User-Centred Change

Introduction: The implementation of technology in telehealth and integrated care poses several challenges as users often expect technologies to be similar to what they know from their everyday lives, such as smartphones, tablets and social media. These expectations are difficult to meet by the healthcare sector, as development and implementation of new technologies can be challenging, especially for smaller healthcare providers such as municipalities and counties. The purpose of this study was to clarify whether there exists a robust health technology assessment model for development, implementation and assessment of maturing telehealth solutions. Methods: We have conducted a narrative literature overview [1] to identify published use of health assessment technology models in order to identify how they can be used in relation to telehealth and telemedicine projects. We searched for the words “telehealth”, “telemedicine” and “health technology assessment” in PubMed and Google Scholar. Results: Seven models were identified: Constructive Technology Assessment [2], Continuous Systematic Evaluation model [3], mini-HTA [4], Model for Assessment of Telemedicine [5], an Assessment for Decision Makers [6], the West Midland Toolkit [7] and Plan-Do-Check-Act [8], an instrument to iterate processes. None of these models seemed to be suitable for application in the setting of development, implementation and evaluation of maturing technologies. Discussion: The identified models all have various benefits in relation to assuring agile development, involving users and stakeholders, aligning processes or ensuring evidence-based practice. However, a model which covers all these areas as one framework is missing. We therefore propose a “Benefit Trajectory” which is a framework based on the business development concept from the Continuous Systematic Evaluation Model [3] with the addition of key elements from the other models. The Benefit Trajectory consists of four stages; I Inception, II Materialization, III Implementation and IV Assessment. The core of the framework is a need-based process that ensures alignment of needs, goals and expected outcome by a smooth project trajectory.

The COVID-19 pandemic in Argentina has challenged health professionals to implement teleconsultation to maintain continuity of care. Describe the implementation of new technologies in teleconsultation by Nutrition professionals from Entre Ríos, from the beginning of the ASPO to the new normal.Methodology: Observational, descriptive, quantitative, and cross-sectional study, in which 72 Nutrition professionals from Entre Ríos, Argentina participated through a self-administered online questionnaire. The descriptive analysis of the data was carried out in the IBM® SPSS Statistics program. 84.7% of professionals began to implement new technologies in teleconsultation since the beginning of the ASPO. Although the majority did not experience significant changes in their income, relationships with patients, or time spent in teleconsultation compared to in-person care, 78% did not receive specific training for the implementation of these technologies in remote care. Despite this challenge, 80% expressed their intention to continue with this type of care in the new normal, allocating hours of their workload for this purpose. The implementation of new technologies in teleconsultation has proven to be an ally in maintaining the continuity of nutritional care since the beginning of ASPO. However, to provide a quality service, it is necessary to select the most appropriate technologies and dedicate sufficient time to planning and implementation.

BackgroundThis case study details the experience of the Proyecto Precancer in applying the Integrative Systems Praxis for Implementation Research (INSPIRE) methodology to guide the co-development, planning, implementation, adoption, and sustainment of new technologies and screening practices in a cervical cancer screening and management (CCSM) program in the Peruvian Amazon. We briefly describe the theoretical grounding of the INSPIRE framework, the phases of the INSPIRE process, the activities within each phase, and the RE-AIM outcomes used to evaluate program outcomes.MethodsProyecto Precancer iteratively engaged over 90 stakeholders in the Micro Red Iquitos Sur (MRIS) health network in the Amazonian region of Loreto, Perú, through the INSPIRE phases. INSPIRE is an integrative research methodology grounded in systems thinking, participatory action research, and implementation science frameworks such as the Consolidated Framework for Implementation Research. An interrupted time-series design with a mixed-methods RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) evaluation framework was used to examine the adoption of human papillomavirus (HPV) testing (including self-sampling), with direct treatment after visual inspection with portable thermal ablation, at the primary level.ResultsThis approach, blending participatory action research, implementation science, and systems-thinking, led to rapid adoption and successful implementation of the new cervical cancer screening and management program within 6 months, using an HPV-based screen-and-treat strategy across 17 health facilities in one of the largest public health networks of the Peruvian Amazon. Monitoring and evaluation data revealed that, within 6 months, the MRIS had surpassed their monthly screening goals, tripling their original screening rate, with approximately 70% of HPV-positive women reaching a completion of care endpoint, compared with around 30% prior to the new CCSM strategy.ConclusionsProyecto Precancer facilitated the adoption and sustainment of HPV testing with subsequent treatment of HPV-positive women (after visual inspection) using portable thermal ablation at the primary level. This was accompanied by the de-implementation of existing visual inspection-based screening strategies and colposcopy for routine precancer triage at the hospital level. This case study highlights how implementation science approaches were used to guide the sustained adoption of a new screen-and-treat strategy in the Peruvian Amazon, while facilitating de-implementation of older screening practices.

