A rise in chronic conditions has put a strain on our healthcare system. Treatment for chronic conditions spans time, agencies, and providers, making coordination a complex problem. Information systems such as electronic health records should be helping with the challenge of coordination, but research shows that often they do not. This thesis aims to alleviate this problem by examining the design of health information technology with an emphasis on social and organizational processes. The focus of this thesis is on the implications of continuous care over time: the shift from a single provider to team-based services, the emergence of patients and families as primary caregivers in the home, and the diffusion of data-driven decision making. I investigated these trends to understand the role of data in coordinating long-term care, and inform the design of information systems. I studied behavioral and mental health services for children, which are coordinated across clinical, home, and special education settings. I found coordination that was unstructured, unpredictable, and adaptive. I developed a conceptual framework, collaborative reflection, to describe my observations and distinguish my findings from the processes of time-critical and protocol-based care. I also found ways in which coordination was not data-driven, due to a lack of support and tools. Collaborative reflection thus illustrates how long-term coordination works when it is data-driven, informing a discussion of what is needed for coordination to be data-driven. Based on the process of collaborative reflection, and using participatory design, I developed Lilypad—a tablet-based information system for data-driven coordination. I conducted a five-month deployment study of Lilypad in the field, to examine its social impact. This study validated designing for collaborative reflection to improve the use of data in coordination. The contributions of this thesis are: a description of unstructured and informal workflow that drives long-term coordination in health services; the theoretical construct of collaborative reflection to inform the design of systems that improve coordination; a field deployment validation, demonstrating how designing for collaborative reflection improves coordination and avoids common unintended consequences of health information technology.

A dissertation submitted to the Faculty of Arts in fulfilment of the requirements for the Degree of Doctor of Philosophy (Library and Information Studies) in the Department of Information Studies at the University Of Zululand, 2017 / This study examined access and use of clinical informatics among medical doctors at University College Hospital, Nigeria and King Edward VIII Hospital, South Africa. The specific objectives of the study were to explain the purposes of using clinical informatics; determine the benefits of using clinical informatics in the selected teaching hospitals; ascertain the availability of clinical informatics infrastructure in the selected teaching hospitals; identify the clinical informatics facilities that are accessible to medical doctors in the selected teaching hospitals; determine the factors that influence the behavioural intention to use clinical informatics by medical doctors in the selected teaching hospitals; determine the policies that guide the effective accessibility and utilisation of clinical informatics among medical doctors in the selected teaching hospitals; and investigate the challenges that faced both the access to and the use of clinical informatics among medical doctors in the selected teaching hospitals. The study adopted the post-positivist paradigm which combines both qualitative and quantitative research methods. The study largely used a survey design. The sample for the study was drawn from medical doctors in two purposively selected teaching hospitals in Nigeria and South Africa. The teaching hospitals were King Edward V111 hospital, Durban, South Africa and University College Hospital, Ibadan, Nigeria. The two teaching hospitals were selected because they belong to the first generation of teaching hospitals in Nigeria and South Africa, among other reasons. It was believed that they would be well established in terms of funding towards infrastructure and human development in their respective countries. Convenience sampling was used to select the respondents for the study. The questionnaire was administered to 413 medical doctors, 258 (63%) of whom returned the questionnaire. Interviews were also conducted with the heads of the ICT units at the University College Hospital in Ibadan, Nigeria, and King Edward VIII Hospital in Durban, South Africa. The quantitative data aspect of the study was analysed using descriptive statistics and Statistical Package for Social Sciences (SPSS), while the qualitative aspect of the data was analysed through the use of qualitative contents analysis. The study was guided by the Unified theory of acceptance and use of technology (UTAUT). The essence of using this theory is to identify the factors that influence the use of clinical informatics. The finding of the study reveals that there was an association between the demographic variables and the use of clinical informatics. It was established that there was a significant association between the medical department and the use of electronic medical records. An assessment of the socio-demographic characteristics and the use of the Clinical Decision Support System revealed that there was a significant association between the years of medical practice and the use of Clinical Decision Support System. The finding also revealed that social demographic variables such as age, years of practice and position were all significant related with the use of diagnostic image archiving. Furthermore, the surveyed medical doctors stated that their main purpose of using clinical informatics is for medical diagnosis. It was also discovered that there is association between the teaching hospitals and the use of clinical informatics for knowledge sharing. In addition, clinical informatics was found to influence the spirit of team work amongst the medical doctors through knowledge sharing with their professional colleagues and their medical students. Similarly, there were association between the teaching hospitals treatment of patients and effective healthcare delivery. In addition, the major benefit of using clinical informatics in the two hospitals was to reduce medical errors. The most available clinical informatics tools in the selected teaching hospitals were the Diagnosis Image Archiving and Clinical Decision Support System. Performance expectancy and effort expectancy were identified as the factors from the UTAUT that influenced the medical doctors’ behavioural intention to use clinical informatics resources in the selected teaching hospitals. The non-availability of clinical informatics resources was identified as the main challenge facing the effective access to and use of clinical informatics. In addition, the two hospitals relied on the ICT policies of other institutions and did not have their own ICT policies, which was problematic. The study concluded that the clinical informatics environments in the two teaching hospitals are inadequate and there is poor access to clinical informatics resources among medical doctors in the selected teaching hospitals. Major recommendations of the study include the need to establish ICT policies and increase investment in clinical informatics resources at the surveyed teaching hospitals in order to promote effective and value-based healthcare delivery. In addition, the hospital management should create awareness on the importance and benefits of clinical informatics particularly for the medical doctors through informal and continuing education and training such as workshops and short courses. Moreover, the hospital managements need to partner with relevant stakeholders such as government, corporate bodies, and departments of health. This is for the provision of adequate and suitable environment to support the access and use of clinical informatics. Further studies on the various types of health informatics such as nursing informatics, pharmacy informatics and veterinary informatics are recommended. It is also suggested that the study should be extended to other regions of Africa. The study is significant and makes tangible contributions to technology acceptance and use in clinical medicine from developing country contexts such as Nigeria and South Africa giving the increasing role of information and communication technology in diagnosis, prescription, treatment, monitoring and overall management of patient care in an environment characterized by complex diseases. The study has the potential to inform policy, practises, and also contribute to this research in the general area of social information in Africa.

