cross-case analysis and then discuss the results in comparison to our research model.
5.1 Cross-Case Analysis Results
Figure 5-1 shows the summary of case analysis presented in the last chapter. As the charts (a) and (b) indicate, we can see the impact of diagonal communication on IT support of each department, as well as the impact of other communications on the non-IT support of each department.
(a)
The impact of diagonal communication on IT support
The impact of other communications on training support
Figure 5-1. Summary of case analysis: (a) the impact of diagonal communication on IT support and (b) impact of other communications on non-IT support.
‧
5.1.1 Impact of diagonal communication on IT support
As the chart indicates, A1, A2 and A3 belong to a medium level of IT support process, while A4 belongs to a medium-to-high level of IT support process. It was observed in the preceding chapter that each department needs to strive for more completeness in their provision of IT-related service. In terms of diagonal communication, A1 and A2 belong to a low and high level, respectively, while A3 and A4 belong to a medium level. In IT-related service quality, we see that A1 belongs to a low-to-medium level;
A4 belong to medium level, A2 belongs to a high level, and A3 belongs to a medium-to-high level. In later paragraphs, we will examine hypothesis H1 and H3a, which we introduced in a previous section.
First, we examine our H1 hypothesis, which stated that ―healthcare staffs with good IT support process would be able to provide good IT-related service quality.‖ We can see that the A1 department had a medium level of IT support and the employee IT related service quality had a low-to-medium level. Even they weren‘t at the same level, we can still classify this as a positive relationship. The A2 department had a medium level of IT support and a high level of employee IT-related service quality;
we can see that this does not demonstrate a positive relationship. The A3 department had a medium level of IT support and a medium-to-high level of employee IT-related service quality. Though this is not classified as being on the same level, we can easily classify this as a positive relation. The A4 department had a medium-to-high level of IT support and a medium-to-high level of employee IT related service quality, as well, so we can also conclude this as a positive relation. To sum up, we could not completely determine that healthcare staffs with good IT support process would allow them to provide good IT-related service; therefore, our case study does not support hypothesis 1. We predict that other factors may have been needed to sufficiently back support the hypothesis.
The second hypothesis we will examine isH3a, which states, ‖when there is good communication between healthcare staffs and IT staffs, IT support will contribute to higher levels of employees IT-related service quality.‖ We can see that A1 department had a medium level of IT support, since the hospital only provided half of the IT system that employees in needed; and, additionally, the communication between healthcare staffs and IT staffs was bad. Therefore, inadequate IT support seems to have a relationship with employee service quality that may have caused it to lower.
The A2 department had a medium level of IT support, since the hospital only provided half of IT system that employees needed, but the healthcare staff had good communication with the IT staffs; this shows that, even if IT support isn‘t good
‧
enough, there can still be a high level of employee IT related service quality. The A3 department had a medium level of IT support, since the hospital only provided half of IT system that employees needed, and, additionally, the communication between healthcare staffs and IT staffs wasn‘t very good. However, A3‘s employee IT related service quality exhibited an unexpected medium-to-high quality. In this case, we think even though the healthcare staff didn‘t have good communication with the IT staff, through their ability to learn spontaneously, they were able to recover the setback.
Lastly, the A4 department had a medium-to-high level of IT support, since the hospital provided almost all the IT support needed; and, once again, the communication between healthcare staffs and IT staffs was not optimal. Therefore, its employee IT related service quality also had a medium-to-high level.
In sum, our case study adequately supports hypothesis H3a, which states: when there is good communication between healthcare staffs and IT staffs, IT support can contribute to higher levels of employees‘ IT-related service quality.
5.1.2 Impact of other communications on training support
Let‘s now look at the impact of other communications on non-IT support. Figure 5-1 chart (b) shows that A1 belongs to a low level of training support process, A2 and A3 belong to a medium-to-high level of training support process, and A4 belongs to a high level of training support process. It was observed in the preceding chapter that each department requires more extensive support training. In terms of the overall levels of the three communications (upward, downward and horizontal communication), A1 belongs to a high level, A2 and A4 belong to a medium-to-high level, and A3 belongs to a medium level. For non-IT related service quality (diagrammed in chart b), we see that A1, A2 and A4 belong to a high level, while A3 belongs to medium-to-high level. In the following paragraph, we will examine our hypotheses H2 and H3b, as proposed in a former section.