Background: It is widely accepted that the digital transformation of business is increasingly attracting the attention of researchers from the academic circles as well as professionals from the business community. The main consequence of this lies in the daily development of new and improvement of existing digital technologies. The outcomes of such events on the market are reflected in all aspects of companies' operations. For this reason, they are constantly looking for various improvements to their business, which most often include the implementation of new technology. Mere implementation of a new technology without any other changes very often leads to failure. The core of this failure can be found and attributed to inadequately identified, analysed, documented and established business processes. Business process management (BPM) and redesign as its integral part are actually an indispensable segment of a successful process of digital business transformation. Therefore, the digital transformation of business should not be viewed exclusively from a technological perspective, but also from a process viewpoint. Purpose: With the aim of shedding additional light on the connection between business process management and digital business transformation, the paper aims to identify and explain the importance of business process redesign. Study design/methodology/approach: For the purposes of this paper, a systematic literature review was conducted. Findings/conclusions: The result of the conducted research indicates that a process approach to the digital transformation of business can contribute to significantly different, more successful results. Limitations/future research: Limitations refer to the number of databases searched during this systematic literature review. Subsequent research could include additional sources that would include additional works that can contribute to a better research result.

A process approach to the implementation of new technology

Objectives The use of robotic-assisted surgery (RAS) remains predominantly in the private sector. In the public sector, the effect of the implementation of RAS on theatre staff is unknown. The aim of this study was to examine the knowledge and attitudes of theatre staff before and after implementation of RAS in the public sector. Methods In all, 250 theatre staff, including nursing, medical and support staff, were invited to participate in the study. A survey investigating the benefits of RAS for patients and staff, concerns towards the workplace environment and facilitators towards the implementation of new technology was administered before (June 2016) and after (February 2019) the implementation of a comprehensive RAS program. Results The survey was completed by 164 (65.6%) staff before and 200 (80.0%) staff after the implementation of RAS. With time, most nursing (P=0.002) and medical staff (P=0.003) indicated that RAS may benefit patients by reducing intraoperative complications, whereas support staff remained uncertain about this benefit (P=0.594). Before the implementation, most medical staff indicated that RAS would benefit staff, although after they were unsure about this benefit. Overall, before RAS implementation, theatre staff were mostly concerned about workplace safety, but this concern was significantly reduced after RAS implementation (P<0.010). Conclusions With time, operating theatre staff considered their RAS program to be associated with enhanced benefits to patients, and their concerns regarding workplace safety were significantly reduced. Conversely, theatre staff were unsure about the benefits of RAS to themselves. It is important for organisations to consider the evolving impact of new technology on their staff and to refine ongoing education and training programs in line with these changes. What is known about the topic? The implementation of RAS is rapidly evolving in major hospitals. Therefore, it is important to investigate the knowledge, attitudes and experiences of operating theatre staff before and after the implementation of RAS, especially in the public sector. What does this paper add? This study found that with time theatre staff considered RAS to be beneficial to patients, and their initial concerns about the effect on workplace safety were significantly reduced. What are the implications for practitioners? It is important for organisations to consider the evolving impact of the implementation of new technology on operating theatre staff and to refine ongoing education and training programs as required.

The increased demand for power transfer in combination with environmental and economic issues which set constraints to building new lines, force the implementation of new technologies into the existing system in order to improve its power capability. Such methods involve re-tensioning, re-conductoring, or modifying the tower design to utilize composite cross-arms. It is hypothesized that a composite cross-arm and a novel conductor together provide an insulating significant opportunity to increase the overhead line voltage. The paper explores the range of options that could be implemented on an L3 overhead line tower typically used at 275kV in the United Kingdom, and demonstrates clear improvement in power capacitiy through the implementation of new technologies.

