L’amélioration de la qualité de l’utilisation des médicaments dans les soins primaires est devenue un enjeu crucial. Les pharmaciens communautaires se présentent comme des acteurs centraux dans l’atteinte de cet objectif, en réclamant une extension de leur rôle. L’objectif principal de cette thèse est de mieux comprendre comment les technologies de prescription informatisée (eRx) influencent la transformation du rôle des pharmaciens communautaires. Le premier article présente les résultats d’une étude de cas qui aborde la transformation du rôle des pharmaciens communautaires à partir du concept de professionnalisation. Elle propose un modèle logique des influences d’une technologie de eRx sur cette professionnalisation, élaboré à partir de la typologie de Davenport. Ce modèle logique a été validé en interviewant douze pharmaciens communautaires participant à un projet pilote typique de technologie de eRx. A partir des perceptions des pharmaciens communautaires, nous avons établi que la technologie était susceptible de soutenir la professionnalisation des pharmaciens en passant par cinq mécanismes : la capacité analytique, l’élimination des intermédiaires, l’intégration, l’automatisation et la diffusion des connaissances. Le deuxième article analyse les perturbations induites par les différentes fonctions des technologies de eRx sur la stabilité de la juridiction des pharmaciens communautaires, en se basant sur un cadre de référence adapté d’Abbott. À partir de trente-trois entrevues, avec des praticiens (médecins et pharmaciens) et des élites, cette étude de cas a permis de décrire en détail les influences des différentes fonctions sur les modalités d’action des professionnels, ainsi que les enjeux soulevés par ces possibilités. La perturbation principale est liée aux changements dans la distribution des informations, ce qui influence les activités de diagnostic et d’inférence des professionnels. La technologie peut redistribuer les informations relatives à la gestion des médicaments autant au bénéfice des médecins qu’au bénéfice des pharmaciens, ce qui suscite des tensions entre les médecins et les pharmaciens, mais aussi parmi les pharmaciens. Le troisième article présente une revue systématique visant à faire une synthèse des études ayant évalué les effets des technologies de eRx de deuxième génération sur la gestion des médicaments dans les soins primaires. Cette revue regroupe dix-neuf études menées avec des méthodes observationnelles. Les résultats rapportés révèlent que les technologies sont très hétérogènes, le plus souvent immatures, et que les effets ont été peu étudiés au-delà des perceptions des utilisateurs, qui sont mitigées. Le seul effet positif démontré est une amélioration de la qualité du profil pharmacologique accessible aux professionnels, alors que des effets négatifs ont été démontrés au niveau de l’exécution des prescriptions, tels que l’augmentation du nombre d’appels de clarification du pharmacien au prescripteur. Il semble donc que l’on en connaisse peu sur les effets des technologies de eRx de deuxième génération. Ces trois études permettent de constater que les nouvelles technologies de eRx peuvent effectivement influencer la transformation du rôle du pharmacien communautaire en perturbant les caractéristiques des prescriptions, et surtout, l’information et sa distribution. Ces perturbations génèrent des possibilités pour une extension du rôle des pharmaciens communautaires, tout en soulignant les défis intra et interprofessionnels associés à l’actualisation de ces possibilités. Dans l’ensemble, nos résultats soulignent que les perturbations associées aux technologies de eRx dépassent les éléments techniques du travail des utilisateurs, pour englober de multiples perturbations quant à la nature même du travail et du rôle des professionnels. Les décideurs et acteurs impliqués dans le déploiement des technologies de eRx auraient avantage à prendre en compte l’ensemble de ces considérations pour rapprocher les effets observés des bénéfices promis de ces technologies. / The quality of medication use in primary care needs to improve: this has become a crucial issue. Community pharmacists want to play a key role in meeting this objective and are calling for an expanded role. The main objective of this thesis is to better understand how electronic prescription (eRx) technologies are influencing the transformation of the role played by community pharmacists. The first article presents results from a case study on the transformation of the community pharmacists’ role, based on the concept of professionalization. It proposes a logical model of how an eRx technology influences this professionalization, developed from the Davenport typology. The logical model was validated by interviewing twelve community pharmacists participating in a typical pilot project involving an eRx technology. Based on the perceptions of community pharmacists, we have determined that there are five mechanisms by which the technology is likely to support the professionalization of pharmacists: analytic capacity, the elimination of intermediaries, integration, automation and the dissemination of knowledge. The