New e-ways of doing the Government's job

Transcription

1 Nº 2 February 2008 New e-ways of doing the Government's job Editorial New e-ways of doing the Government's job 2 Trond Arne Undheim Articles Interoperability and the exchange of good practice cases 3 Sylvia Archmann and Immanuel Kudlacek Can Government be a good ebayer? Using online auctions to sell surplus property 13 Enrico Ferro and Lucy Dadayan Best practices in egovernment: - on a knife-edge between success and failure 23 Trond Arne Undheim Making the clinical process safe and efficient using RFID in healthcare 47 Elena Sini, Paolo Locatelli and Nicola Restifo Surfing, creating and networking: Tampere City Library drives into the Information Society 64 Elina Harju The European Journal of epractice is a digital publication on etransformation by epractice.eu, a portal created by the European Commission to promote the sharing of good practices in egovernment, ehealth and einclusion. Edited by P.A.U. Education, S.L. Web: editorial@epractice.eu The texts published in this journal, unless otherwise indicated, are subject to a Creative Commons Attribution- Noncommercial-NoDerivativeWorks 2.5 licence. They may be copied, distributed and broadcast provided that the author and the e-journal that publishes them, European Journal of epractice, are cited. Commercial use and derivative works are not permitted. The full licence can be consulted on

2 Editorial: New e-ways of doing the Government's job Trond Arne Undheim European Commission 1 This second issue of the European Journal of epractice presents a variety of case studies that show Governments are willing to experiment. From interoperability, to RFID via online portals to bridging the digital gap, public actors take home important insights every day. Government's ways are now naturally e-enabled. Sylvia Archmann finds that the interoperability challenges at local and regional levels are formidable. Based on an analysis of European good practice in the area, she recommends massively deploying open standards in order to avoid the blockage of legacy systems that cannot work together with new technology. Enrico Ferro and Lucy Dadayan document that Government can benefit from online auctions to sell its surplus property and generate significant revenue. New York State, which is their case, was challenged to respond more quickly to feedback, improve service and track return on investment all of which we are used to thinking of as private sector tools. Trond Arne Undheim provides an in-depth exploration of three best practice cases in egovernment. Findings from the Norwegian portal Mypage, the Austrian portal Help, and the Dutch Horeca1 project, all previous European Award winners, indicate that even successful projects face significant challenges. However, generic success factors do exist, and lessons learned for practitioners include: Achieving leadership buy-in, keeping technology as simple as possible, getting early stakeholder and user involvement, gaining momentum and planning for sustainability. Elena Sini, Paolo Locatelli and Nicola Restifo showcase the safe and efficient clinical processes that can be achieved through an integrated Radio Frequency Identification (RFID) strategy in a healthcare organization. Applications include making the blood transfusion process more effective as well as tracking surgical instruments. Elina Harju documents how Tampere City Library tries new ways to bridge the digital divide. Through an Internet bus with hands-on tools one can bring to life a combination of mobile library, literacy enhancer, and outdoor cinema. Careful reading of these articles will increase awareness of the importance of sharing solutions, lessons, technology and experience with others; indeed, the learning process is equally important to furthering one's own excellence. Most challenging of all, as practitioners and policymakers alike, we must understand how best practice actually helps existing and emerging projects to succeed faster. Governments are now naturally e-enabled. Now the challenge is to be sufficiently efficient and responsive. In future, public services may become ad-hoc and distributed, generalising the peer-topeer logic of the Internet. Government must meet the demand the users are not waiting around. They want a seamless integration of Internet and face-to-face. Clearly, we are only at the beginning of this path. 1 Opinions expressed here are the author s and do not necessarily represent the opinions of the European Commission European Journal of epractice 2

3 Interoperability and the exchange of good practice cases The exchange of good practice is a valuable tool to boost egovernment services across Europe s public administrations. To achieve an open and competitive digital economy, public administrations have to be linked together and therefore need to be interoperable. Interoperability, the ability of ICT systems to communicate, interpret and interchange data in a meaningful way, is one of the main challenges for successful, efficient and citizen-centred egovernment applications. The MODINIS Study on Interoperability is a state of the art analysis of key success factors and barriers to interoperability, using good practice cases as a reference framework. Over the past few years, good practice cases have been identified, analysed and discussed. Achievements and results have been continuously disseminated and communicated to the public, thus creating a well-informed community of egovernment experts interested in interoperability. Input received by the experts has been included in the study and subsequently recommendations have been drafted providing a manual for public administrations (at national, local and also European level) on how to successfully implement egovernment solutions. This article provides a general overview of the importance of good practice cases and briefly describes the results of the study, especially focusing on the main recommendations for public administrations. Keywords Sylvia Archmann European Institute of Public Administration Immanuel Kudlacek European Institute of Public Administration Interoperability, Good Practice exchange, Success Factors, Barriers, Recommendations, MODINIS Study, egovernment, public administrations Interoperability requires the use of metadata and technical standards so that different infrastructures can be linked together and data can be exchanged. European Journal of epractice 3