Digitisation is developing a transformational potential that is profoundly changing people, our societies and the planet. Like any major societal transformation, it offers both, significant opportunities for progress and significant risks with harmful consequences for societies. This paper, therefore, addresses the question: ‘What are the critical social outcomes and concerns flowing from the advances in digitisation on our work environment?’ To discuss the broad research question in sufficient depth, this paper focuses not only on specific critical social outcomes of digitisation but also on how some of them can be mitigated by combining digital tools with the concept of a circular economy (representing the abstract idea of sustainable development). The implementation of blockchain technologies and new business models shows that digital technologies have the potential to close the realisation gap between theory and practice of the circular economy concept by enhancing the information flow and the communication between stakeholders in the value chain. Nonetheless, the implementation of these technologies also entails social and economic risks, such as power abuse or regulatory arbitrage, which should be considered in advance. To avoid jeopardising digital innovations, future research should therefore develop a more holistic and interdisciplinary understanding of the complex interactions to exploit the potential of digitisation for social progress.

The current stage of development of science and technology is characterized by a significant complication of the tasks. The development of the economy to produce a situation where the development, implementation and operation of complex technical and socio-technical systems have to be in conditions of fierce competition. This is necessary to reduce the time of development and implementation of new technologies, especially in high-load systems. Highly loaded systems are, by and large, the same websites, only with a very large audience, and as a consequence with a large load, which requires an optimized server part of the site. A qualitative characteristic for a highly loaded system is the bandwidth of this system, it describes the amount of work that must be able to perform the system per unit time. The development of highly loaded systems is time consuming and poorly formalized. Since the production of high-load systems is one of the most dynamically developing areas in the field of information technology, which is demonstrated by a significant annual increase in volumes. In the practical task of decision-making, there is often a situation where you cannot limit yourself to considering a single criterion for choosing a decision. An attempt at mathematical formalization of such problems has led to the creation of the Theory of Multicriteria Optimization, which is used in the development of methods, intended for support of decision makers, in the presence of several criteria. The steps for construction of algorithm of multicriteria optimization in designing of highly loaded systems, carries out search of solutions of a maximum in a multicriteria problem are resulted. The algorithm was based on the descent method in Simplex problems. Simplex method - an algorithm for solving the optimization problem of linear programming by searching the vertices of a convex polyhedron in multidimensional space. Multicriteria optimization is based on finding solutions in problems with a large number of options. Now the type of tasks is very resource-intensive and is calculated using computers. Keywords: high-load data systems, high-load computing system.

The article is devoted to the process of transformation of society into information, which is inextricably linked with the development of information and communication technologies. Taking into account, that the integration of information and communication technologies into society led to the creation of new relations in the economic and social spheres, the social structure of society has been changed. That is why it is necessary clarify the process of transformation that directly affects economic relations in society, the main feature of which is the production and transfer of knowledge, which becomes the driving force of society and a source of sustainable economic growth. On the other hand, as a result of the intellectualization of technology there has been a rapid increase in productivity and economic transformation. The relevance of the research is determined by the demand of society to implement such economic relations, where knowledge and information become a full-fledged product, and any new product carries unique knowledge. A clear outline of the process of such transformation is necessary for understanding the changes in the structure of the economy, which are developed through scientific and technological progress and, as a consequence, in increasing the rate of services and information in GDP. Considering information society as a knowledge society, knowledge plays a crucial role in economics, and their production becomes a source of development. The transformation process in information society related to the production of knowledge, the creation and implementation of technologies and other products of intellectual activity. Furthermore, the transformation to the information society also involves the transformation of public administration. Due to the new role of knowledge and information, the source of power in the society has changed, as well as the development of new means of electronic communication and improving education. That is why the urgent challenge for countries on their way to the information society, is the informatization of all management processes as a key feature of the new model of public administration.