second article analyzes the disturbances produced by the various functions of eRx technologies on the jurisdiction of community pharmacists, based on an adaptation of Abbott’s model. Using data from 33 interviews with practitioners, physicians and pharmacists, as well as elite members of these two professions, this case study provides a detailed description of how different functions influence professionals’ modalities of action, as well as the issues raised by these possibilities. The primary disturbance is associated with changes in the distribution of information, which can influence the diagnostic and inference activities of professionals. The technology may redistribute information on the management of medication to the benefit of both physicians and pharmacists, and this creates tensions, not only between physicians and pharmacists but also among pharmacists. The third article presents a systematic review that synthesized studies assessing the impacts of second-generation eRx technologies on the management of medication in primary care. It examined 19 studies that applied observational methods. The findings reveal that the technologies are very heterogeneous and often far from mature, and that their effects received little attention beyond the perceptions of users, which were mixed. The only positive impact shown is an improvement to the quality of the pharmacological profile available to professionals. Negative impacts touched on the execution of prescriptions, such as a greater number of calls from pharmacists to prescribers to clarify information. It would therefore appear that little is known about the impacts of second-generation eRx technologies. These three studies allow us to conclude that new eRx technologies may well influence how the role of the community pharmacist is being transformed, specifically by disturbing the characteristics of prescriptions and, above all, information and its distribution. These disturbances generate opportunities for extending the role of community pharmacists, while underscoring the intra and interprofessional challenges associated with their realization. Overall, our results suggest that the disturbances associated with eRx technologies go beyond technical aspects of users’ work, to include multiple disturbances of the very nature of the professionals’ work and role. The decision makers and actors involved in deploying eRx technologies would be well advised to take all these considerations into account to bring the observed effects of these technologies more in line with their promised benefits.

L’amélioration de la qualité de l’utilisation des médicaments dans les soins primaires est devenue un enjeu crucial. Les pharmaciens communautaires se présentent comme des acteurs centraux dans l’atteinte de cet objectif, en réclamant une extension de leur rôle. L’objectif principal de cette thèse est de mieux comprendre comment les technologies de prescription informatisée (eRx) influencent la transformation du rôle des pharmaciens communautaires. Le premier article présente les résultats d’une étude de cas qui aborde la transformation du rôle des pharmaciens communautaires à partir du concept de professionnalisation. Elle propose un modèle logique des influences d’une technologie de eRx sur cette professionnalisation, élaboré à partir de la typologie de Davenport. Ce modèle logique a été validé en interviewant douze pharmaciens communautaires participant à un projet pilote typique de technologie de eRx. A partir des perceptions des pharmaciens communautaires, nous avons établi que la technologie était susceptible de soutenir la professionnalisation des pharmaciens en passant par cinq mécanismes : la capacité analytique, l’élimination des intermédiaires, l’intégration, l’automatisation et la diffusion des connaissances. Le deuxième article analyse les perturbations induites par les différentes fonctions des technologies de eRx sur la stabilité de la juridiction des pharmaciens communautaires, en se basant sur un cadre de référence adapté d’Abbott. À partir de trente-trois entrevues, avec des praticiens (médecins et pharmaciens) et des élites, cette étude de cas a permis de décrire en détail les influences des différentes fonctions sur les modalités d’action des professionnels, ainsi que les enjeux soulevés par ces possibilités. La perturbation principale est liée aux changements dans la distribution des informations, ce qui influence les activités de diagnostic et d’inférence des professionnels. La technologie peut redistribuer les informations relatives à la gestion des médicaments autant au bénéfice des médecins qu’au bénéfice des pharmaciens, ce qui suscite des tensions entre les médecins et les pharmaciens, mais aussi parmi les pharmaciens. Le troisième article présente une revue systématique visant à faire une synthèse des études ayant évalué les effets des technologies de eRx de deuxième génération sur la gestion des médicaments dans les soins primaires. Cette revue regroupe dix-neuf études menées avec des méthodes observationnelles. Les résultats rapportés révèlent que les technologies sont très hétérogènes, le plus souvent immatures, et que