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Browsing by Subject "Digitale Transformation"

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    Digitale Transformation der Gesundheitsversorgung von Patienten mit Depression
    (2024) Kittlick, Cornelia; Leukel, Jörg
    Digitale Versorgungslösungen werden im deutschen Gesundheitssystem zunehmend eingesetzt, um die Patientenbehandlung effektiver und effizienter zu gestalten. Sie erleichtern Patienten mit Depressionen den Zugang zur Versorgung und können den Behandlungsprozess niederschwelliger gestalten. Krankenversicherungen, welche aufgrund der u.a. hohen ökonomischen Relevanz psychischer Erkrankungen vor großen wirtschaftlichen Herausforderungen stehen, benötigen nachhaltige Versorgungslösungen für ihre Versicherten. Hierzu gehören insbesondere hybride Versorgungslösungen, die Telefoncoaching mit Online-Kognitiver-Verhaltenstherapie kombinieren und i. d. R. von telemedizinischen Anbietern entwickelt werden. Zwar liegen bereits Untersuchungen zur Wirksamkeit und Kosteneffektivität von singulären Lösungen vor, allerdings ist noch ungeklärt, wie hybride Lösungen wirken, wie gesundheitsökonomisch sie sind und wie sie von der Zielgruppe akzeptiert werden. Erste Hinweise ergeben sich aus randomisierten kontrollierten Studien zu telefon-begleiteten Einzellösungen, jedoch mangelt es an empirischer Evidenz hinsichtlich der Wirksamkeit, Kosten und Akzeptanz von hybriden Ansätzen. Ziel der Dissertation war es, mittels einer kontrollierten Feldstudie die Wirksamkeit, Kosten und Akzeptanz einer hybriden gegenüber einer singulären Versorgungslösung zu unter-suchen. Die Studie wurde mit Versicherten einer privaten Krankenversicherung durchgeführt. Es wurden zwei Patientengruppen untersucht, welche sich für eine hybride (Interventionsgruppe IG, n = 207) oder eine singuläre Versorgungslösung (Kontrollgruppe KG, n = 102) entscheiden konnten. Für die Kostenanalyse wurde eine dritte Patientengruppe aus Nicht-Teilnehmern (n = 2.738) hinzugezogen, deren Kostendaten der IG und KG gegenübergestellt wurden. Die Wirksamkeit der Versorgungslösungen wurde mittels standardisierter Messinstrumente (Gesundheitsbezogene Lebensqualität: SF-36, Grad der Depression: PHQ-9) untersucht und definierte den individuellen Nutzen der jeweiligen Versorgungslösungen. Hierbei wurde die Hypothese untersucht, dass die hybride Versorgungslösung wirksamer ist als die singuläre. Die Wirtschaftlichkeit wurde durch eine Kosten-Effektivitäts-Analyse bewertet, um zu ermitteln, ob hybride Versorgungslösungen kosten-effektiver sind. Die Akzeptanzanalyse untersuchte Einflussfaktoren bei der Wahl der Versorgungslösung und identifizierte Merkmale der Zielgruppen, die sich für die hybride oder die singuläre Versorgungslösung entschieden. Hierbei wurden die Krankheitsschwere, die Versorgungssituation und die Internetaffinität als Einflussfaktoren vermutet. Die Ergebnis-se zeigen insgesamt, dass beide Versorgungslösungen wirksam und kosteneffektiv sind. Die Lebensqualität erhöhte sich im Durchschnitt über alle Subskalen (IG = 47,9 %; KG = 21,7 %). Ein Vergleich der Mittelwertdifferenzen zeigte statistische Effekte bei IG in den Subskalen VITA und SOFU mit jeweils schwachem Effektmaß. Die Analyse des Depressionsgrades wies ebenfalls statistische Unterschiede für IG und KG zwischen Baseline und Follow-up auf (IG: ΔM = –3,24; SD = 4,29; KG: ΔM = –2,78; SD = 5,66). Die Kostenanalyse zeigte, dass KG im Jahr vor Teilnahme die höchsten durchschnittlichen Gesamtbehandlungskosten aufwies (20.346 €), gefolgt von der IG (17.625 €) und der Gruppe der Nicht-Teilnehmer (16.928 €). Im Jahr der Teilnahme reduzierten sich die Kosten bei beiden Gruppen etwa im gleichen Maße (IG: –36,0 %; KG: –37,6 %). Die höchste Kostenreduktion zwischen dem Jahr vor und nach Teilnahme erfuhr KG (–46,1 %). Die Kosten-Effektivitäts-Analyse ergab, dass die IG sowohl höhere Nutzwerte als auch geringere durchschnittliche Gesamtkosten als KG aufwies. Bezüglich der Reduktion der Depressionsschwere zeigte sich, dass mit jeder Nutzwerteinheit Kosten in Höhe von 2.642 € (ICER = ¬2.642) und bei der gesundheitsbezogenen Lebensqualität zwischen 98 € und 330 € eingespart wurden. Somit zeigte die hybride gegenüber der singulären Versorgungslösung ein vorteilhafteres Kosten-Effektivitäts-Verhältnis. Die Akzeptanzanalyse ergab, dass die Krankheitsschwere sowie die Versorgungssituation wesentliche Einflussfaktoren auf die Wahl der Versorgungslösung waren. Patienten mit einer geringeren Krankheitsschwere und einer besseren Versorgung bevorzugten die hybride Versorgungslösung, während schwerer erkrankte Patienten mit einer schlechteren Versorgung die singuläre Lösung wählten. Die kontrollierte Feldstudie ermöglichte durch die multidimensionale Analyse von medizinischen Daten, Kostendaten sowie Akzeptanzbefragungen ein umfassenderes Verständnis zur digitalen Transformation der Versorgung von Patienten mit Depression. Sie schafft zusätzliche Evidenz zur Wirksamkeit, den Kosten und der Akzeptanz hybrider und singulärer Versorgungslösungen. Die Ergebnisse bieten neue Einsichten für Anbieter digitaler Versorgungslösungen, wie sie diese zielgruppengerecht entwickeln können. Krankenversicherungen dienen die Ergebnisse für eine bessere Entscheidungsfindung, wie sie digitale Versorgungslösungen nachhaltig einsetzen können, um Betroffenen zu helfen und gleichzeitig dem Ressourcenmangel im deutschen Gesundheitssystem entgegenzuwirken.
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    The human side of digital transformation