4 1 Introduction Over the past years, interoperability has become highly significant for public administrations as increasing attention is being paid to return on investment, citizen-centred government focusing on customer needs, and effective and efficient government services. At European level, the i2010 Action Plan is of great importance for developing egovernment strategies and promotes an open and competitive digital economy emphasising information and communication technologies (ICT) in public administrations as a driver of inclusion and quality of life (European Commission, 2005). To achieve an open and competitive digital economy, public administrations should be linked to share experiences using common methodologies and interoperable solutions for exchanging data. Interoperability is not only one of the main challenges to be addressed by public administrations at national level in the future development of egovernment; it is also an important element in connecting public administrations of different countries. Interoperability is not an end itself, but a tool to solve the problems of different stakeholders (Archmann & Nielsen, 2006). The importance attached to interoperability in a European context is illustrated by the 2003 egovernment Communication, which points out that the exchange of good practice has already demonstrated its usefulness (European Commission, 2003). Besides the epractice.eu portal, several other actions promote interoperability, such as the IDABC 1 and TerreGov 2 projects as well as the eeurope 2005 Action Plan (now the i2010 Programme) and the Ministerial Declaration following the high-level Ministerial egovernment Conference in Como (IT) held in July 2003, which recognised that the...cooperation required to develop pan-european services depends partly on the interoperability of information and communication systems used at all levels of government... (Ministerial Declaration, 2003). Furthermore, as stated by Viviane Reding, Member of the European Commission responsible for Information Society and Media ICT is the bedrock of the modern economy, a major source of innovation and an increasingly important sector [ ] accounting for 40% of EU productivity growth (Reding). This article underlines the importance of exchanging good practice cases, particularly focusing on interoperability by addressing the results and achievements deriving from the MODINIS Study on Interoperability at Local and Regional Level 3. 2 Exchange of Good Practice Cases The MODINIS Study was carried out in a consortium consisting of three well-qualified partners involving two centres of technical excellence, the Institut für Informationsmanagement Bremen (ifib) attached to the University of Bremen, and the Centre for Research and Technology Hellas and the Informatics and Telematics Institute (CERTH/ITI), as well as the European Institute of Public Administration (EIPA) acting as a hub in Europe for the collection and dissemination of knowledge in order to support and promote the i2010 objectives. EIPA had the lead in conducting the MODINIS Study, the main objectives being (Tarabanis & Tambouris, 2006): To analyse and collect case studies of successful interoperable applications at regional and local level and to feed them into the epractice.eu portal 4 ; 1 IDABC Interoperable Delivery of European egovernment Services to Public Administrations, Businesses and Citizens: 2 TerreGov 3 MODINIS Study on Interoperability at Local and Regional Level: European Journal of epractice 4

5 To study these cases and identify the main challenges and key success factors in terms of interoperability; To organise workshops so as to boost the exchange of experience; To provide a forum for researching and discussing interoperability issues at local and regional level; To identify key stakeholders in interoperability and learn about their experiences; To provide a mechanism for encouraging the exchange of experience and knowledge gained by other interested parties in the European local and regional context so as to support further actions and improve cross-border and pan-european interoperability; To conduct a study on good practice in interoperability, taking case studies and workshops as a baseline to determine the current status, to identify key success factors and barriers, to analyse areas where benefits can be gained and technologies that have been successfully used, and to provide recommendations to stakeholders. Stakeholders Parties Interested in IOP Champions in IOP Workshops Good Practice Cases Study epractice.eu Portal Figure 1. Workflow MODINIS Study The consortium had to identify good practice cases of egovernment, feed them into the epractice.eu portal and promote and disseminate them at several workshops. The methodology used is described in Figure 1. Feedback for the study and the descriptions of good practice cases were gathered from stakeholders (all parties interested in IOP and champions in IOP already extensively involved in the implementation of good practice cases) in personal interviews and several workshops. All findings and conclusions were fed into the epractice.eu portal. Furthermore, the good practice cases have been used for identifying key success factors of and barriers to interoperability and additionally to make a list on recommendations for building up IOP architectures. A comprehensive list of these cases has been stored in the epractice portal, which serves as a knowledge database for sharing experience and supporting administrations in the development and reuse of good practice. In addition, each case European Journal of epractice 5

