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This study explores the relationship between the governance of architecturally embedded applications and their longevity in organizational use. Using a contingency-fit logic, it posits that alignment between application governance (distribution of decision rights) and architectural contingencies contributes to sustained durations of organizational use. Architectural contingencies include internal application modularity, application inter-connectedness, and governance of surrounding application clusters. Evidence for the governance-architecture fit hypothesis is derived from analyzing temporally ordered data about applications (n = 225, n = 498, n = 193) from organizations in the media, banking, and utilities sectors over five years. Using a two-step approach with ordinal regression, along with Cox proportional hazards and logistic regression models, our findings indicate that a fit between observed governance and the governance induced by architectural contingencies reduces the likelihood of application decommissioning. The study advances the fields of information systems (IS) governance and architecture by offering a micro-level perspective on the longevity of organizational IS use while also shedding light on the importance of governance choices aligned with unique architectural application properties. [ABSTRACT FROM AUTHOR]

Background: Management of sedation, analgesia, and delirium influences morbidity, mortality, and quality of life in patients treated in intensive care. Assessing quality indicators as part of a quality management and assurance program is an established method to ensure process quality. Currently, there is limited research on the effect of evaluating quality indicators on economic outcomes. The aim of the study was to investigate the adherence to an indicator on management of sedation, analgesia and delirium, and explore potential effects on hospital economics and clinical outcomes. Methods: In this retrospective cohort study, we analyzed routine data from 20,220 patient records from the hospital information system of a tertiary university hospital, collected from January 2012 to December 2019. We compared two predefined subgroups with either high indicator adherence or low indicator adherence regarding factors like disease severity scores, comorbidities, and outcome measures. We used logistic regression models to examine the influence of quality indicator adherence on economic measures such as Diagnosis-related group (DRG) incomes, revenue margins, and costs, and clinical outcomes. Additionally, we used propensity score matching to probe our findings. Results: Overall revenue margins in this cohort were negative (-320€). High adherence to the quality indicator was associated with a positive revenue margin (+197€) compared to low adherence (-482€). Higher adherence was also associated with lower costs. Additionally, high adherence was associated with reduced mortality (OR 0.84, 95% CI 0.75–0.95) and reduced duration of mechanical ventilation and hospital stay (17 hours and 1 day respectively). Conclusion: Higher adherence to a quality indicator for sedation, analgesia, and delirium management was associated with economic returns and costs. We also found an association with lower mortality and reduced length of stay. Further research on these associations may help identify opportunities for quality improvement without increased resource use. [ABSTRACT FROM AUTHOR]

This scoping review investigates sustainability in the reuse of health data on a technological, intra-organizational, inter-organizational, and regulatory level. Thereby, it focuses on the evolutionary, relational, and durational perspective of sustainability. The study highlights various challenges in achieving data sustainability, from regulatory norms such as FAIR principles towards data governance processes and responsibilities in organizations that facilitate data sharing. By highlighting the need for economic sustainability of health data sharing platforms and adapted principles for data sharing, this study aims to analyze current practices that aim for sustainability in the secondary use of health data. [ABSTRACT FROM AUTHOR]

The assumption that generativity engenders unbounded growth has acquired an almost taken-for-granted position in information systems and management literature. Against this premise, we examine the relationship between generativity and user base growth in the context of a digital platform. To do this, we synthesize the literature on generativity into two views, social interaction (expansion of ecosystem boundaries) and product view (expansion of product boundaries), that jointly and individually relate to user base growth. Both views help us explain how opening a platform relates to the emergence and resolution of conflicting expectations in a platform ecosystem that result in new functions and expanded use. We adopt a panel vector autoregressive approach combining data from six large transaction platforms that engaged with open-source developer communities. We found that the dominant narrative of generativity engendering growth, although generally supported by our analysis, obscures the fact that the inverse is also true; that is, growth can lead to expansion of product boundaries (inverse generativity) and that generativity can be bounded; that is, growth can stabilize ecosystem boundaries (bounded generativity). Against this background, we propose an extended generativity theory that presents generativity and growth in an integrative view and raises awareness about the limitations of the "unbounded growth" claim. We conclude that there is value in separating the two views of generativity conceptually and analytically, along with their relationship to user base growth, and we call for research on the pathways through which generativity produces growth. History: Ola Henfridsson, Senior Editor; Robert Wayne Gregory, Associate Editor. [ABSTRACT FROM AUTHOR]