    understanding the changing role of employees and leaders

    (2021) Krehl, Eva-Helen; Büttgen, Marion
    In the last few years, digital transformation forced organizations to integrate digital technology into different business areas. While many companies undergoing a digital transformation focus on the technology-side, the more successful approach to tackle digital transformation is focusing on the people who make things work (Berlin, 2018; Kane, 2019). Digital transformation has tremendously changed the way people live and work (Larson & DeChurch, 2020). Employees are augmented or substituted by technology (Breidbach & Maglio, 2016; Breidbach et al., 2018; Huang & Rust, 2018) and hence, employee roles are changing, and new skills are required (Bowen, 2016). Moreover, leader roles are changing in the light of digital transformation (Larson & DeChurch, 2020; Schallmo et al., 2017). They find themselves confronted with challenging and complex situations, such as introducing a new agile mindset (Kane, 2019). In addition to the outlined challenges for employees and leaders, digital transformation was accelerated in 2020 by the COVID-19 pandemic. Employees and leaders were required to work from home to follow social distancing restrictions (Brynjolfsson et al., 2020). Suddenly, new daily routines such as the intense use of digital tools while working from home were established (Criscuolo et al., 2020). In their roles as pioneers, motivators, and mentors, leaders have a particularly decisive function during the pandemic (Bartsch et al., 2020). In sum, the challenges of digital transformation and the COVID-19 pandemic can be described as a volatile, uncertain, complex, and ambiguous environment, also referred to as VUCA world (Bennett & Lemoine, 2014). It is important to understand the required roles and skill set for employees and leaders acting in a VUCA world, to be able to improve skills by training or learning on the job (Peterson et al., 2001). However, existing research regarding the human side of digital transformation accelerated by a global pandemic and the changing roles of employees and leaders is stretched to their limits. Thus, this dissertation focusses on employees and leaders as key factors for a successful digital transformation (Kane, 2019), by answering the following research questions: (1) How do digital transformation and new technologies transform service employee and leadership roles? (2) What specific skills are required for service employees in technology-based service encounters? (3) What are appropriate leadership behaviors in the context of digital transformation? (4) Which leadership practices do leaders perform from home during the COVID-19 pandemic? (5) How can leaders be effective working remotely with the aid of digital tools during the COVID-19 pandemic? By answering the research questions, this thesis advances research on the human side of digital transformation in four important points. First, this research extends our understanding on the human side of digital transformation by focusing on the changing roles, skills and practices of employees and leaders in the light of a (crisis-induced) digital transformation. Second, this thesis contributes to our understanding of how technology is changing employees’ roles in the service encounter. Specifically, this thesis explores which particular skills service employees need to perform in the technology-based service encounter. Hence, a skill-based framework for frontline service employees is presented. Third, this thesis contributes to leadership research by providing a deeper understanding of leadership challenges resulting from digital transformation. Moreover, this thesis presents insights into digital leadership roles appropriate to the leadership challenges associated with digital transformation, including a measurement scale for the identified leadership roles. Fourth, this thesis contributes to existing virtual and crisis leadership literature. Existing findings are supplemented by demonstrating the suitability of video conferences to make up for face-to-face communication when leading from home. In addition, this thesis reveals several drivers and barriers with positive and negative impacts on leadership effectiveness when coping with crisis-specific challenges. Following an introduction (chapter 1), this thesis is divided into three main chapters with a concluding overarching discussion (chapter 5). Chapter 2 examines employee roles and skills in technology-based service encounters, Chapter 3 includes the conceptualization of a Digital Transformation Leadership Framework, and Chapter 4 explores the daily experience of leaders aiming to lead effectively while using digital tools and working remotely during the COVID-19 pandemic. Since the global pandemic has pushed organizations to change current practices and embrace digital solutions while creating hybrid collaboration models, this research might encourage further research on the human side of digital transformation.
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    The human side of digital transformation

