Organizational factors affecting successful adoption of innovative eHealth services: a case study employing the FITT framework

Objective

The paper presents an application of the “Fit between Individuals, Task and Technology” (FITT) framework to analyze the socio-organizational-technical factors that influence IT adoption in the healthcare domain.

Method

The FITT framework was employed as the theoretical instrument for a retrospective analysis of a 15-year effort in implementing IT systems and eHealth services in the context of a Regional Health Information Network in Crete. Quantitative and qualitative research methods, interviews and participant observations were employed to gather data from a case study that involved the entire region of Crete.

Results

The detailed analysis of the case study based on the FITT framework, showed common features, but also differences of IT adoption within the various health organizations. The emerging picture is a complex nexus of factors contributing to IT adoption, and multi-level interventional strategies to promote IT use.

Conclusion

The work presented in this paper shows the applicability of the FITT framework in explaining the complexity of aspects observed in the implementation of healthcare information systems. The reported experiences reveal that fit management can be viewed as a system with a feedback loop that is never really stable, but ever changing based on external factors or deliberate interventions. Management of fit, therefore, becomes a constant and complex task for the whole life cycle of IT systems.     

Riluzole disrupts autoresuscitation from hypothermic respiratory arrest in neonatal hamsters but not rats

We examined the effect of riluzole on expression of the central respiratory rhythm and the ability of neonates to autoresuscitate from hypothermic respiratory arrest using in vitro brainstem-spinal cord preparations of rats and hamsters. At a constant temperature of 27 °C, riluzole (5–200 μM) decreased the burst amplitude of respiratory-related motor discharge, but had little effect on the fictive respiratory frequency in rat preparations. In contrast, in hamster preparations, riluzole reduced fictive respiratory frequency, but had little effect on burst amplitude. Hamster preparations were more cold-tolerant than rat preparations, with respiratory arrest and autoresuscitation occurring at lower temperatures during cooling of the preparation. This difference was removed by incubation with riluzole (5 μM); riluzole significantly increased the temperature at which fictive respiration arrested and restarted in hamster preparations, but had no effect in rat preparations. The species differences observed in this study may reflect fundamental differences in the relative role of riluzole-sensitive mechanisms in the expression of the respiratory rhythm in early development of an altricial vs. a more precocial species.     

Radio-induced low-grade glioma: report of two cases and review of the literature

With the increasing number of cancer survivors, we can observe a population that will present a higher risk of developing secondary long-term toxicities related to adjuvant chemo and radiotherapy regimens. Among these, children surviving from acute lymphoblastic leukemia (ALL) that were treated with prophylactic cranial irradiation represent a group of patients at a high risk of developing secondary brain tumors. Radiation-induced intracranial tumors have been documented since 1950, and today, more than one-hundred cases have been described. We report our experience with two young patients who were hospitalized for low grade gliomas and had a positive anamnesis for ALL and consequent radiotherapy.