les effets ont été peu étudiés au-delà des perceptions des utilisateurs, qui sont mitigées. Le seul effet positif démontré est une amélioration de la qualité du profil pharmacologique accessible aux professionnels, alors que des effets négatifs ont été démontrés au niveau de l’exécution des prescriptions, tels que l’augmentation du nombre d’appels de clarification du pharmacien au prescripteur. Il semble donc que l’on en connaisse peu sur les effets des technologies de eRx de deuxième génération. Ces trois études permettent de constater que les nouvelles technologies de eRx peuvent effectivement influencer la transformation du rôle du pharmacien communautaire en perturbant les caractéristiques des prescriptions, et surtout, l’information et sa distribution. Ces perturbations génèrent des possibilités pour une extension du rôle des pharmaciens communautaires, tout en soulignant les défis intra et interprofessionnels associés à l’actualisation de ces possibilités. Dans l’ensemble, nos résultats soulignent que les perturbations associées aux technologies de eRx dépassent les éléments techniques du travail des utilisateurs, pour englober de multiples perturbations quant à la nature même du travail et du rôle des professionnels. Les décideurs et acteurs impliqués dans le déploiement des technologies de eRx auraient avantage à prendre en compte l’ensemble de ces considérations pour rapprocher les effets observés des bénéfices promis de ces technologies. / The quality of medication use in primary care needs to improve: this has become a crucial issue. Community pharmacists want to play a key role in meeting this objective and are calling for an expanded role. The main objective of this thesis is to better understand how electronic prescription (eRx) technologies are influencing the transformation of the role played by community pharmacists. The first article presents results from a case study on the transformation of the community pharmacists’ role, based on the concept of professionalization. It proposes a logical model of how an eRx technology influences this professionalization, developed from the Davenport typology. The logical model was validated by interviewing twelve community pharmacists participating in a typical pilot project involving an eRx technology. Based on the perceptions of community pharmacists, we have determined that there are five mechanisms by which the technology is likely to support the professionalization of pharmacists: analytic capacity, the elimination of intermediaries, integration, automation and the dissemination of knowledge. The second article analyzes the disturbances produced by the various functions of eRx technologies on the jurisdiction of community pharmacists, based on an adaptation of Abbott’s model. Using data from 33 interviews with practitioners, physicians and pharmacists, as well as elite members of these two professions, this case study provides a detailed description of how different functions influence professionals’ modalities of action, as well as the issues raised by these possibilities. The primary disturbance is associated with changes in the distribution of information, which can influence the diagnostic and inference activities of professionals. The technology may redistribute information on the management of medication to the benefit of both physicians and pharmacists, and this creates tensions, not only between physicians and pharmacists but also among pharmacists. The third article presents a systematic review that synthesized studies assessing the impacts of second-generation eRx technologies on the management of medication in primary care. It examined 19 studies that applied observational methods. The findings reveal that the technologies are very heterogeneous and often far from mature, and that their effects received little attention beyond the perceptions of users, which were mixed. The only positive impact shown is an improvement to the quality of the pharmacological profile available to professionals. Negative impacts touched on the execution of prescriptions, such as a greater number of calls from pharmacists to prescribers to clarify information. It would therefore appear that little is known about the impacts of second-generation eRx technologies. These three studies allow us to conclude that new eRx technologies may well influence how the role of the community pharmacist is being transformed, specifically by disturbing the characteristics of prescriptions and, above all, information and its distribution. These disturbances generate opportunities for extending the role of community pharmacists, while underscoring the intra and interprofessional challenges associated with their realization. Overall, our results suggest that the disturbances associated with eRx technologies go beyond technical aspects of users’ work, to include multiple disturbances of the very nature of the professionals’ work and role. The decision makers and actors involved in deploying eRx technologies would be well advised to take all these considerations into account to bring the observed effects of these technologies more in line with their promised benefits.