This research reported in this thesis explores job search networking amongst 16-24 year olds living in Scotland, and the role of social media platforms (i.e. Facebook, Twitter, and LinkedIn) during this process. Networking is treated as an information behaviour; reflecting this, the study is underpinned by a prominent model from the domain of information science. A sequential, mixed methods approach was applied to gather data. This included the use of interviews, focus groups, and a survey questionnaire. The interviews incorporated ego-centric network methods to develop a relational perspective of job search networking. The findings show that young people accrue different types of information from network contacts which can be useful for all job search tasks. Indeed, frequent networking offline and on social media is associated with positive job search outcomes. This is especially true of engaging with family members and acquaintances, and frequent use of Facebook for job search purposes. However, demographic and other contextual factors have a substantial impact on the nature of networking behaviours, and the extent to which they can influence outcomes. Additionally, young jobseekers face a range of barriers to networking, do not always utilise their networks thoroughly, and are more likely to use social media platforms as supplementary tools for job search. A key contribution of this work is that it provides a detailed insight into the process of networking that has been neglected in previous studies. Its focus on social media also reveals a new dimension to the concept which has received little attention in the job search literature. Given its focus on young jobseekers living in Scotland, the findings have also been used to create a detailed list of recommendations for practitioners.

Geographically distributed and multidisciplinary collaborations have proven invaluable in answering a range of important scientific questions, such as understanding and controlling disease threats like SARS and AIDS or exploring the nature of matter in particle physics. Despite this, however, collaboration can often be problematic. There are institutional obstacles, collaboration tools may be poorly designed, and group coordination is difficult. To better design technologies to support research activities, we need an improved understanding of why scientists collaborate and how their collaborations work. To achieve this improved understanding, this study compares two theoretical approaches to collaboration propensityâ that is, the extent to which collaboration is perceived as useful by individual researchers. On one hand, cultural comparisons of disciplines suggest that collaboration propensity will be higher in disciplinary cultures that have a more collectivist orientation, as indicated by low levels of competition for individual recognition and few concerns about secrecy related to commercialization and intellectual property. In contrast, an approach based on social and organizational psychology suggests that collaboration propensity will vary as a function of resource concentration, fieldwide focus on a well-defined set of problems, and the need for and availability of help when difficult problems are encountered in day-to-day work. To explore this question, a mail survey of 900 academic researchers in three fields was conducted, along with 100 interviews with practicing researchers at 17 sites in the field. Results support a focus on work attributes in interpreting collaboration propensity. That is, cultural factors such as competition for individual recognition and concerns about intellectual property were not perceived as significant impediments to collaboration. Instead, characteristics like resource concentration and the need for coordination were more important in determining collaboration propensity. Implications of these findings include a call for more careful examination of the day-to-day work of scientists and engineers, and a suggestion that concerns about scientific competition impeding collaboration may be unwarranted.

