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I am heading to Beijing today to attend 2019 International Symposium on Budget Performance Management: National Governance and Comprehensive Budget Performance Management in the New Era hosted by the China Development Research Foundation. I will present a paper co-authored with M. Zhang, Evolving from Performance Management to Proactive Governance: The Opportunity and Gaps.
New paper published in Journal of Medical Internet Research with Tarricone, Cucciniello, Armeni, Petracca, Hall, and Keefe.
Mobile Health Divide Between Clinicians and Patients in Cancer Care: Results From a Cross-Sectional International Survey
Background: Mobile technologies are increasingly being used to manage chronic diseases, including cancer, with the promise of improving the efficiency and effectiveness of care. Among the myriad of mobile technologies in health care, we have seen an explosion of mobile apps. The rapid increase in digital health apps is not paralleled by a similar trend in usage statistics by clinicians and patients. Little is known about how much and in what ways mobile health (mHealth) apps are used by clinicians and patients for cancer care, what variables affect their use of mHealth, and what patients’ and clinicians’ expectations of mHealth apps are.
Objective: This study aimed to describe the patient and clinician population that uses mHealth in cancer care and to provide recommendations to app developers and regulators to generally increase the use and efficacy of mHealth apps.
Methods: Through a cross-sectional Web-based survey, we explored the current utilization rates of mHealth in cancer care and factors that explain the differences in utilization by patients and clinicians across the United States and 5 different countries in Europe. In addition, we conducted an international workshop with more than 100 stakeholders and a roundtable with key representatives of international organizations of clinicians and patients to solicit feedback on the survey results and develop insights into mHealth app development practices.
Results: A total of 1033 patients and 1116 clinicians participated in the survey. The proportion of cancer patients using mHealth (294/1033, 28.46%) was far lower than that of clinicians (859/1116, 76.97%). Accounting for age and salary level, the marginal probabilities of use at means are still significantly different between the 2 groups and were 69.8% for clinicians and 38.7% for patients using the propensity score–based regression adjustment with weighting technique. Moreover, our analysis identified a gap between basic and advanced users, with a prevalent use for activities related to the automation of processes and the interaction with other individuals and a limited adoption for side-effect management and compliance monitoring in both groups.
Conclusions: mHealth apps can provide access to clinical and economic data that are low cost, easy to access, and personalized. The benefits can go as far as increasing patients’ chances of overall survival. However, despite its potential, evidence on the actual use of mobile technologies in cancer care is not promising. If the promise of mHealth is to be fulfilled, clinician and patient usage rates will need to converge. Ideally, cancer apps should be designed in ways that strengthen the patient-physician relationship, ease physicians’ workload, be tested for validity and effectiveness, and fit the criteria for reimbursement.
Paper available at: https://mhealth.jmir.org/2019/9/e13584/
I am spending the next two weeks in Brazil visiting colleagues and developing research partnerships. I will deliver two research seminars:
Shaping the Future of Autonomous Systems in Society: Research with Impact
Emerging technologies are fundamentally impacting and transforming all aspects of our society. I am particularly concerned with how technological innovations impact 1) the design of our public institutions, 2) the apparatuses through which we shape, implement, and evaluate public policies, and 3) our governance frameworks for public goods. All indications suggest that we are moving toward a world where autonomous systems will dictate how we interface and interact with other agents and objects in our society. We can take advantage of emerging technologies to make our societies more livable, just, resilient, and sustainable. To realize this future, we need active and sustained engagement by scholars across a myriad of disciplines, especially public policy and management.
Public policy and governance scholars have largely been absent when it comes to engineering efforts related to the design and deployment of autonomous systems and policy debates that will shape their impact on our society. In this talk, I will outline why we need active engagement by public policy and management scholars during phases of autonomous systems development and implementation. Examples will be drawn from over a dozen research engagements that have studied emerging technologies in the public sector, from predictive analytic systems to blockchain, social media platforms, and machine learning algorithms. I will outline key governance dilemmas and policy challenges confronting public agencies as they try to keep up with the rapid pace of technological innovations.
Studying complex phenomena requires us to undertake research that 1) draws on multiple disciplines, 2) engages a diverse group of stakeholders, 3) appreciates a plurality of research approaches, and 4) generates actionable solutions. Executing inter-disciplinary research is no easy feat to accomplish. Researchers face daunting challenges from the onset; beginning with the inception of ideas, continuing to the crafting of problem statements, executing the research process, and then communicating the results via publications in academic and practitioner outlets. However, these challenges should not be viewed as an excuse to abandon inter-disciplinary research in favor of narrowly focused research exercises. Opportunities for use-inspired research will be discussed. In addition, I will present a working model for executing inter-disciplinary research that has served me well. I will openly share some of the trials and tribulations that I have encountered along the way.
Atif Ahmad (University of Melbourne), Jeb Webb (Oceania Cyber Security Centre), James Boorman (Oceania Cyber Security Centre), and I have a new article accepted for publication in Computers & Security.
Advanced persistent threat (APT) is widely acknowledged to be the most sophisticated and potent class of security threat. APT refers to knowledgeable human attackers that are organized, highly sophisticated and motivated to achieve their objectives against a targeted organization(s) over a prolonged period. Strategically-motivated APTs or S-APTs are distinct in that they draw their objectives from the broader strategic agenda of third parties such as criminal syndicates, nation-states, and rival corporations. In this paper we review the use of the term “advanced persistent threat,” and present a formal definition. We then draw on military science, the science of organized conflict, for a theoretical basis to develop a rigorous and holistic model of the stages of an APT operation which we subsequently use to explain how S-APTs execute their strategically motivated operations using tactics, techniques and procedures. Finally, we present a general disinformation model, derived from situation awareness theory, and explain how disinformation can be used to attack the situation awareness and decision making of not only S-APT operators, but also the entities that back them.
Jim Denford (Royal Military College, Canada), Greg Dawson (Arizona State University) and I were pleased to see that our paper was the best paper for the Information Systems division at the Administrative Sciences Association of Canada 2019 Conference.