Chris Kimble

Most large, modern, information systems are built from standard software modules that need to be configured before they can be used. Implementing such systems requires contextualization—adjusting predefined parameters and adapting standardized templates to the organization's requirements. A key challenge for the users of these systems is to ensure that the data they hold are interpreted in a way that best serves the organization that uses them. In complex, multilayered, and event‐driven environments such as healthcare, this poses a particular challenge. An analysis of the experiences of a French teaching hospital that switched to an electronic medical records system reveals six issues raised by contextualization and offers guidance for those who need to manage this process in their own organization.

The aim of this paper is to provide a perspective on the sources of innovation that underlie the creation of low-cost products in emerging economies. It differs from previous analyses in its emphasis on the influence that country specific factors can have, opening the possibility that similar firms, with similar products and similar goals may follow fundamentally different trajectories. It presents two case studies from the automobile industry in China and India, Geely and Tata that show precisely this phenomenon. Building on its capability for flexibility and responsiveness and the existence of a loosely-coupled network of suppliers, Geely took a quasi-open approach to the product architecture for its vehicles. Tata on the other hand followed a broadly closed integral approach to product architecture, building on its vertically integrated structure and tradition of frugal innovation. Based on these case studies, existing theory concerning the co-evolution of product architecture and organisational capabilities and using a process of abductive reasoning, we present a framework that can be used to explain this divergence. The framework highlights the interactions between a product's architecture, a firm's organisational capabilities and country specific external factors such as institutions, industry, markets and technology.

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Objectives: The evaluation of telemedicine from the patient's point of view has focused on the patient pathway and patient satisfaction. However, research in this field does not provide us with the means to assess a patient's perception of the procedure if their reasoning ability is impaired. In this study, we use direct observation of a patient's behavior and mood to assess their perception of an oral teleconsultation procedure.Methods: This study has been conducted in the context of a pilot project using an asynchronous teleconsultation to improve access to dental care for the dependent elderly, disabled people, and prisoners, some of whom may be cognitively impaired. We use a direct observation form consisting of five behavioral variables and eight affect variables to reflect the patient's experience of the oral teleconsultation procedure.Results: A total of 135 patients were evaluated; 10 refused the procedure. Psychotic patients (n = 33) had a somewhat negative experience during the oral teleconsultation procedure. Patients who were not psychotic had a positive experience; this decreased as we moved from the autonomous to the semi-autonomous and then to the dependent sub-group. Some gender differences were also noted.Conclusions: Improving evidence on evaluating the acceptance of the cognitively impaired is required to improve the technology development process so that it can be translated into an improved patient experience and adherence. Although the study was specifically focused on teledentistry, the approach described in this study could be adapted to other forms of teleconsultation.