6 identifies at least one, but mostly several experts. These experts can be contacted and used as a network on different aspects of egovernment. A template and several guidelines support the access to the database by providing a standardised layout and a common way of describing cases. Already existing and implemented cases may be easily adapted and failures that occurred in the past can be avoided, thus saving time, money and energy. All of this supports the penetration and comprehensive implementation of egovernment services. Public availability of good practice cases is a way to successfully accomplish transparent and competitive egovernment services through sharing experiences, creating synergies and building cooperation between public administrations, not only in a national but also in a European context so as to provide interoperable egovernment solutions. Short profiles of 18 good practice cases presented at the MODINIS workshops have been added to the MODINIS Study. These profiles especially analyse interoperability issues and are aligned with feedback and results from the discussions with workshop attendees and other experts on interoperability (Tarabanis & Tambouris, 2006). To provide an overview and to discuss several aspects on interoperability, these cases have been chosen according to different topics as for instance eidentification (eidentification in Estonia 5 and the Finnish Address System 6 ), einvoicing (einvoicing in Finland the example of the Region of South Karelia 7, einvoicing in Denmark 8 ), eprocurement (e- Bourgogne Regional Shared egovernment in the Region of Burgundy/France 9 ) or good practice examples on platforms for egovernment services (the Hamburg Gateway 10 ). Other short profiles of cases are also listed in the MODINIS Study and are available in greater detail on the epractice portal. All these cases have been analysed according to several aspects on interoperability. According to the results, key success factors and barriers to interoperability have been identified. Subsequently, recommendations have been built upon those key success factors. 3 egovernment Interoperability Interoperability, the ability of ICT systems to communicate, interpret and interchange data in a meaningful way, is one of the main challenges for successful, efficient and citizen-centred egovernment applications. Interoperable solutions need to overcome organisational, administrative and even national boundaries. The MODINIS Study took the European Interoperability Framework of the European Public Administration Network (EPAN) as a reference (IDABC, 2004; European Public Administration Network egovernment Working Group, 2004). The framework is displayed in Figure 2, connecting the organisational, semantic and technical layers as well as the governance aspect of interoperability. The customer-centred approach of egovernment providing government services according to the needs of the citizens in line with their life situations is based on these layers of interoperability. Citizens want to access egovernment services without bothering about competent municipalities or public administrations. In the Ministerial Declaration on egovernment issued in Manchester (UK) in 2005 (Ministerial Declaration, 2005) the importance of No citizen left behind, Using ICT to make a reality of effective and efficient government and Delivering high impact services designed around customer s needs was pointed out and subsequently included in the i2010 programme. To achieve these goals, services have to be widely available, to be secure via mutually recognised electronic identifications and to be interoperable European Journal of epractice 6

7 Figure 2. Interoperability Topology According to the United Nations Development Programme (UNDP, 2007), most of the governments have finalised the design of national egovernment strategies and are implementing priority programmes. Unfortunately though, those implementations do not necessarily lead to efficient and effective eservices, as the required attention has not yet been paid to the collaboration between public administration and sharing and exchanging of data, which is key for one-stop-shop egovernment services. Nowadays data needed is usually available but inaccessible. Public administrations vary and are diverse in structure. Interoperability will facilitate not only the internal collaboration within public administration on a local, regional and national level but also ease the external access to data by citizens via one-stop-shop egovernment services. Furthermore, the international aspect will also be facilitated as cross-border applications, especially within the European Union, and it will become more and more important to share and exchange data for a citizen-centred approach without any national boundaries. European Journal of epractice 7

