Modelling maximum cyber incident losses of German organisations: an empirical study and modified extreme value distribution approach.

Cyber incidents are among the most critical business risks for organisations and can lead to large financial losses. However, previous research on loss modelling is based on unassured data sources because the representativeness and completeness of op-risk databases cannot be assured. Moreover, there is a lack of modelling approaches that focus on the tail behaviour and adequately account for extreme losses. In this paper, we introduce a novel 'tempered' generalised extreme value (GEV) approach. Based on a stratified random sample of 5000 interviewed German organisations, we model different loss distributions and compare them to our empirical data using graphical analysis and goodness-of-fit tests. We differentiate various subsamples (industry, size, attack type, loss type) and find our modified GEV outperforms other distributions, such as the lognormal and Weibull distributions. Finally, we calculate losses for the German economy, present application examples, derive implications as well as discuss the comparison of loss estimates in the literature.

Reducing hospital admissions and transfers to long-term inpatient care: A systematic literature review.

Individuals in need of long-term care and their relatives prefer to receive and give care in their domestic environment for as long as possible. Residential long-term care is to be avoided for as long as possible. To achieve this goal, the care setting must be optimally oriented to the needs of the person in need of care. Moreover, relatives who provide care must be professionally supported. The Regional Care Competence Center (ReKo), launched on October 1, 2019, is a quasi-experimental study (two groups and pre-post design), funded by the Innovation Fund. As part of the ReKo project, people in need of care and their relatives are assisted by a case management (CM) system. An independent CM, supported by an IT network that includes the most important service providers, is to establish a comprehensive CM for people in need of care. Based on a literature review, this paper aimed to take a conceptual approach to the ReKo project by drawing on previous research and comparing the findings with the ReKo approach. The review considered CM projects that defined avoidance of hospitalization and/or delay in the transition of care recipients to long-term inpatient care as endpoints. Using PubMed and Google Scholar, the study screened 270 articles, abstracted and quality-assessed data, and included eight randomized clinical trials, two other studies, and seven reviews in the analysis. The review results and ReKo approaches are presented along the dimensions of clinical and medical benefits, community and public health benefits, economic benefits, and political and legislative benefits. CM organizations will continue to be established internationally in aging societies. The questions of improving quality of care, avoiding service costs, and the costs of establishing a CM must be raised, even if clear evidence is difficult to provide.

Advantages of virtual reality for the participative design of work processes: An integrative perspective.

BACKGROUND: The participative design of work processes is hampered by as-yet unresolved challenges. A root cause is seen in high information-pass-on-barriers. Virtual Reality (VR) may have a significant potential to overcome these challenges. Yet, there is no systematic understanding of which advantages provided by VR can support the participative design of work processes. OBJECTIVE: The present study aims to assess the potential of VR to support the participative design of work processes by conducting an integrative literature review identifying the advantages of VR in general work contexts and mapping them to known challenges in participative design of work processes. METHODS: The integrative literature review was conducted based on 268 sources of which 52 were considered for an in-depth analysis of the advantages offered by VR. RESULTS: The resulting conceptual framework consisted of 13 characteristic-related advantages (e.g., immersion, interactivity, flexibility) and 10 effect-related advantages (e.g., attractivity, involvement, cost efficiency) which readily address known challenges in the participative design of work processes. CONCLUSION: Mapping the advantages of VR to the challenges in participative design of work processes revealed a substantial potential of VR to overcome high information-pass-on-barriers. As such, employing VR in work process design initiatives represents a fruitful avenue for the promotion of prevention and employee health.

Learnings from the design and acceptance of the German COVID-19 tracing app for IS-driven crisis management: a design science research.

BACKGROUND: This article investigates the research problem of digital solutions to overcome the pandemic, more closely examining the limited effectiveness and scope of the governmental COVID-19 tracing apps, using the German COVID-19 tracing app (Corona-Warn-App) as an example. A well-designed and effective instrument in the technological toolbox is of utmost importance to overcome the pandemic. METHOD: A multi-methodological design science research approach was applied. In three development and evaluation cycles, we presented, prototyped, and tested user-centered ideas of functional and design improvement. The applied procedure contains (1) a survey featuring 1993 participants from Germany for evaluating the current app, (2) a gathering of recommendations from epidemiologists and from a focus group discussion with IT and health experts identifying relevant functional requirements, and (3) an online survey combined with testing our prototype with 53 participants to evaluate the enhanced tracing app. RESULTS: This contribution presents 14 identified issues of the German COVID-19 tracing app, six meta-requirements, and three design principles for COVID-19 tracing apps and future pandemic apps (e.g., more user involvement and transparency). Using an interactive prototype, this study presents an extended pandemic app, containing 13 potential front-end (i.e., information on the regional infection situation, education and health literacy, crowd and event notification) and six potential back-end functional requirements (i.e., ongoing modification of risk score calculation, indoor versus outdoor). In addition, a user story approach for the COVID-19 tracing app was derived from the findings, supporting a holistic development approach. CONCLUSION: Throughout this study, practical relevant findings can be directly transferred to the German and other international COVID-19 tracing applications. Moreover, we apply our findings to crisis management theory-particularly pandemic-related apps-and derive interdisciplinary learnings. It might be recommendable for the involved decision-makers and stakeholders to forego classic application management and switch to using an agile setup, which allows for a more flexible reaction to upcoming changes. It is even more important for governments to have a well-established, flexible, design-oriented process for creating and adapting technology to handle a crisis, as this pandemic will not be the last one.