The overall aim of this research was to enhance the understanding of what affects the social impact of ICT in lifelong learning on disadvantaged women. In contributing to the field of social informatics, this research employs behavioural theories as strategy and analytic possibilities. This research mainly used the Kenyan digital villages as CRCs as settings but did also look beyond such establishments to provide a more solid picture. The studies were located in Kenya with complementary studies in Bolivia, Cameroon, Sri Lanka, and Sweden. The main strategies and methods used were case study, comparative education approaches, and observations and interviewing techniques. The findings suggest that ICT and CRCs have the potential to support disadvantaged women and their lifelong learning. However, the positive social impacts are limited because the arrangement of them generally does not favour vernacular languages, illiterate users, female owners and users, or non-students. In general, the use of ICT was sometimes perceived as forced, which is both a barrier and a stressor in the use of ICT in lifelong learning. It also emerged from the comparative studies that discussions among the participants in the CRCs largely covered issues in respect to 1) family and reproduction and 2) self-esteem, i.e. what settles the matter of the social impact of ICT in lifelong learning depends on change attitude among men and women. With minimal if not zero self-esteem a change that would make the difference or break a woman’s “legendary status quo” in order for a woman to feel that she can reach her goal or ambitions in lifelong learning would be difficult. Hence the lack of self-esteem is a stressor in itself. This research is valuable for stakeholders delving into issues of development and learning using ICTs, not only in Kenya but in a broader, global perspective. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 6: Submitted.</p>

This dissertation presents a preliminary grounded theory of community networking based on 63 evaluations of community networking projects funded by the National Telecommunications and Information Administration’s Technology Opportunities Program (TOP) between 1994 and 2007. The substantive grounded theory developed is that TOP projects differed in their contribution to positive outcomes for intended disadvantaged community beneficiaries based on the extent and manner in which they involved the disadvantaged community during four grant process phases: partnership building, project execution, evaluation, and close-out. Positive outcomes for the community were facilitated by using existing communication channels, such as schools, to connect with intended beneficiaries; local financial institutions to provide infrastructure to support local trade; and training to connect community members to jobs. Theoretical contributions include situating outcomes for disadvantaged communities within the context of the grant process; introducing the “vulnerable community” concept; and identifying other concepts and properties that may be useful in further theoretical explorations. Methodological contributions include demonstrating grounded theory as a viable method for exploring large text-based datasets; paving the way for machine learning approaches to analyzing qualitative data; and illustrating how project evaluations can be used in a similar fashion as interview data. Practical contributions include providing information to guide community networking-related policies and initiatives from the perspectives of stakeholders at all levels, including establishing funded projects as local employment opportunities and re-conceptualizing sustainability in terms of human networks rather than technological networks.

Införandet av ett IT-system är en socioteknisk förändring som ställer många krav på en orga-nisation om det ska betraktas som framgångsrikt. Det finns utmaningar av både teknisk, social och organisatorisk karaktär. I beskrivningar av lyckade systeminföranden framträder ofta fak-torer som påverkade införandets framgång. Syftet med uppsatsen är att få kunskap om dessa faktorer och hur de kan påverka systeminföranden i kommunala organisationer. I detta arbete identifieras dessa faktorer som kallas framgångsfaktorer i teori och genom studier av verkliga omständigheter i organisationer. Faktorerna undersöks och kunskap om dem samlas och pre-senteras. Arbetet genomförs som en kvalitativ intervjuundersökning av två organisationer i två mindre kommuner med stora erfarenheter av systemimplementationer. De personer som intervjuades hade varierande roller inom organisationen och olika erfarenheter av införande-processen. Som resultat presenteras respondenternas upplevelser, erfarenheter och synpunkter på implementationer rörande områden som till exempel systemets användbarhet, ledarskap, utbildning och engagemang. I arbetet framkommer faktorer som uppfattas ha bidragit till framgång, till exempel ledning-ens stöd och engagemang, teknisk stabilitet och användardeltagande. De viktigaste slutsat-serna av arbetet är att flera framgångsfaktorer som beskrivs i studier från andra typer av orga-nisationer även återfinns i kommunala organisationer. Faktorer som påverkar systeminföran-dens framgång återfinns i områden som organisation, kompetens, systemets användbarhet och systemanvändarna. Det förekommer olika metoder för utvärdering, och olika definitioner av framgång, därför är framgångsfaktorer inte generella genvägar till framgång utan snarare un-derlag för arbete före, under och även efter systeminföranden. De specifika omständigheterna vid varje systeminförande och organisationens övergripande strategi för system- och verksam-hetsutvecklingsarbete kan variera, och påverka faktorernas effekter. / An implementation of an IT system is a socio-technical change that places many demands on the organization if the implementation is to be considered successful. There are challenges of both the technical, social and organizational nature. Descriptions of the implementations that were perceived as successful often refers to common factors that contributed to the successful implementation, so-called success factors. The purpose of this work is to obtain knowledge about those factors and how they can affect system implementations in municipal organiza-tions. In this work those so-called success factors are identified based on theory and studies of practical circumstances in organizations. The factors are examined and knowledge about them is gathered and presented. This work is conducted using a qualitative interview study of two organizations in two small municipalities with large experience on system implementations. The interviewed persons have varying roles in the organizations and different experiences of implementations. The results are the respondents' perceived views, experiences and comments on implementations regarding such as system usability, leadership, training and commitment. This work presents factors perceived to have contributed to the success, for example the lead-ers support and commitment, technical stability and user participation. The main conclusions of this work include that a number of success factors that are described in studies from other types of organizations can even be found in municipal organizations. Factors that affect the implementations success are found in fields that regards organization, qualifications, systems applicability and the systems users. There are different methods for evaluation, and different definitions of success, therefore they are not general shortcuts to success, but rather a base for the work before, during and even after the systems implementation. The specific circum-stances of each system implementation and organization overall strategy for system and busi-ness development may vary and influence the factors' effects.