8 Austria Belgium Chile Croatia Cyprus Czech Republic Denmark EC Estonia Finland France Germany Greece Hungary Iceland Ireland Italy Lithuania Latvia Luxembourg Norway Poland Portugal Romania Republic of Slovenia Slovak Republic Spain Sweden The Netherlands United Kingdom Figure 3. Workshop Participants Within this context of the MODINIS Study, eight workshops took place from 2005 to 2007, gathering information on key aspects and barriers to interoperability from stakeholders such as experts from the IT business and academia, politicians and other decision makers from all levels of public administration across Europe. At these workshops good practice cases were analysed and discussed in regard to interoperability, and participants were asked to provide feedback. All in all, more than 320 participants from all over Europe attended the workshops and gave valuable feedback (see Figure 3 for the geographical spread of workshop participants), mainly through interactive and face-to-face communication (e.g. discussion forums and plenary sessions, question and answer sessions) as well as through assessment and evaluation forms. The feedback gathered was taken into account in the MODINIS Study and then fed into the epractice.eu portal. Usually good practice cases presented were discussed, but in addition a great emphasis was put on key success factors and barriers to interoperability and recommendations. The main interoperability barriers identified included sensitivity of data, cultural differences between governmental departments, issues of trust, timing, collaboration between agencies, organisational and technical problems, unsatisfactory workflows, convincing stakeholders of the importance of the system, legal issues and also the importance of political support and funding. On the other hand, key success factors that have been analysed on interoperability are the wide use of digital signatures, commitment at all political levels to interoperability projects, engagement and involvement of all stakeholders from the very beginning and time constraints. Summarising issues on semantic and organisational interoperability have been considered of utmost importance and relevance for future actions to be solved, while technical interoperability does not seem to be the highest priority (Tarabanis & Tambouris, 2006). European Journal of epractice 8

9 4 Results, Key Success Factors and Barriers to Interoperability The main aim of the MODINIS Study was to identify key success factors and barriers of interoperability and subsequently recommendations for public administrations on how to successfully implement egovernment applications. Therefore the MODINIS Study focused on these aspects. The following brief abstract will describe the main findings. Information in greater detail is available in the MODINIS Study 11. The key success factors and barriers have been grouped according to the four layers of interoperability (as described in figure 2). To start with technical aspects on interoperability, key success factors for this layer have been grouped by core technical and supportive technical interoperability aspects. To support interoperability, already existing technologies should be used to facilitate the exchange, common understanding and usage of data. Technologies considered for core technical interoperability on the one hand (data schemes and definitions, workflows, semantic web which are necessary for understanding the data, syntax or semantic as such) are for example xml 12, RDF 13, OWL-S 14. Supportive technical interoperability key factors on the other hand are for instance accessibility, multilingualism, security and privacy and cover broader technical issues (Tarabanis & Tambouris, 2006). Semantic interoperability key factors are drafting, agreeing on and using common definitions. Therefore a wide and high commitment and support at all organisational levels is essential. The promotion and dissemination of these common definitions are further steps in this process to attract the public s interest. The modelling and visualisation of public administration processes and services is essential at the organisational layer. Users have to be integrated and involved by setting up communities. Multi-channel solutions and a customer-centred approach are crucial to be successful. The Governance layer on interoperability describes four types of key factors: Political, legal, managerial and economic. The political level relates to broader policy and institutional issues (e.g. developing national egovernment strategies). Legal issues deal with intellectual property rights or the diffusion of digital signatures and electronic identities. Willingness for cultural change and staff training related to interoperability aspects concerns the managerial level, and last but not least economic issues deal with funding and financing schemes. On the other hand, the recommendations build on these key success factors have mainly been drafted by international experience, feedback received at workshops and good practice cases. Furthermore a different structure has been used to group the results, namely along two dimensions: Firstly, according to the level of action (local, national, and pan-european), and secondly regarding the area where a recommendation should be applied (legislation, funding/financial, policy/management, technical) (Tarabanis & Tambouris, 2006): Local public administrations should follow the legislative standards given by national authorities and to communicate any encountered obstacles to superior authorities. As local authorities have only limited capabilities and influence to deal with obstacles, national authorities should take them into account and assist local public administrations in dealing with and overcoming them. Additionally, the promotion of eservices is key to success. The pan-european level might be responsible for the harmonisation of national egovernment strategies, but also for coordinating strategies for protecting and dealing with 11 MODINIS Study on Interoperability at Local and Regional Level: 12 xml: Extensible Markup Language 13 RDF: Resource Decription Framework 14 OWL-S: Web Ontology Language for Web Services European Journal of epractice 9