    understanding the changing role of employees and leaders. - Updated version

    (2022) Krehl, Eva-Helen
    In the last few years, digital transformation forced organizations to integrate digital technology into different business areas. While many companies undergoing a digital transformation focus on the technology-side, the more successful approach to tackle digital transformation is focusing on the people who make things work (Berlin, 2018; Kane, 2019). Digital transformation has tremendously changed the way people live and work (Larson & DeChurch, 2020). Employees are augmented or substituted by technology (Breidbach & Maglio, 2016; Breidbach et al., 2018; Huang & Rust, 2018) and hence, employee roles are changing, and new skills are required (Bowen, 2016). Moreover, leader roles are changing in the light of digital transformation (Larson & DeChurch, 2020; Schallmo et al., 2017). They find themselves confronted with challenging and complex situations, such as introducing a new agile mindset (Kane, 2019). In addition to the outlined challenges for employees and leaders, digital transformation was accelerated in 2020 by the COVID-19 pandemic. Employees and leaders were required to work from home to follow social distancing restrictions (Brynjolfsson et al., 2020). Suddenly, new daily routines such as the intense use of digital tools while working from home were established (Criscuolo et al., 2020). In their roles as pioneers, motivators, and mentors, leaders have a particularly decisive function during the pandemic (Bartsch et al., 2020). In sum, the challenges of digital transformation and the COVID-19 pandemic can be described as a volatile, uncertain, complex, and ambiguous environment, also referred to as VUCA world (Bennett & Lemoine, 2014). It is important to understand the required roles and skill set for employees and leaders acting in a VUCA world, to be able to improve skills by training or learning on the job (Peterson et al., 2001). However, existing research regarding the human side of digital transformation accelerated by a global pandemic and the changing roles of employees and leaders is stretched to their limits. Thus, this dissertation focusses on employees and leaders as key factors for a successful digital transformation (Kane, 2019), by answering the following research questions: (1) How do digital transformation and new technologies transform service employee and leadership roles? (2) What specific skills are required for service employees in technology-based service encounters? (3) What are appropriate leadership behaviors in the context of digital transformation? (4) Which leadership practices do leaders perform from home during the COVID-19 pandemic? (5) How can leaders be effective working remotely with the aid of digital tools during the COVID-19 pandemic? By answering the research questions, this thesis advances research on the human side of digital transformation in four important points. First, this research extends our understanding on the human side of digital transformation by focusing on the changing roles, skills and practices of employees and leaders in the light of a (crisis-induced) digital transformation. Second, this thesis contributes to our understanding of how technology is changing employees’ roles in the service encounter. Specifically, this thesis explores which particular skills service employees need to perform in the technology-based service encounter. Hence, a skill-based framework for frontline service employees is presented. Third, this thesis contributes to leadership research by providing a deeper understanding of leadership challenges resulting from digital transformation. Moreover, this thesis presents insights into digital leadership roles appropriate to the leadership challenges associated with digital transformation, including a measurement scale for the identified leadership roles. Fourth, this thesis contributes to existing virtual and crisis leadership literature. Existing findings are supplemented by demonstrating the suitability of video conferences to make up for face-to-face communication when leading from home. In addition, this thesis reveals several drivers and barriers with positive and negative impacts on leadership effectiveness when coping with crisis-specific challenges. Following an introduction (chapter 1), this thesis is divided into three main chapters with a concluding overarching discussion (chapter 5). Chapter 2 examines employee roles and skills in technology-based service encounters, Chapter 3 includes the conceptualization of a Digital Transformation Leadership Framework, and Chapter 4 explores the daily experience of leaders aiming to lead effectively while using digital tools and working remotely during the COVID-19 pandemic. Since the global pandemic has pushed organizations to change current practices and embrace digital solutions while creating hybrid collaboration models, this research might encourage further research on the human side of digital transformation.

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