Traditionally, social network analysis (SNA) techniques enable the examination of relationships and the flow of information within networks of human members or groups of humans. This study extended traditional social network analysis to include a nonhuman group member, specifically a document retrieval system. The importance of document retrieval systems as information sources, the changes in business environments that necessitates the use of information and communication technologies, and the attempts to make computer systems more life-like, provide the reasons for considering the information system as a group member. The review of literature for this study does not encompass a single body of knowledge. Instead, several areas combined to inform this study, including social informatics for its consideration of the intersection of people and information technology, network theory and social network analysis, organizations and information, organizational culture, and finally, storytelling in organizations as a means of transferring information. The methodology included distribution of surveys to two small businesses that used the same document retrieval system, followed by semi-structured interviews of selected group members, which allowed elaboration on the survey findings. The group members rated each other and the system on four interaction criteria relating to four social networks of interest, including awareness, access, information flow, and problem solving. Traditional measures of social networks, specifically density, degree, reciprocity, transitivity, distance, degree centrality, and closeness centrality provided insight into the positioning of the nonhuman member within the social group. The human members of the group were able to respond to the survey that included the system but were not ready to consider the system as being equivalent to other human members. SNA measures positioned the system as an average member of the group, not a star, but not isolated either. Examination of the surveys or the interviews in isolation would not have given a complete picture of the system's place within the group.

Technology has allowed for the ability to create online platforms for sources ofreliable and unreliable news media. It is therefore important to understand the roleand relevance of alternative news media today and how disinformation is spreadonline. In this paper, we will examine the role of alternative news media websites inSweden and how it compares to the mainstream media websites spread of informationduring the coverage of the Covid-19 pandemic. We will also explore what thedifference is in their portrayal of events during the coronavirus, and what makes thisdifference appealing to certain readers. Using Google, we searched the top ten articlesfrom four online media news sources. Two of which sources were mainstream mediasources and the other two sources as alternative media. These articles were searchedfor during a specific timeframe and with the keywords such as “Corona” and “Covid19”. The dates for the timeframe of this experiment come from when the coronavirusbroke out in Sweden to one year after the event occurred. The top ten search resultsfrom each news source, as provided to us by Google’s algorithm, were placedthrough a text analysis tool called Voyant. The data findings are presented in threeformats: a Word Cloud, TermsBerry and Distinctive Words Comparison. The resultsof the experiment show a stark contrast in the difference in reporting on thecoronavirus topic between different online newspaper media, specifically alternativemedia news sources. Further research is recommended on a larger scale within thetopic of online alternative media.

Online marketing activities play an increasingly important role for organization in connection with the development of internet based technologies and their positive reception by the society. The aim of this dissertation is to design an artefact that would support the decision making of marketing specialists and thus the management of online marketing activities. The starting point is an explorative research among Czech companies, which identifies the issues felt as problematic and the needs of the selected set of organizations. Introduced at the same time is the current state of use of selected tools for online marketing by these organizations, and the situation is compared with worldwide development. The output of this explorative research, the examination of scientific literature, and a critical analysis serve as a basis for designing an own method, Genoma, whose purpose is to support the decision making of marketing specialists, and thereby also the management of marketing activities in internet-mediated environment. This method is presented as Deming (PDCA) cycle, which enables it to be used not only separately, but also as part of other frameworks for the management of marketing activities (e.g. the frameworks PMF, MCPF and RACE, which are presented in the dissertation). The Genoma method uses mainly the genetic algorithm for selecting a suitable portfolio of online marketing tools for a particular campaign. The selection is made on the basis of expected feedback at the level of social interaction, meeting the given marketing targets, and the financial demands of the individual tools. The prerequisite of using this method is a knowledge base that includes the area of sociotechnical interaction, which is based on interpreting phenomena related to the internet-mediated environment and the features of complex networks. Methodically, this dissertation builds on the complementary relationship of the behavioural (social informatics) and the design type of research (design science research). The final assessment of the suitability of the proposed method is done on the basis of a multiple case study, which uses also an own program created in C#, implementing the genetic algorithm used in the Genoma method.