 2012) at reduced costs and allow them to address a much larger audience (Kaplan & Haenlein, 2010). On the other hand, customers can now express their needs in a more direct way to organizations. However, each technology or application category may present a completely different benefit to the process of innovation or parts of it and, thus, the innovation itself. Reflecting these developments, organizations need to know two things: how can they exploit the customers’ knowledge for innovation purposes and how may the implementation of social soft-ware support this. Hence, this research addresses the integration of customers in organizational innovation, i.e. new product development. It addresses how and why firms activate customers for innovation and which contribution customers provide to the process of innovation. Additionally, it investigates which tasks customers may take over in open innovations projects and which strategies organiza-tions may choose to do so. It also addresses which social software application supports each task best and how organizations may select the most suitable application out of a rapidly growing num-ber of alternatives. The nature of this research is recommendatory and aims at designing a solution for organizations that are interested in the potential contribution of customers during innovation, already involve customers in innovation tasks or plan to do so. Following the recommendations of this research should result in a more effective organizational exploitation of customer knowledge and their workforce and, thus, a value added to innovation and the outcomes of the process of innovation, e.g., a product that better fits the customers’ expectations and demands or consequently a better adoption of the product by the customer.

Involving customers in the creation and design process of new products and services has been dis-cussed in practice and research since the early 1980’s. As one of the first researchers, von Hippel (1986) shed light on the concept of Lead Users, a group of users who are able to provide most accu-rate data on future needs for organizations. Subsequently, many scholars emphasized different areas of contribution for customers and how they provide assistance to the process of innovation. First of all, customers may contribute to product innovation (Cooper & Kleinschmidt, 1987; Driessen & Hillebrand, 2013; Füller & Matzler, 2007; Gruner & Homburg, 2000; Sawhney, Verona, & Prandelli, 2005; Snow, Fjeldstad, Lettl, & Miles, 2011; Yang & Rui, 2009) and service innovation (Abecassis-Moedas, Ben Mahmoud-Jouini, Dell’Era, Manceau, & Verganti, 2012; Alam, 2002; Chesbrough, 2011; Larbig-Wüst, 2010; Magnusson, 2003; Paton & Mclaughlin, 2008; Shang, Lin, & Wu, 2009; Silpakit & Fisk, 1985), e.g., by co-creating values (Prahalad & Ramaswamy, 2004), such as concepts or designs as well as reviewing and testing them throughout the stages of the process of innovation. From the customers’ point of view, being involved in innovation processes and becoming a part of the organ-ization is a desire of an increasing number of them. Customers are demanding more individual and more tailored products. They are increasingly knowledgeable and capable of designing and produc-ing their own products and services. Due to the fact that their influence on product development is positively related to the quality of the new product (Sethi, 2000), more and more organizations appreciate them as innovation actors and are willing to pay them for their input. Today, customers are not only involved in the qualification of products (Callon, Méadel, & Rabeharisoa, 2002; Callon & Muniesa, 2005; Grabher, Ibert, & Flohr, 2009) but also allowed to customize and evaluate them on the path to innovation (Franke & Piller, 2004; Piller & Walcher, 2006; von Hippel & Katz, 2002; von Hippel, 2001). Moreover, there is an abundance of studies that stress the customers’ influence on effectiveness (de Luca & Atuahene-Gima, 2007; Kleinschmidt & Cooper, 1991; Kristensson, Matthing, & Johansson, 2008; Still, Huhtamäki, Isomursu, Lahti, & Koskela-Huotari, 2012) and risk (Bayer & Maier, 2006; Enkel, Kausch, & Gassmann, 2005; Enkel, Perez-Freije, & Gassmann, 2005). While the latter comprises the risk of customer integration as well as the customers’ influence on market risks, e.g., during new product development, studies on effectiveness are mostly concerned with customer-orientation and products/services in line with customers’ expectations (Atuahene-Gima, 1996, 2003; Fuchs & Schreier, 2011). The accompanying change in understanding became known as open innovation (OI; first coined by Chesbrough in 2003) and represents a paradigm shift, where organizations switch their focus from internally generated innovation (i.e., ideation, in-house R&D, etc.) toward external knowledge and open innovation processes, thus, allowing them to integrate external ideas and actors, i.e. custom-ers (Chesbrough, 2006) and other external stakeholders (Laursen & Salter, 2006). Since then, OI has been identified as a success factor for increasing customer satisfaction (Füller, Hutter, & Faullant, 2011; Greer & Lei, 2012) and growing revenues (Faems, De Visser, Andries, & van Looy, 2010; Mette, Moser, & Fridgen, 2013; Spithoven, Frantzen, & Clarysse, 2010). In addition to that, by open-ing their doors to external experts and knowledge workers (Kang & Kang, 2009), organizations cope with shorter innovation cycles, rising R&D costs, and the shortage of resources (Gassmann & Enkel, 2004). Parallel to the paradigm shift in innovation, another shift has taken place in information and com-munication technologies (Kietzmann, Hermkens, McCarthy, & Silvestre, 2011). Only a few years ago, when customer integration was still very costly, companies had to fly in customers, provide facilities onsite, permanently assign employees to such activities, and incentivise each task execut-ed by customers. Today, emerging technologies (subsumed under the term ‘social software’) help integrating customers or other external stakeholders, who are increasingly familiar with the such technologies from personal usage experience (Cook, 2008), and grant them access from all over the world in a 24/7 fashion. Examples include blogging tools, social networking systems, or wikis. These technologies help organizations to access customer knowledge, facilitate the collaboration with customers (Culnan, McHugh, & Zubillaga, 2010; Piller & Vossen, 2012) at reduced costs and allow them to address a much larger audience (Kaplan & Haenlein, 2010). On the other hand, customers can now express their needs in a more direct way to organizations. However, each technology or application category may present a completely different benefit to the process of innovation or parts of it and, thus, the innovation itself. Reflecting these developments, organizations need to know two things: how can they exploit the customers’ knowledge for innovation purposes and how may the implementation of social soft-ware support this. Hence, this research addresses the integration of customers in organizational innovation, i.e. new product development. It addresses how and why firms activate customers for innovation and which contribution customers provide to the process of innovation. Additionally, it investigates which tasks customers may take over in open innovations projects and which strategies organiza-tions may choose to do so. It also addresses which social software application supports each task best and how organizations may select the most suitable application out of a rapidly growing num-ber of alternatives. The nature of this research is recommendatory and aims at designing a solution for organizations that are interested in the potential contribution of customers during innovation, already involve customers in innovation tasks or plan to do so. Following the recommendations of this research should result in a more effective organizational exploitation of customer knowledge and their workforce and, thus, a value added to innovation and the outcomes of the process of innovation, e.g., a product that better fits the customers’ expectations and demands or consequently a better adoption of the product by the customer.:1 Introduction 2 Theoretical foundation 3 Research areas and focal points 4 Research aims and questions 5 Methods 6 Findings 7 Conclusion References Essay 1: The Role of External Knowledge in Open Innovation – A Systematic Review of Literature Essay 2: External Knowledge in Organisational Innovation – Toward an Integration Concept Essay 3: Idea Mining – Text Mining Supported Knowledge Management for Innovation Purposes Essay 4: How do Tasks and Technology fit? – Bringing Order to the Open Innovation Chaos