Weidong Xia

Background: Mobile health portals (MHPs) are becoming increasingly important and prevalent among health care organizations for engaging and retaining patients. However, their success hinges on patient adoption and usage. Organizations face ongoing challenges with high adoption but low usage of MHPs. While affordance theory offers a valuable theoretical perspective for exploring patient perceptions and uses of MHPs, there is a gap in research that empirically investigates the distinct types of affordances and their determinants. Objective: This study develops and empirically evaluates an integrated sociotechnical research model and hypotheses to bridge the literature gap by connecting theoretical constructs with empirical evidence and practical guidelines, thereby enhancing the understanding of patient MHP use. We extend the existing literature by differentiating 3 MHP affordance types: general, contextual, and behavioral. We examined the effects of patient absorptive capacity and hospital MHP innovativeness on the 3 types of affordances and their relationships. Based on the integrated sociotechnical research model and empirical results, we provide theoretical insights and practical guidelines on how organizations may enhance patient MHP use by enhancing patient absorptive capacity and improving patient-centered designs. Methods: We evaluated our research model and hypotheses using survey data from 401 patients regarding a WeChat-based MHP platform in 4 large urban hospitals in China. We pretested the measures via 3 rounds of Q-sorting, supplemented by field observations, expert reviews, and patient pilot tests. We tested the research model and hypotheses with partial least squares-structural equation modeling using the SmartPLS software. Results: General affordance was significantly affected by patient absorptive capacity (b=.191, P <.001) and MHP innovativeness (b=.567, P <.001). Contextual affordance was influenced significantly by patient absorptive capacity (b=.148, P <.001) and general affordance (b=.484, P <.001), but not by MHP innovativeness (b=.036, P =.564). Behavioral affordance was significantly influenced by contextual affordance (b=.430, P <.001) and general affordance (b=.140, P =.014). General affordance and contextual affordance mediate the effects of patient absorptive capacity and the innovativeness of hospital MHPs on behavioral affordance. Conclusions: Patient absorptive capacity and the innovativeness of MHPs in hospitals play distinct roles in predicting the 3 types of affordances. While the technology innovativeness of MHPs affects only general affordance but not contextual affordance, patient absorptive capacity affects both. Yet, contextual affordance is 3 times more effective in explaining behavioral affordance than general affordance. An unexpected finding related to the only unsupported hypothesis suggests that while the technology innovativeness of MHPs is necessary for general affordance, it does not directly influence MHP use; rather, it is indirectly and fully mediated by contextual affordance. Understanding and appropriately managing the contextual affordance of MHPs is critical in enhancing patient MHP use. To achieve the benefits of investing in MHPs, organizations must holistically understand and manage the 3 types of affordances, their determinants, and the relationships between them.

Contemporary Information systems development (ISD) involves not only implementing a predefined set of requirements but also managing changes that emerge during the development process due to unanticipated business and technical needs. ISD project requirements increasingly become both planned and emergent. ISD teams need delivery capabilities to routinely execute what has been planned, and agile capabilities to sense and respond to changes that emerge during the development project. In other words, ISD teams must effectively manage their abilities to not only routinely deliver software applications that meet defined requirements but also sense and respond to changes emerging during the project. The extant literature has not studied the distinction and relationship between ISD team delivery capability and agility. This study empirically examines the differential effects of ISD team delivery capability and agility on ISD project outcomes. Survey data collected from professionals working on 160 software development projects were used to test the research model and hypotheses. The results suggest that ISD delivery capability positively affects agility, agility positively impacts change-response outcome, and agility mediates the relationship between delivery capability and change-response outcome.

Background: Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. Objective: The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. Methods: First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. Results: In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. Conclusions: Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.

BACKGROUND Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. OBJECTIVE The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. METHODS First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. RESULTS In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. CONCLUSIONS Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.

Information systems (IS) offshoring has become a widespread practice and a strategic sourcing choice for many firms. While much has been written by researchers about the factors that lead to successful offshoring arrangements from the client's viewpoint, the vendor's perspective has been largely scarce. The vendor perspective is equally important as offshore IS vendors need to make important decisions in terms of delivering operational and strategic performance and aligning their resources and processes in order to meet or exceed targeted outcomes. In this article, we propose and test a three‐level capability–quality–performance (CQP) theoretical framework to understand vendor outcomes and their antecedents. The first level of the framework represents three vendor capabilities: relationship management, contract management, and information technology management. The second level has three mediating variables representing process quality: partnership, service, and deliverable quality. The third level has three dependent variables representing vendor outcomes: operational performance, strategic performance, and satisfaction. The model was tested with 188 vendor firms from India and China, the two most popular destinations for IS offshoring. Results support the CQP framework; vendor capabilities are significant predictors of intermediate quality measures, which in turn affect vendor outcomes. Implications of the study findings to both theory development and IS offshore vendor strategic decision making are discussed.