In the context of an ever-changing environmental dynamic, educational institutions are required to continuously adapt in a sustainable manner. This article discusses how strategic management can be employed as a comprehensive framework to understand and manage the complex interactions between structural and cultural changes within the school environment. Through a qualitative approach based on a literature study, this research highlights that the process of institutional transformation does not occur linearly but is dialectical and full of dynamics. The analysis reveals that structural measures, such as the implementation of new technologies or curriculum updates, often clash with the deeply rooted organizational culture, including established value systems, norms, and long-standing practices. Resistance or rejection arising from these changes should not be viewed as obstacles but rather as important indicators reflecting underlying tensions within the system. By adopting perspectives from Complex Adaptive Systems (CAS) theory, Activity Theory, and dialectical approaches, this article emphasizes the importance of strategic leadership in managing and aligning these contradictions to promote sustainable and internally ingrained change. The main conclusion of this study is that leaders in the education sector need to shift from a control- and managerial-based leadership style toward an adaptive, facilitative approach that empowers all members of the school community as key agents in the transformation process.

Shaking for innovation: The (re)building of a (smart) city in a post disaster environment

Currently, higher education institutions are facing new challenges, the purpose of which is to provide highly qualified specialists who have mastered not only professional knowledge, but also ready for intercultural communication in a multilingual world, independent problem solving, teaching subjects in two or more languages. For teacher training, we need a multilingual multicultural environment, design and implementation of new technologies. This article discusses the interpretation of the concepts of "competency " and "competence ", as well as the diversity of the proposed structures. The practical significance of the work is that the results obtained allow us to offer teachers of pedagogical universities scientifically -based recommendations for the formation of professional competencies of future teachers in the process of multilingual training.

Aim: The development of the 21st century technology poses enormous challenges to the modern legislator, as the dynamics of new technologies prevent the traditional normative model from fully achieving its objectives. In the previous article (SFT Vol. 60 Issue 2, 2022), the author discussed the legal aspects related to the development and implementation of new technologies and answered the question of whether the current legislation combines the intentions of the rule-makers with social and economic needs. This publication discusses selected aspects of personal data protection (GDPR), product safety legislation and Directive 2016/680, continuing the discussion on the role of law and how legislation should be structured to enable or at least facilitate the safe development of new technologies. Introduction: As technology evolves, new threats also arise – making it necessary to introduce new or improve existing methods of security protection. An analysis of selected issues relating to both privacy risks and the redistribution of goods and services indicates a direct relationship between deployed technologies and instruments for security in the broadest sense. Regardless of the type of new technology, the most important issue is to ensure the safety of individuals. GDPR Regulation, Directive 2016/680 of the European Parliament and of the Council (EU) on the protection of natural persons and Regulation 2023/988 on general product safety are important pieces of legislation that serve to protect the security of community members and those who work with EU countries. Methodology: The article uses theoretical research methods, including an analysis of the applicable legislation and the literature and views of the doctrine, as well as the results of the research work of the author of the publication. Conclusions: The use of 21st century technology – especially over the last decade – has shown that personal and product information is a very valuable commodity in the marketplace. Anything of value is potentially exposed to numerous dangers, hence the need to create legal tools to protect privacy and the security of individuals and products. GDPR legislation, Directive 2016/680 on the protection of natural persons (...), Directive 2019/1937 on the protection of whistle-blowers in the EU and Regulation 2023/988 on general product safety are examples of regulations that address phenomena resulting from developments in technology. Keywords: new technology law, product safety, GDPR, online trading platforms

The article examines the features of innovative development of industry in Russia in the context of globalization, sanctions pressure, and the need to ensure technological sovereignty. The theoretical foundations of the concept of innovation, modern models of its implementation, and the role of the state in the formation of an innovative ecosystem are analyzed. Based on statistical data and analytical materials, an assessment of the level of innovative activity of Russian industrial enterprises was carried out, and industry-specific implementation of new technologies was identified. Key barriers, such as lack of private investment, personnel shortage, dependence on imported technologies, and bureaucratization of state support, were found. Particular attention is paid to the prospects for innovative development: digitalization, ESG agenda, development of clusters, venture capital, and future technologies (quantum computing, biotechnology, new materials). In conclusion, the need for an integrated approach based on the interaction of the state, business, and science is substantiated.