In the United States, the health care sector is 20 years behind in the use of information technology to improve the process of health care delivery as compared to other sectors. Patients have to deliver their data over and over again to every health professional they see. Most health care facilities act as data repositories with limited capabilities of data analysis or data exchange. A remaining challenge is, how do we encourage the use of IT in the health care sector that will improve care coordination, save lives, make patients more involved in decision-making, and save money for the American people? According to Healthy People 2020, several challenges such as making health IT more usable, helping users to adapt to the new uses of health IT, and monitoring the impact of health IT on health care quality, safety, and efficiency, will require multidisciplinary models, new data systems, and abundant research. In this dissertation, I developed and used systems engineering methods to understand the role of new health IT in improving the coordination, safety, and efficiency of health care delivery. It is well known that care coordination issues may result in preventable hospital readmissions. In this dissertation, I identified the status of the care coordination and hospital readmission issues in the United States, and the potential areas where systems engineering would make significant contributions (see Appendix B). This literature review introduced me to a second study (see Appendix C), in which I identified specific patient cohorts, within chronically ill patients, that are at a higher risk of being readmitted within 30 days. Important to note is that the largest volume of preventable hospital readmissions occurs among chronically ill patients. This study was a retrospective data analysis of a representative patient cohort from Tampa, Florida, based on multivariate logistic regression and Cox proportional hazards models. After finishing these two studies, I directed my research efforts to understand and generate evidence on the role of new health IT (i.e., health information exchange, HIE) in improving care coordination, and thereby reducing the chances of a patient to be unnecessarily readmitted to the hospital. HIE is the electronic exchange of patient data among different stakeholders in the health care industry. The exchange of patient data is achieved, for example, by connecting electronic medical records systems between unaffiliated health care providers. It is expected that HIE will allow physicians, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically, and thereby improving the speed, quality, safety and cost of patient care. The federal government, through the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, is actively stimulating health care providers to engage in HIE, so that they can freely exchange patient information. Although these networks of information exchange are the promise of a less fragmented and more efficient health care system, there are only a few functional and financially sustainable HIEs across the United States. Current evidence suggests four barriers for HIE: •Usability and interface issues of HIE systems •Privacy and security concerns of patient data •Lack of sustainable business models for HIE organizations •Loss of strategic advantage of "owning" patient information by joining HIE to freely share data To contribute in reducing usability and interface issues of HIE systems, I performed a user needs assessment for the internal medicine department of Tampa General Hospital in Tampa, Florida. I used qualitative research tools (see Appendix D) and machine learning techniques (see Appendix E) to answer the following fundamental questions: How do clinicians integrate patient information allocated in outside health care facilities? What are the types of information needed the most for efficient and effective medical decision-making? Additionally, I built a strategic gaming model (see Appendix F) to analyze the strategic role of "owning" patient information that health care providers lose by joining an HIE. Using bilevel mathematical programs, I mimic the hospital decision of joining HIE and the patient decision of switching from one hospital to another one. The fundamental questions I tried to answer were: What is the role of competition in the decision of whether or not hospitals will engage in HIE? Our mathematical framework can also be used by policy makers to answer the following question: What are the optimal levels of monetary incentives that will spur HIE engagement in a specific region? Answering these fundamental questions will support both the development of user-friendly HIE systems and the creation of more effective health IT policy to promote and generate HIE engagement. Through the development of these five studies, I demonstrated how systems engineering tools can be used by policy makers and health care providers to make health IT more useful, and to monitor and support the impact of health IT on health care quality, safety, and efficiency.