Collaboration applications for mixed home care - A systematic review of evaluations and outcomes.

OBJECTIVES: Mixed home care, in which informal and professional actors work closely together, contributes significantly to ensuring home care up to old age. In this context, collaboration applications can considerably enhance the interactions among caregivers. However, although much research is conducted on need and requirement analyses of such applications, little is known about their introduction and use in care models. The purpose of this contribution is to identify studies that evaluate collaboration applications for mixed home care and compare their outcomes. METHODS: To identify literature on mixed home care collaboration applications (mHCA) and their evaluation, a systematic literature review was conducted in five bibliographic databases covering the years 2008 through 2019. The results were supplemented by a search in the meta-database Google Scholar. The evaluation approaches of the studies were analyzed and results compared by using the NASSS framework. Finally, a context concretized model was derived which summarizes interrelations. RESULTS: Twelve qualitative studies evaluating eleven applications could be identified. They report on increased competency in self-management, psychological relatedness, involvement, and understanding. However, most studies conclude that large scale platform tests are still needed to prove significant changes in care processes, communication, or organization. CONCLUSION: Among other things, their implementation is rather difficult due to the specifics of the target group. To enable a more targeted and successful implementation, it might be helpful to classify care networks beforehand and assess their communication behavior and needs. To prove the added value of mHCAs standardized assessment tools should be used.

Towards a Stakeholder-Oriented Blockchain-Based Architecture for Electronic Health Records: Design Science Research Study.

BACKGROUND: Data security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. Therefore, we have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs. OBJECTIVE: This study aimed to introduce blockchain technology for EHRs, based on identifying stakeholders and systematically eliciting their requirements, and to discuss the key benefits (KBs) and key challenges (KCs) of blockchain technology in the context of EHRs. METHODS: The blockchain-based architecture was developed in the framework of the design science research paradigm. The requirements were identified using a structured literature review and interviews with nine health care experts. Subsequently, the proposed architecture was evaluated using 4 workshops with 15 participants. RESULTS: We identified three major EHR stakeholder groups and 34 respective requirements. On this basis, we developed a five-layer architecture. The subsequent evaluation of the artifact was followed by the discussion of 12 KBs and 12 KCs of a blockchain-based architecture for EHRs. To address the KCs, we derived five recommendations for action for science and practice. CONCLUSIONS: Our findings indicate that blockchain technology offers considerable potential to advance EHRs. Improvements to currently available EHR solutions are expected, for instance, in the areas of data security, traceability, and automation by smart contracts. Future research could examine the patient's acceptance of blockchain-based EHRs and cost-benefit analyses.

Hospital CEOs Need Health IT Knowledge and Trust in CIOs: Insights from a Qualitative Study.

BACKGROUND: IT is getting an increasing importance in hospitals. In this context, major IT decisions are often made by CEOs who are not necessarily IT experts. OBJECTIVES: Therefore, this study aimed at a) exploring different types of IT decision makers at CEO level, b) identifying hypotheses if trust exists between these different types of CEOs and their CIOs and c) building hypotheses on potential consequences regarding risk taking and innovation. METHODS: To this end, 14 qualitative interviews with German hospital CEOs were conducted to explore the research questions. RESULTS: The study revealed three major types: IT savvy CEOs, IT enthusiastic CEOs and IT indifferent CEOs. Depending on these types, their relationship with the CIO varied in terms of trust and common language. In case of IT indifferent CEOs, a potential vicious circle of lack of IT knowledge, missing trust, low willingness to take risks and low innovation power could be identified. CONCLUSION: In order to break of this circle, CEOs seem to need more IT knowledge and/or greater trust in their CIO.

Towards Designing a Secure Exchange Platform for Diabetes Monitoring and Therapy.

BACKGROUND: Diabetes mellitus is one of the most prominent examples of chronic conditions that requires an active patient self-management and a network of specialists. OBJECTIVES: The aim of this study was to analyze the user and legal requirements and develop a rough technology concept for a secure and patient-centered exchange platform. METHODS: To this end, 14 experts representing different stakeholders were interviewed and took part in group discussions at three workshops, the pertinent literature and legal texts were analyzed. RESULTS: The user requirements embraced a comprehensive set of use cases and the demand for "one platform for all" which is underlined by the right for data portability according to new regulations. In order to meet these requirements a distributed ledger technology was proposed. CONCLUSION: We will therefore focus on a patient-centered application that showcases self-management and exchange with health specialists.

Implementing a Data Management Platform for Longitudinal Health Research.

Health IT adoption research is rooted in Rogers' Diffusion of Innovation theory, which is based on longitudinal analyses. However, many studies in this field use cross-sectional designs. The aim of this study therefore was to design and implement a system to (i) consolidate survey data sets originating from different years (ii) integrate additional secondary data and (iii) query and statistically analyse these longitudinal data. Our system design comprises a 5-tier-architecture that embraces tiers for data capture, data representation, logics, presentation and integration. In order to historicize data properly and to separate data storage from data analytics a data vault schema was implemented. This approach allows the flexible integration of heterogeneous data sets and the selection of comparable items. Data analysis is prepared by compiling data in data marts and performed by R and related tools. IT Report Healthcare data from 2011, 2013 and 2017 could be loaded, analysed and combined with secondary longitudinal data.