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Journal Article

Developing Virtual Healthcare Systems in Complex Multi‑Agency Service Settings: the OLDES Project  pp163-170

Gregory Maniatopoulos, Ian McLoughlin, Rob Wilson

© Apr 2009 Volume 7 Issue 2, ECEG 2007, Editor: Frank Bannister, pp123 - 208

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Abstract

Recent developments in internet and digital technologies offer increasing possibilities for transforming the delivery of care by virtual means. However, the care of older people presents challenges and issues at many levels. The realities of the world of older people and of the multiple institutions and agencies that provide care services for them have to be better understood if virtual services are to be configured appropriately. This paper presents the results of an action research exploration of the complexity of needs found in care environments and the difficulties of configuring services when delivered in multi‑agency settings (i.e. jointly across organizational, professional and occupational boundaries). The deployment of a computer‑based graphical demonstrator is illustrated as one means through which, visualizations of different socio‑technical scenarios can be generated. We suggest that this tool can support processes of shared sense making amongst care agencies and institutions. In so doing, it can provide the basis for facilitating more effective 'user' engagement with the design, development and implementation of virtual healthcare systems.

 

Keywords: socio-technical systems, healthcare, older people, virtual services, action research

 

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Journal Issue

Volume 7 Issue 2, ECEG 2007 / Apr 2009  pp123‑208

Editor: Frank Bannister

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Editorial

At the time of writing this editorial, I have just returned from the ICEGOV conference on e‑government and e‑governance in Ankara. In addition to excellent Turkish hospitality, the conference threw up a couple of lively debates in the parallel sessions. A good, well behaved academic argument can be one of the most productive and rewarding parts of a conference. Unfortunately good debates tend to be relatively rare as Session Chairs, armed with a “time up” card and a severe set of instructions from the organisers give each presenter their statutory 20 minutes plus five for questions before it is time for “next please”. Occasionally a discussion will continue during coffee or lunch, but sometimes debates only occur because the next speaker doesn’t turn up.

In Ankara, one of these debates was about what was meant by “e‑governance”? During the discussion, it quickly became clear that not only was there no agreement in the room on what the term meant, but also that some of those present were even unclear in their own minds what the difference was between e‑ government and e‑governance. The sight of academics disagreeing about anything and everything, including semantics, is as old as the first university seminar, but semantics matter in academia and the absence of clarity on what is meant by e‑governance was somewhat disconcerting. Rightly or wrongly, I got the feeling that many in the room had not actually given the matter much thought.

This lack of clarity is not an unknown phenomenon. Information systems have an unhappy history of relabelling basic concepts even though, in many cases, nothing fundamental in the technology has changed. Sometimes terms outlive their usefulness and have to be replaced and/or upgraded. On other occasions it seems more like an attempt to resuscitate a floundering field. Recently, even the term “e‑ government” has been under attack. At a meeting I attended last December, one of those present even suggested, I think only partially in jest, that we needed an exit strategy for e‑government. Various replacements are mooted including “transformational government”, “digital government” (popular in the US), “government 2.0” and, more recently, e‑governance. The latter is an unfortunate suggestion, because government and governance have quite different meanings. Furthermore, governance is a notoriously contentious, not to say downright slippery, subject even before putting “e‑“ in front of it.

Not surprisingly, a number of scholars have addressed the difference between e‑governance and e‑ government (including in this journal). While this is of some help, there are just too many interpretations of the expression. Definitions of e‑governance range from an information age model of governance to a “commitment” to use ICT to, inter alia, enhance human dignity and deliver economic development. Other authors more or less equate e‑governance with e‑democracy (in one article published in a leading journal a few years ago, the word “e‑governance” appears in the title and nowhere else in the text!). All this does not help when attending a conference presentation with “e‑governance” in the title although it may give a frisson of excitement as we await the definition that the presenter has in mind.

In a simple search on the web, it is possible to find quite a large number of scholarly papers on e‑ governance. Google throws up over four and half thousand of them. Prior to writing this, I scanned about a dozen of these. While a few differentiated between e‑government and e‑governance, none of them gave a satisfactory account of the material difference between e‑governance and plain old non “e‑“ governance. Such an article may be out there, but I suspect that there is a gap in the market for a really good paper on this topic.

Whatever the definition(s), it behoves academics and scholars to be clear in what they say. Muddling up two quite different concepts is not good scholarship. There is also a need to put some clear blue water between e‑governance and governance generally. ICT certainly enables us to do many things that were heretofore impractical thus reifying hitherto theoretical or abstract problems. Whether it creates new problems is not so obvious. There is plenty of scope for some further contributions to this debate.

 

Keywords: business process improvement, business process reengineering, case study, digital democracy, digital services, e-business, e-commerce, e-democracy, e-governance, e-government services, electronic tax filing, engagement, enterprise information architecture, e-participation, e-procurement, e-revenue, e-tax, e-transactions, e-transparency, e-trust, information technology, internal stakeholders, international tax strategy, Japan, local e-government, National Tax Agency, organizational (re-)design, permanent establishment (PE), public service reform, Romanian e-government, socio-technical systems design, systems architecture, telehealthcare, transfer pricing, transformational impact of e-government

 

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