Tato práce rozšiřuje nástroj ANaConDA pro dynamickou analýzu vícevláknových programů o možnost analyzovat také programy víceprocesové. Část práce se soustředí na popis nástroje ANaConDA a mechanismů, které pro monitorování využívá, a na jejich nutné úpravy vzhledem k rozdílům procesů a vláken. Tyto zahrnují nutnost složitějších mechanismů pro meziprocesovou komunikaci, nutnost překládat logické adresy na jiný jednoznačný identifikátor a monitorování obecných semaforů. Rozšíření pro monitorování procesů tyto problémy řeší za vývojáře analyzátorů, čímž velmi zjednodušuje jejich vývoj. Užitečnost rozšíření je ukázána na implementaci dvou analyzátorů pro detekci souběhu (AtomRace a FastTrack), které bylo dosud možné využít pouze na vícevláknové programy. Implementace algoritmu FastTrack využívá happens-before relaci pro obecné semafory, která byla také definována jako součást této práce. Experimenty s analyzátory na studentských projektech ukázaly, že nástroj ANaConDA je nyní schopen detekovat paralelní chyby i ve víceprocesových programech a může tak pomoci při vývoji další skupiny paralelních programů.

This thesis is focused on the enterprise information systems innovation or more precisely on the implementation of the Enterprise Resource Planning system in concrete SME. The second main objective of this thesis is to explicate the possibilities of IS/ICT development cofinancing from the state budget and EU Structural Funds and also to present experience gained during this process in specified company.

Цель исследования – реализация проекта по автоматической проверки контрагентов с использованием современных технологий и методов машинного обучения, выявление проблем конкурентного окружения и разработка способов их решения. Исследование также направлено на определение эффективности такого проекта по автоматизации процесса по сравнению с ручными методами проверки контрагентов и определение его потенциальной экономической выгоды. Объект исследования: процесс автоматизации проверки контрагента на предприятии. Основными результатами работы являются выделенные текущие проблемы в процессе автоматизации проверки контрагента, разработанные пути их решения и собственный проект по автоматизации процесса. Практическая значимость исследования заключается в применении авторских предложений по совершенствованию процесса автоматизации проверки контрагента на предприятия. / The purpose of the study is to implement a project to automatically check counterparties using modern technologies and machine learning methods, identify problems in the competitive environment and develop ways to solve them. The study also aims to determine the effectiveness of such a project to automate the process compared to manual methods of verifying counterparties and determine its potential economic benefits. Object of study: the process of automating the verification of a counterparty at an enterprise. The main results of the work are the identified current problems in the process of automating the verification of a counterparty, developed ways to solve them and our own project to automate the process. The practical significance of the study lies in the application of the author’s proposals for improving the process of automating the verification of counterparties at enterprises.