We will first examine hypothesis H2: ―Healthcare staffs with good Training support process will provide good non-IT related service quality‖. Our results show that the A1 department had a low level of training support, but a high level of employee non-IT related service quality; clearly these two levels have an inverse relationship. The A2 department had a medium-to-high level of training support and a high level of employee non-IT related service quality. Even though these didn‘t they have same quality level, we can still classified this as a positive relationship. The A3 department exhibited a medium-to-high level of training support, as well as a medium-to-high level of employee service non-IT related quality, in which we can classify as a positive relationship. Lastly, the A4 department had a high level of
‧
training support, in addition to a high level of employee non-IT related service quality, which also demonstrated a positive relationship. To sum up, we could not completely conclude that healthcare staffs with good training support process would provide good non-IT related service; to prove this, we would need other factors to back up the hypothesis. We therefore conclude that our case study does not support hypothesis 2, that ―healthcare staffs with good training support process would provide good non-IT related service quality.‖
We next examine hypothesis H3b, which states that ―upward, downward, and horizontal communication can allow training support to contribute to a higher or lower level of employee non-IT related service quality. We can see that the A1 department had a low level of training support, since they did not provide need training; fortunately, however, the healthcare staffs had good overall communication using the three types effectively, and thus, were able to demonstrate a high level of employee non-IT related service quality. The A2 department had a medium-to-high level of training support, since the hospital only lacked one missing training session, and additionally exhibited a medium-to-high level of communication between its employees; this communication made up their lack of training support, and thus contributed to a higher level of employee non-IT related service quality. The A3 department had a medium-to-high level of training support, since the hospital also only missed lacked in one training session; thus, with medium level of healthcare staff communication, its employee non-IT related service quality was still at a medium-to-high level. The A4 department still had a high level of training support, since the hospital provides all training that employees needed; and additionally, the healthcare staffs had a medium-to-high level of all of three communications, which lead to a higher level of employee non-IT related service quality.
Therefore, our case study supports hypothesis 3b, which states that, ―when there is good communication between healthcare staffs and doctors, as well as between each other, training support can contribute to higher levels of employees‘ non-IT related service quality.
5.2 Managerial Implications
According to Figure 5-1, we find that communication plays an important role in managerial implications, even the level of IT support or training support is low. If the level of communication is high, this would increase employee service quality and vice versa. As a result, we realize that quality e-Health services should provide training support to healthcare and before they start their service and provide IT support to
‧
國立 政 治 大 學
‧
N a tio na
l C h engchi U ni ve rs it y
26
assist the service process. To facilitate service performance, the four types of communication should also be included.
‧
especially in remote areas, since it can reduce the number of required resources and provide more convenience to hospitals and patients.In our research, in order to make the service process more efficient and improve the performance of whole service delivery system, we discussed the factors that influence the internal processes of a delivery system. By studying related literature, we build our research model to measure the factors that may impact the performance of delivery system and, in doing so, divided the whole delivery service system into four parts: (1) the support process which includes training and IT, (2) the IT and non-IT service quality of healthcare staffs, (3) the communication within the whole e-Health service team, and (4) customer quality action. To test the proposed hypotheses, we carried out group interviews to gather useful insights about healthcare delivery services; and, after a series of measurement assessments and a cross-case analyses, we found many of our hypotheses d to be valid.
Through our research, we found that support processes can influence the service quality of employee and that communication is the most important factor in the delivery of service—more specifically, the diagonal, upward, downward, and horizontal communication within the organization. Through careful analysis, we have shown that these factors have a great impact on the e-Health delivery system.
Final, we give some suggests for each departments:
• A1: To enhance training support and IT support, and their diagonal communication.
• A2: To enhance IT support.
• A3: To enhance IT support, and their communication within organization.
• A4: To enhance their diagonal communication.
6.2 Limitations and Implications of Future Research
In our study, we evaluated our measurements by group interviews and organizing weekly meeting minutes. For future research, we hope in the future, through our lasting research and cooperate with NTUH, we could extend our research to discuss whether employee service quality could influence patients‘ satisfaction quality or not.
The service quality can be investigated from two categories, IT related service quality and non-IT related service quality.