【目的】

人力资源能力是决定机构数字档案存储能力的重要因素。本研究主要以坦桑尼亚文件和档案管理部(RAMD)和登记、破产和托管机构(RITA)为参考对象，旨在评估坦桑尼亚支持数字档案保存的人力资源能力水平。

【设计/方法/方法】

本研究采用了描述性案例研究设计，通过分析多个案例来研究调查主题。本研究基于简单随机和目的抽样方法来确定研究对象，并通过问卷调查、访谈和文献回顾等方法收集数据。其中定性数据使用内容分析法，定量数据采用国际商业机器公司的统计包和服务解决方案进行分析。

【发现】

RAMD和RITA的人力资源能力最低，并且缺乏具备合格数字档案保存能力的工作人员和技术人员。资金短缺、管理层尚未对数字档案保存进行管理承诺、员工对数字档案保存缺乏认识，以及档案工作者对数字档案保存工作的参与不足，都是两所机构面临的紧迫挑战。

【实际意义】

本研究的建议包括寻找其他资金来源、聘用数字档案专家，并提供数字档案保存培训。此外，本研究提出了一个可供机构用于评估数字档案保存的人力资源能力的框架。

【创意/价值】

本研究为资源匮乏国家研究人力资源能力在支持数字档案保存方面的作用提供了新思路和新见解。

关键词：人力资源能力；数字档案保存；最小能力；最优能力；RAMD；RITA

Abstract：

【Purpose】

Human resource capability is an important factor in determining institutional capacities in digital records preservation. This study aims to assess human resource capabilities in supporting digital records preservation in Tanzania, with special reference to the Records and Archives Management Department (RAMD) and Registration, Insolvency and Trusteeship Agency (RITA).

【Design/methodology/approach】

This study employed a descriptive case study design with multiple cases to generate insights into the topic under inquiry. Simple random and purposive sampling methods were used to select study respondents. Data were collected using questionnaires, interviews and documentary review. Qualitative data collected were subjected to content analysis, whereas quantitative data were analysed using international business machine-corporation-statistical packages and service solution.

【Findings】

RAMD and RITA have minimal human resource capabilities, as they contend with a shortage of qualified staff and technical personnel for digital records preservation. The shortage of funds, lack of management commitment to preserving digital records, lack of staff awareness on digital records preservation and inadequate participation of records practitioners in digital records preservation emerged as pressing challenges the two agencies contended with.

【Practical implications】

This study’s recommendations include finding alternative sources of funding, employing digital records specialists and provision of training on digital records preservation. Furthermore, this study proposes a framework that institutions can use in assessing human resource capabilities for digital records preservation.

【Originality/value】

This study contributes new knowledge and insights on the role of human resource capabilities in supporting digital records preservation in a resource-poor country.

Keywords：

Human resource capabilities；Digital records preservation；Minimal capabilities；Optimal capabilities；RAMD；RITA

关键词：档案管理；云计算；鉴定；大学档案馆

Abstract：Cloud-based productivity, collaboration, and storage tools offer increased opportunities for collaboration and potential cost-savings over locally hosted solutions and have seen widespread adoption throughout industry, government, and academia over the last decade. While these tools benefit organizations, IT departments, and day-to-day-users, they present unique challenges for records managers and archivists. As a review of the relevant literature demonstrates, issues surrounding cloud computing are not limited to the technology—although the implementation and technological issues are numerous—but also include organization management, human behavior, regulation, and records management, making the process of archiving digital information in this day and age all the more difficult. This paper explores some of the consequences of this shift and its effect on digital recordkeeping at the Bentley Historical Library, whose mission is to “collect the materials for the University of Michigan.” After providing context for this problem by discussing relevant literature, two practicing archivists will explore the impact of the move toward cloud computing as well as various productivity software and collaboration tools in use at U-M throughout the various stages of a standard lifecycle model for managing records.

Keywords: 

Records management；Cloud computing；Appraisal；University archives

【目的】

尽管目前已有电子病案系统，但许多国家仍使用传统的纸质方法来记录数据和消除病案缺陷（译者注：medical record deficiency，病案缺陷，为专有名词。），浪费病人和医院的资源。本研究的目的在于评估传统的缺陷管理系统，并明确在同时使用纸质记录和电子医院信息系统的背景下，电子缺陷管理系统的构建需求。

【设计/方法/方法】

本次混合方法研究分三个阶段进行。首先，定性评价传统病案缺陷管理流程；其次，比较传统检查表和重新设计的检查表识别缺陷的准确性。第三，在焦点小组会议上讨论电子缺陷管理系统的要求。

【发现】

传统缺陷管理系统主要存在指导准则不充分、评价表格的程序不完整以及随附的活动延误等问题，还包括遗漏重要数据元素，以及缺乏所有文件管理人员对文件缺陷的实时反馈。传统检查表和重新设计的检查表确定的缺陷平均数量之间存在显著差异(p<0.0001)。基于此，作者以重新设计的检查表为基础，提出了一种电子缺陷管理系统，并对其系统功能进行改进，比如可以根据文件形成者和管理者的角色来识别缺陷，提供系统反馈和生成自动报告。