In the production of paper, the quality of the pulp is an important factor both for the productivity and for the final quality. Reliable real-time measurements of pulp quality are therefore needed. One way is to use acoustic or vibration sensors that give information-rich signals and place the sensors at suitable locations in a pulp production line. However, these sensors are not selective for the pulp properties of interest. Therefore, advanced signal processing and multivariate calibration are essential tools. The current work has been focused on the development of calibration routes for extraction of information from acoustic sensors and on signal processing algorithms for enhancing the information-selectivity for a specific pulp property or class of properties. Multivariate analysis methods like Principal Components Analysis (PCA), Partial Least Squares (PLS) and Orthogonal Signal Correction (OSC) have been used for visualization and calibration. Signal processing methods like Fast Fourier Transform (FFT), Fast Wavelet Transform (FWT) and Continuous Wavelet Transform (CWT) have been used in the development of novel signal processing algorithms for extraction of information from vibrationacoustic sensors. It is shown that use of OSC combined with PLS for prediction of Canadian Standard Freeness (CSF) using FFT-spectra produced from vibration data on a Thermo Mechanical Pulping (TMP) process gives lower prediction errors and a more parsimonious model than PLS alone. The combination of FFT and PLS was also used for monitoring of beating of kraft pulp and for screen monitoring. When using regular FFT-spectra on process acoustic data the obtained information tend to overlap. To circumvent this two new signal processing methods were developed: Wavelet Transform Multi Resolution Spectra (WT-MRS) and Continuous Wavelet Transform Fibre Length Extraction (CWT-FLE). Applying WT-MRS gave PLS-models that were more parsimonious with lower prediction error for CSF than using regular FFT-Spectra. For a Medium Consistency (MC) pulp stream WT-MRS gave predictions errors comparable to the reference methods for CSF and Brightness. The CWT-FLE method was validated against a commercial fibre length analyzer and good agreement was obtained. The CWT-FLE-curves could therefore be used instead of other fibre distribution curves for process control. Further, the CWT-FLE curves were used for PLS modelling of tensile strength and optical parameters with good results. In addition to the mentioned results a comprehensive overview of technologies used with acoustic sensors and related applications has been performed. / Vid framställning av pappersprodukter är kvaliteten på massan en viktig faktor för produktiviteten och kvalitén på slutresultatet. Det är därför viktigt att ha tillgång till tillförlitliga mätningar av massakvalitet i realtid. En möjlighet är att använda akustik- eller vibrationssensorer i lämpliga positioner vid enhetsoperationer i massaprocessen. Selektiviteten hos dessa mätningar är emellertid relativt låg i synnerhet om mätningarna är passiva. Därför krävs avancerad signalbehandling och multivariat kalibrering. Det nu presenterade arbetet har varit fokuserat på kalibreringsmetoder för extraktion av information ur akustiska mätningar samt på algoritmer för signalbehandling som kan ge förbättrad informationsselektivitet. Multivariata metoder som Principal Component Analysis (PCA), Partial Least Squares (PLS) and Orthogonal Signal Correction (OSC) har använts för visualisering och kalibrering. Signalbehandlingsmetoderna Fast Fourier Transform (FFT), Fast Wavelet Transform (FWT) och Continuous Wavelet Transform (CWT) har använts i utvecklingen av nydanande metoder för signalbehandling anpassade till att extrahera information ur signaler från vibrations/akustiska sensorer. En kombination av OSC och PLS applicerade på FFT-spektra från raffineringen i en Termo Mechnaical Pulping (TMP) process ger lägre prediktionsfel för Canadian Standard Freeness (CSF) än enbart PLS. Kombinationen av FFT och PLS har vidare använts för monitorering av malning av sulfatmassa och monitorering av silning. Ordinära FFT-spektra av t.ex. vibrationssignaler är delvis överlappande. För att komma runt detta har två signalbehandlingsmetoder utvecklats, Wavelet Transform Multi Resolution Spectra (WT-MRS) baserat på kombinationen av FWT och FFT samt Continuous Wavelet Transform Fibre Length Extraction (CWT-FLE) baserat på CWT. Tillämpning av WT-MRS gav enklare PLS-modeller med lägre prediktionsfel för CSF jämfört med att använda normala FFT-spektra. I en annan tillämpning på en massaström med relativt hög koncentration (Medium Consistency, MC) kunde prediktioner för CSF samt ljushet erhållas med prediktionsfel jämförbart med referensmetodernas fel. Metoden CWT-FLE validerades mot en kommersiell fiberlängdsmätare med god överensstämmelse. CWT-FLE-kurvorna skulle därför kunna användas i stället för andra fiberdistributionskurvor för processtyrning. Vidare användes CWT-FLE kurvor för PLS modellering av dragstyrka samt optiska egenskaper med goda resultat. Utöver de nämnda resultaten har en omfattande litteratursammanställning gjorts över området och relaterade applikationer. / QC 20100629

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.