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WHY RFID PROJECTS IN HOSPITALS FAILLESSONS FROM COMPARATIVE CASE STUDIES
Falk Zwicker, Torsten EymannUniversity of Bayreuth, Germany
Agenda
Why RFID?
Life Sciences – not an innovation-friendly domain?
Innovating with IT – an adapted process model
Comparative Case Studies
Summary
Why RFID?
?
Great Technology Yet a little greater technology…
RFID couples physical and logical world
[Zwicker 2009, p.23]
Why RFID?
Visible Technology InvisibleTechnology
Ubiquitous Computing
Pervasive Computing
Ambient Intelligence
Augmented Reality
Calm Technology
“In the 21st century the technology revolution will move into the everyday, the small and the invisible…”
“The most profound technologies are those that disappear. They weave themselves into the fabrics of everyday life until they are indistinguishable from it.”
Mark Weiser, Xerox PARC, Palo Alto: “The Computer for the 21st Century”, Scientific American, 1991
Agenda
Why RFID?
Life Sciences – not an innovation-friendly domain?
Innovating with IT – an adapted process model
Comparative Case Studies
Summary
High Reliability Organizations (HRO)
Why should HROs remain skeptic?
• Anticipation:
– Preoccupation with failure
– Reluctance to simplify
– Sensitivity to operations
[Weick/Sutcliffe 2007]
How do HROs react?
• Containment:– Commitment to resilience
• Absorb strain and preserve function despite adversity• Maintain the ability to return to service from untoward
events• Learn and grow from previous episodes.
– Deference to expertise
[Weick/Sutcliffe 2007]
In other words: no bandwagon effect!
≠
A quote from the case studies
• „The clinical system reacts exceptionallyeffective and dynamic to changes and youneed to pay attention, that this dynamic is not enchained by information technology […].“
[Zwicker 2009]
…never change a running system?
How would one then get a hospital toinnovate – ever?
Agenda
Why RFID?
Life Sciences – not an innovation-friendly domain?
Innovating with IT – an adapted process model
Comparative Case Studies
Summary
Steps to convince skeptical users
http://aisel.aisnet.org/icis1995/4
A process model how IT innovationswork
Investments
Conversion Process
Appropriate Use Competitive Dynamics
ImpactsAssets Organizational Performance
Competitive Process
Use Process
Management/Conversion Activities
[Soh/Markus 1995]
Introducing RFID in Hospitals – Results from Literature
[Zwicker 2009]
(RFID) Investments
Adaptation of IT Infrastructure
Strategy
Communication
Planning
Pilot studies / Experiences
Qualification
Management
Conversion
determines(P2)
influences(P13)
supports (P10)
Increases (P9a, b)Pervasiveness
Acceptance
Privacy Valuation
influences(P4)
influences(P5)
determines(P12)
supports (P6)
supports(P7)
supports(P3)
(RFID) Assets
(RFID)Impacts
Use
Staff Competence
IS Risk Management
Committment
Staff Performance
Patient Satisfaction
Efficiency
Effectiveness
Quality
influences(P11a)
Should increase (P1a, b, c, d)
supports(P8)
(P14)
(P15a)
(P15b)
(P16)
Counts to
benefits
influences(P11b)
constitutes
Agenda
Why RFID?
Life Sciences – not an innovation-friendly domain?
Innovating with IT – an adapted process model
Comparative Case Studies
Summary
Case Study 1: Patient ID Safety
[Zwicker 2009]
Case Study 2: Pharmaceutical Safety
Case Study 3: Patient Tracking
[Zwicker 2009]
Quotes on Starting Innovation
• „It is difficult to transfer any technologywhatsoever from industry into a clinicalenvironment. That mostly does not work.“
• „In a larger hospital it is absolutely mandatorythat the external partners have substantiateddomain knowledge.“
[Zwicker 2009]
Quotes on usability
• „Many error messagesresulted from normal user behaviour. You do use medicamentsalloted to somebodyelse, to give higherdoses to patients in caseof an emergency.“
[Zwicker 2009]
Quotes on patient‘s acceptance
• „The patients all said yes and immediatelycomplied. The aspect of increased safety ledthem all to participate.“
• „Every introduction of an identificationtechnology results in discomfort andsuspiciousness for the patients. In a hospital, they never think of being mistaken forsomebody else at all.“
[Zwicker 2009]
Quote on the role of staff
• „The occasional pocketing of a RFID wristbandby hospital staff and the following errormessages when he moved through the ER areawas a problem.“
• „Hospital staff looks very closely to that thescarce resource ‚time‘ is not made any scarcerby introducing new technology.“
[Zwicker 2009]
Agenda
Why RFID?
Life Sciences – not an innovation-friendly domain?
Innovating with IT – an adapted process model
Comparative Case Studies
Summary
RFID in hospitals – beacon projects
• „RFID has not been a breakthrough in thiscase.“
[Lighthouse at Folly Island, Charleston]
[Zwicker 2009]
Summary
• „The benefit of the projects was not sufficient. The project examples have shown thattechnologically they could be implemented, but the final solutions were not convincing in business terms.“
[Zwicker 2009]
Introducing RFID in Hospitals –the resulting framework
[Zwicker 2009]
RFIDInvestments
RFID ImpactsUse Process
Staff Competence
Process Quality
Patient Satisfaction
RFID AssetsConversion Process
Staff Acceptance
Accounts toCounts
to
Usability Error handling culture
Reputation of Project Leader
Information
Expertise of external Partners Qualification
Privacy Issues
Pervasiveness
Work Strain
Patient Acceptance
InnovationCompetence
Counts to
H1
H2(+)
H3(+)
H4
H6(+)
H7(+)
H8(-)
H9(+)
H10(+)
H11
H12
Electromagnetic compatibility
H13
Treatment Risk
H14(-)
H15(+)
H5
References• [Eymann et al. (2008)] Eymann, T.,
Niemann, C., Zwicker, F.: Innovating mindfully in healthcare IT using RFID technology, in: Meckl, R., Rongping, M., Fanchem M. (Hrsg.): Technology and Innovation Management. Oldenbourg, München (2008), p. 121-130
WHY RFID PROJECTS IN HOSPITALS FAILLESSONS FROM COMPARATIVE CASE STUDIES
Falk Zwicker, Torsten EymannUniversity of Bayreuth, Germany