Although BIM today is a well-known practice, there are shortcomings, mainly within interoperability and communication. It is relevant to seek solutions through new work methods and not just through new technical solutions. There are difficulties in implementing new work methods, as the industry is known to be routine based.  The aim of the study is to clarify the need for increased efficiency in the design process in terms of model calculations, to investigate the possibilities for an improved work method for construction engineers.  To reach the goal, the data collection methods interview and literature study have been chosen. This have been chosen, in order to portray the reality of the business community as well as current research within the chosen problem area.  The study has generated factors, such as: a more frequent information exchange reduces the risk of information loss. Using standardised details as support for reporting provides the ability to mediate preservation of collective experience.  Interoperability can reduce double modelling (which today is a time-consuming part of the workflow). Using the model in more parts of the process as the model has great potential for this since it contains a lot of information. These factors can contribute to increased efficiency of the construction process in terms of model calculations.  The size of the company is not the only thing that factors in when dividing work load. Clear dialogue between disciplines can create better conditions at the start of projects. By connecting more of the design details to the model it can be used in several stages, such as in the inspection phase. For the development of the preservation of experience, a library of construction details for support in design is recommended. Another recommendation is to start the collaboration between the construction engineer and the architect at an earlier stage, to facilitate their work processes.  The results of the study are nationally applicable. The factors relating to efficiency in cost, time and quality have only been studied briefly. The interview methodology applied to the study limits the generalizability when interpretation of opinions is carried out. / Även om BIM idag är en välkänd arbetsmetod så finns det brister, främst inom interoperabilitet och kommunikation. Det är därför relevant att söka lösningar genom nya arbetsmetoder och inte enbart genom tekniska lösningar. Det finns en svårighet att implementera nya arbetsmetoder då branschen är känd för att vara rutinbaserad.  Målet med studien är att klarlägga behoven för en ökad effektivitet i konstruktionsprocessen när det gäller beräkning av modell, för att utreda möjligheterna till en förbättrad arbetsmetod för konstruktörer.  För att uppnå målet, har datainsamlingsmetoderna intervju och litteraturstudie valts. Detta för att ge en förankring till näringslivet samt aktuell forskning inom det valda problemområdet.  Studien har genererat följande faktorer. Att ha ett tätare informationsutbyte minskar risken för informationsförlust. Att använda standardiserade typdetaljer som stöd vid redovisning ger möjlighet att förmedla och erfarenhetsåterföra information.  Interoperabilitet kan minska dubbelmodellering (som idag är en tidskrävande del av arbetsgången). Att kunna nyttja modellen under fler steg i processen då modellen innehåller mycket information och därför har stor potential för detta. Ovan nämnda faktorer kan bidra till ökad effektivitet inom konstruktionsprocessen när det gäller beräkning av modell.  Uppdelning av arbetet beror inte enbart på företagets storlek. Tydlig dialog mellan discipliner kan skapa bättre förutsättningar vid uppstart av projekt. Genom att koppla mer av konstruktionens information till modellen skulle den kunna nyttjas vid fler delmoment, exempelvis vid granskning. För utveckling av erfarenhetsåterföring rekommenderas ett typdetaljsbibliotek för stöd i projektering. En annan rekommendation är att tidigare ha ett samarbete mellan konstruktör och arkitekt för att underlätta bådas arbetsprocess.  Studiens resultat är nationellt applicerbart. Det har inte gjorts några fördjupningar inom faktorer gällande effektivitet inom kostnad, tid och kvalitet. Intervjumetodiken som tillämpats för studien begränsar generaliserbarheten, då tolkning av åsikter utförts.

Class of 2014 Abstract / Specific Aims: Assess the change in efficiency and accuracy of healthcare in provider access to HIE for medication profiles at the PCADC. Methods: Adults detainees admitted from October 22, 2012 to July 31, 2013 were enrolled in this study. A completed Intake Medical Screening form with self-reported/correction facility staff verified medication list will (the old method) be compared to the medication list obtained by querying the medication HIE (the new method). Descriptive statistics will describe the patients. Statistical significance will be calculated using the McNemar chi-square test for comparing the proportions of omissions (medications and strengths) on the 765PI to the HIE with an a priori alpha of 0.05. Main Results: In progress. Conclusion: HIE has the potential to be a valuable tool for healthcare providers operating at an adult detention facility.

Class of 2016 Abstract and Report / Objectives: To evaluate the successes and failures of the recent implementation of the Arizona Health-e Connection (AzHeC) health information exchange (HIE) at the Pima County Adult Detention Center (PCADC); to identify a generalized infrastructure and draft recommendations for implementing HIE at other correctional facilities. Methods: Participants pertinent to the implementation by current staff at the PCADC were identified through snowball sampling. Interviews were conducted in-person or by telephone using a semi-structured interview guide. Demographics regarding roles and responsibilities during implementation were collected during each interview. Participants were asked for input regarding key aspects and lessons learned from the implementation. Interviews were audio-recorded, transcribed verbatim, and then analyzed with Atlas.ti software for common themes. Results: A total of 12 individuals were interviewed, providing a comprehensive set of perspectives. Six common themes were identified: impact of being a novel implementer; challenges surrounding implementation; problems during implementation; what was done well; benefits of the system; and communication during implementation. Potential barriers that were successfully anticipated were establishing the value of the HIE through pilot studies to obtain early stakeholder buy-in, and addressing legal/privacy issues for the at-risk population in the corrections system. Problems that arose during implementation often involved information technology issues. Conclusions: Despite challenges faced throughout the HIE implementation, improvements in patient care, workflow, and time-savings made a tremendous impact for those involved. The lessons learned and advice given by the participants of this study can provide guidance for other correctional health systems wishing to implement a HIE at their facility.