【原创性/价值】

以往研究只考察了审计和反馈方法对于加强电子和纸质病案中数据元素记录的积极作用。为解决上述问题，作者提出了一种电子病案缺陷管理系统，医疗政策制定者、医院管理人员以及卫生信息系统开发人员都可以使用该系统来管理病案缺陷，完善病历档案文件。

关键词：病历档案；文件管理员；文件；缺陷；卫生信息系统；审计和反馈

Abstract：

【Purpose】

Despite the presence of electronic medical records systems, traditional paper-based methods are often used in many countries to document data and eliminate medical record deficiencies. These methods waste patient and hospital resources. The purpose of this study is to evaluate the traditional deficiency management system and determine the requirements of an electronic deficiency management system in settings that currently use paper records alongside electronic hospital information systems.

【Design/methodology/approach】

This mixed-method study was performed in three phases. First, the traditional process of medical records deficiency management was qualitatively evaluated. Second, the accuracy of identifying deficiencies by the traditional and redesigned checklists was compared. Third, the requirements for an electronic deficiency management system were discussed in focus group sessions.

【Findings】

Problems in the traditional system include inadequate guidelines, incomplete procedures for evaluating sheets and subsequent delays in activities. Problems also included the omission of some vital data elements and a lack of feedback about the documentation deficiencies of each documenter. There was a significant difference between the mean number of deficiencies identified by traditional and redesigned checklists (p < 0.0001). The authors proposed an electronic deficiency management system based on redesigned checklists with improved functionalities such as discriminating deficiencies based on the documenter’s role, providing systematic feedback and generating automatic reports.

【Originality/value】

Previous studies only examined the positive effect of audit and feedback methods to enhance the documentation of data elements in electronic and paper medical records. The authors propose an electronic deficiency management system for medical records to solve those problems. Health-care policymakers, hospital managers and health information systems developers can use the proposed system to manage deficiencies and improve medical records documentation.

Keywords：

Medical record；Documenters；Documentation；Deficiencies；Health information system (HIS)；Audit and feedback

【目的】

沃伦•巴菲特(Warren Buffett)曾断言，美国企业和经济面临的最大问题是不断上升的医疗成本，其占国内生产总值(GDP)的比例已升至17%。公共政策制定者、医疗服务提供者和其他利益相关方都必须努力控制成本，提高医疗服务效率。关于信息技术与电子健康档案（EHR）如何为提高医院的底线业绩提供管理机制，从而获得竞争优势的理论驱动的研究非常少。

【设计/方法/方法】

基于资源优势理论(RAT)的系统性跨学科文献综述，能够为分析医院供应链管理的核心要素，即财务、信息和物理工作流提供概念基础。

【发现】

资源优势理论(RAT)将电子健康档案如何影响医院供应链中的盈利能力、竞争优势和宏观营销等因素联系起来。文献综述则为其提供了实施和采用电子健康档案的研究依据，揭示其对提升医院竞争优势的影响。尽管2009年的《卫生信息技术促进经济和临床健康法案》和《平价医疗法案》等立法举措鼓励采用电子健康档案，但目前仍有很多医院尚未实施。

【原创性/价值】

现有文献均先于相关立法，文献内容数据不完整或仅关注于患者的恢复结果。

关键词：电子健康档案；资源优势理论；医院财务绩效；医疗保健政策

Abstract：

【Purpose】

Warren Buffett asserted that the greatest issue confronting American business and the economy is rising health-care costs, which have risen to 17% of gross domestic product. Public policymakers, health-care providers and other stakeholders grapple with cost-containment and increased health-care delivery efficiencies. There exists a paucity of theory-driven research addressing how information technology vis-à-vis electronic health records (EHR) may supply a managerial mechanism for increasing bottom-line hospital performance, thereby attaining competitive advantage.

【Design/methodology/approach】

A systematic interdisciplinary literature review motivated by resource advantage theory (RAT) offers a conceptual foundation for analyzing the financial, informational and physical workflows that are core elements of supply chain management in a hospital.

【Findings】

RAT links how EHR impacts profitability, competitive advantage and macromarketing factors in hospital supply chains. The literature review provides a research synthesis of the implementation and adoption of EHR to reveal its impact on a hospital’s competitive advantage. Although legislative initiatives like the 2009 Health Information Technology for Economic and Clinical Health Act and the Affordable Care Act encourage EHR adoption, there remains a reluctance for hospitals to do so.

【Originality/value】

The extant literature precedes the relevant legislation, has incomplete data or focuses solely on patient outcomes.

Keywords：

Electronic health record (EHR)；Resource advantage theory；Hospital financial performance；Health-care policy