This text is designed to help managers who have to deal with a complex environment, and who are often presented with \"ready-made\" solutions as to how to best organize their firm, to best use information technology. The book presents a simple and attractive framework within which managers can analyze their firm's environment and characteristics, and reflect on the most appropriate way - for them - to \"put the puzzle together.\" It provides the manager and student with an integrated conceptual but pragmatic framework to analyze their situation. Courses examining the role of Information Technology in emerging organizational forms will find a well-grounded conceptual framework, illustrated with in-depth case studies. The book draws from the latest research in industrial organization, strategy, information technology, organizational theory, and leadership. It examines the individual puzzle pieces that have to be put together - strategy, structure, information technology, and leadership, and present the cases of three firms that were equally successful in putting these pieces together, while choosing pieces with dramatically different forms and adjusting them in radically different ways. The three in-depth cases included in the book are international:Oticon is a Danish firm with close to 1500 employees and is a world leader in the manufacture of hearing aids. Li & Fung is another, fist established in Canton and is an international trading company. Progressive Insurance which is the third largest insurance company in the US.

A risk analysis framework was used to examine the implementation barriers that may hamper the successful implementation of interorganizational clinical information systems (ICIS). In terms of study design, an extensive literature review was first performed in order to elaborate a comprehensive model of project risk factors. To test the applicability of the model, we next conducted a longitudinal multiple-case study of two large-scale ICIS demonstration projects carried out in Quebec, Canada. Variations in the levels of several risk dimensions measured throughout the duration of the projects were analyzed to determine their impact on successful implementation. The analysis shows that the proposed framework, composed of five risk dimensions, was very robust, and suitable for conducting a thorough risk analysis. The results also show that there are links between the quality of the risk management and the level of project outcomes. To be successful, it is important that the implementation efforts be distributed proportionally according to the importance of each of the risk factors. Furthermore, because the risks evolve dynamically, there is a need for high responsiveness to emerging implementation problems. Thus, implementation success lies in the ability of the project management team to be aware of and to manage several risk threats simultaneously and coherently since they evolve dynamically through time and interact with one another.

Sommaire: La volonté de transformation du système de santé est propice à une recrudescence du discours public sur la responsabilisation du patient. Les technologies d'information et de communication (tic) sont régulièrement envisagées comme moyens pouvant permettre au patient d'exercer un rôle accru dans la prise en charge des questions de santé. Ce texte vise à cerner le sens de la responsabilisation dans un contexte de télésoins à domicile. L‘étude d'un service de suivi à domicile met en lumière l'un des quatre paradigmes d'interprétation de la responsabilisation du patient: le paradigme professionnel qui est orienté vers l'habilitation en matière de santé. Par une double lecture représentant les approches sociologique et psychologique, cette étude montre les possibilités et les limites d'une technologie de télésoins à domicile par rapport à six principales variables: accès aux connaissances; développement d'une réflexion argumentée; influence sur l'action ou la décision; compétence perçue; contrôle perçu; et intériorisation des buts. Les résultats permettent d'observer le haut niveau d'exigence que représenterait une initiative visant l’émergence de patients informés et compétents. Surtout des patients “experts” dans une vision de la responsabilisation fondée sur la reconnaissance du caractère holistique des connaissances, du principe d'autonomie de pensée et du potentiel d'influence du patient sur une variété de décisions. En conclusion, sont précisées les implications qu'ont ces résultats sur la gestion du système public de santé.Abstract: The willingness to transform the health care system is conducive to a new wave of public discourse on patient empowerment. Information and communications technologies (ict) are regularly considered as means that allow the patient to exercise increased control in addressing health issues. This text aims at examining this phenomenon within the tele‐homecare context. The study of a follow‐up home‐care service highlights one of the four paradigms of the interpretation of patient empowerment: the professional paradigm that is health empowerment‐oriented. By using both a sociological and a psychological approach, the study identifies the possibilities and limitations of tele‐homecare technology, based on six major variables: access to knowledge, development of critical thinking, personal impact on action or decision, perceived competency, perceived control, and internalization of goals. The results show the high level of requirements needed for an initiative that would produce informed, competent and, most importantly, “expert” patients according to a vision of empowerment based on the recognition of the holistic nature of knowledge, the principle of autonomous thinking, and the patient's potential impact on a variety of decisions. In conclusion, the article defines the implications of these results in terms of the management of the public health system.