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Previous research on lead generation has ignored the perceived benefits that buyers receive when exchanging information for firm-generated content. This research contends that digital content offered in a content marketing strategy contains specific benefits that drive the customer to participate in information exchange with the firm. Drawing on the social exchange theory (SET), this work examines how business-to-business (B2B) buyers’ perceived benefits of information exchange affect customer social networking site (SNS) engagement, consequently fostering lead generation. The author argues that content appeal (rational versus emotional) and content focus (buyer versus firm) are critical conditions that influence the relationship between buyers’ perceived benefits of information exchange on their engagement levels. The results of the present study support these statements by uncovering that potential buyers rely on more subjective evaluations (such as perceived benefits as source’s credibility, emotional appeals, and content focus). These subjective evaluations thus spur their behaviors (SNS engagement behaviors and disclosure of information) that ultimately impacts firm performance (sales lead generation). This research has important implications for theory, including the use of source credibility, as a construct for the particularism dimension, to analyze how specific benefits of digital content drive customers to participate in information exchange, and engage with the content. Also, results suggest that potential buyers will be more willing to interact and engage with emotional appeals and buyer focused content. This is relevant because it provides insight on how potential buyers, engaged with B2B content marketing, are willing to disclose information in return for digital firm-generated content. This research also has strong implications for managers. The author offers practical guidance to help marketers implement appropriate combinations of content material that increases the customers’ perceived benefits of the information exchange as a way of fostering customer engagement that leads to information disclosure and successful lead generation.

abstract: Blockchain technology enables a distributed and decentralized environment without any central authority. Healthcare is one industry in which blockchain is expected to have significant impacts. In recent years, the Healthcare Information Exchange(HIE) has been shown to benefit the healthcare industry remarkably. It has been shown that blockchain could help to improve multiple aspects of the HIE system. When Blockchain technology meets HIE, there are only a few proposed systems and they all suffer from the following two problems. First, the existing systems are not patient-centric in terms of data governance. Patients do not own their data and have no direct control over it. Second, there is no defined protocol among different systems on how to share sensitive data. To address the issues mentioned above, this paper proposes MedFabric4Me, a blockchain-based platform for HIE. MedFabric4Me is a patient-centric system where patients own their healthcare data and share on a need-to-know basis. First, analyzed the requirements for a patient-centric system which ensures tamper-proof sharing of data among participants. Based on the analysis, a Merkle root based mechanism is created to ensure that data has not tampered. Second, a distributed Proxy re-encryption system is used for secure encryption of data during storage and sharing of records. Third, combining off-chain storage and on-chain access management for both authenticability and privacy. MedFabric4Me is a two-pronged solution platform, composed of on-chain and off-chain components. The on-chain solution is implemented on the secure network of Hyperledger Fabric(HLF) while the off-chain solution uses Interplanetary File System(IPFS) to store data securely. Ethereum based Nucypher, a proxy re-encryption network provides cryptographic access controls to actors for encrypted data sharing. To demonstrate the practicality and scalability, a prototype solution of MedFabric4Me is implemented and evaluated the performance measure of the system against an already implemented HIE. Results show that decentralization technology like blockchain could help to mitigate some issues that HIE faces today, like transparency for patients, slow emergency response, and better access control. Finally, this research concluded with the benefits and shortcomings of MedFabric4Me with some directions and work that could benefit MedFabric4Me in terms of operation and performance. / Dissertation/Thesis / Masters Thesis Computer Engineering 2020

In the context of military field, more and more international coalitions among allied forces have takenplace. Information from heterogeneous systems needs to be exchanged without misinterpretation so theinvolved participating actors can share a common situational awareness regarding certain data and/ormessages. This, in turn, requires the preservation of the intended meaning not only on the syntax,language, and representation level, but on a semantic level as well.The application domain of the Business Object Reference Ontology Program (BORO) method focuseson the development of ontological or semantic models for large complex operational applications,especially in the military context. It is chosen by FOI, the Swedish Defense Research Agency in thefield of Information Systems, to apply to their Semantic Interoperability (SI) project.The goal of this thesis is to investigate how BORO method can be implemented for aligning the dataand/or messages between the Swedish Armed Forces and other military organizations on a semanticlevel for the FOI SI project. To achieve this goal the design science research methodology is conductedthrough a series of steps. The analysis regarding the usability of BORO method for FOI to obtainsemantic interoperability in its project will be demonstrated as the result of this thesis, which can alsobe utilized as a reference for other military organizations when conducting activities of informationexchange.

Purpose – The objective of this study is to shed some light on the information flow between executives and financial analysts in the context of manufacturing performance measurement and evaluation. Design/methodology/approach – The predictive value, information availability and frequency of performance measures used by the sampled manufacturing organizations and financial analysts are compared using multiple regression analysis. Findings – The findings of this study clearly underscore the increasing significance of non-financial and non-traditional performance measures. The importance of customer-based and quality-related measures is noted. Research limitations/implications – The sample used in this study is specific in nature. It consisted of Portuguese manufacturing organizations and Portuguese financial analysts. Thus, the results should be interpreted accordingly. Practical implications – The findings of this study have clear implications for organizational information systems. Re-engineering of organizational information systems is called for toward closing the information gaps which exist in the context of organizational performance measurement. Originality/value – This study has both practical and theoretical value, as it empirically explores the practical implications of some important issues related to organizational performance.