10 intellectual property rights when exchanging data between public administrations in a European context. Public Private Partnerships (PPP) are one way to promote and fasten egovernment strategies and projects. Such partnerships are worthwhile for both partners, as local public administrations can use latest technologies and funding from the private sector. The private sector on the other hand benefits from the cooperation with authorities, and will be encouraged and entitled to improve technology and take part in the modernisation process. National authorities therefore should promote such funding schemes and try to find new ways for financing, by increasing flexibility and reducing any limitations to achieve common infrastructures and agreements on standards already given and accepted. Study research and support of following interoperability projects in any field (especially for semantic and organisational issues as technological aspects have mostly been solved) should be financed in a broader way by the European Union. To avoid stand-alone solutions egovernment strategies and visions should be provided at a national level and subsequently taken up by local authorities. For the take-up of eservices it is recommended to start with services which can easily be provided online, and at the same time with economic results obvious and transparent to communicate to the citizens and decision-makers. Identifying, documenting and communicating good practice examples assist in fulfilling the egovernment strategy by sharing and exchanging experience to avoid failures made in the past. Currently there are more than 750 good practice cases available on the epractice.eu portal containing egovernment, einclusion and ehealth topics. Additionally, contact persons are also of great importance. Therefore the MODINIS Study identified numerous experts and has invited them to the project s workshops (see figure 3) and added to the project s website. This initiative has been taken up and currently contact details for more than 11,800 members are available on the epractice.eu portal. Besides, national egovernment units meetings and collaboration between these experts is crucial for the ongoing success of egovernment. The MODINIS Study has been a first effort by inviting experts, decision-makers and other stakeholders to the workshops. There is a great demand for such initiatives and opportunities to meet, share experience, discuss and get to know experts from several nationalities. Such networks of experience are crucial and have to be continuously maintained for the ongoing egovernment development throughout Europe. Technologies already exist for a great variety of services, solutions and applications. Interoperability requires the use of metadata (definitions which have been commonly agreed upon) and technical standards so that different infrastructures can be linked together and data can be exchanged. There are several possibilities for solving this problem, but as technologies already exist, organisational, political or legal issues have to be prepared for providing interoperable environments. 5 Summary and Conclusion ICT is an enabler for egovernment, providing the technical background. More important, however, are the changes involved in restructuring back offices and tailoring public services to citizens needs. Nowadays, the question is no longer to be or not to be e... but the emerging need seems to be the requirement for a new set of skills in the public service both at the organisational and personal level to cope with the structural challenges of modernisation and transformation against the background of socio-economic considerations (Leitner, 2005). Europe s rich diversity in culture-defining unitary processes, which are required for pan-european egovernment services, forms the main challenge. Learning from good practice cases instead of reinventing the wheel will become increasingly important. As stated above, the epractice.eu portal already contains more than 750 good practice cases of egovernment which can be accessed, analysed and adapted to public administrations individual needs. Nevertheless, local and regional European Journal of epractice 10

11 peculiarities have to be prioritised and taken into account. The MODINIS Study has been a first effort in analysing good practice cases and disseminating the results of interoperability throughout Europe and drafting recommendations on how to successfully implement interoperable egovernment solutions analysing different layers and aspects: National authorities should provide legislative standards to be followed by local public administrations Promoting eservices Protecting and dealing with intellectual property rights Funding projects via Public Private Partnerships (PPP) and further co-operations between the public and the private sector Funding schemes for interoperability projects egovernment strategies and visions should be provided at a national level and subsequently taken up by local authorities Using good practice examples to exchange experience Using already existing technologies and avoiding stand alone solutions Using metadata to overcome semantic interoperability obstacles Creating and maintaining egovernment communities Identifying and communicating good practice examples Creating and disseminating visions on egovernment However, further ongoing activities in this field are necessary to stimulate a comprehensive take-up of egovernment initiatives in a European context. References Archmann, S. & Nielsen, M. (2006). Interoperability at Local and Regional Level A Logical Development in egovernment, EIPASCOPE 2006/1, p. 39 European Commission (2003). The Role of egovernment for Europe s Future, COM(2003) 567, , Brussels (BE) p. 21 European Commission, (2005). i2010 A European Information Society for Growth and Employment, SEC (2005)717, COM(2005) 229 final, Brussels (BE) European Public Administration Network egovernment Working Group (2004). Key Principles of an Interoperability Architecture, Luxembourg (LU) IDABC (2004). European Interoperability Framework for pan-european egovernment Services, European Communities, Luxembourg (LU) Leitner, C. (2005). Organisational Changes, Skills and the Role of Leadership Required by egovernment, 9 June 2005, Luxembourg (LU), p. 13 Ministerial Declaration (2003). egovernment Conference 2003, 7-8 July 2003, Como (IT), p. III European Journal of epractice 11

12 Ministerial Declaration (2005). Ministerial egovernment Conference 2005, Manchester (UK): Reding, V.: Tarabanis, K., Tambouris, E. (2006). MODINIS Study on Interoperability at Local and Regional Level, Final Version, 31 December 2006, Thessaloniki (EL) UNDP (2007). United Nations Development Programme. egovernment: Interoperability Overview, UNDP Regional Centre in Bangkok Authors Sylvia Archmann Seconded National Expert European Institute of Public Administration (EIPA) Immanuel Kudlacek European Institute of Public Administration (EIPA) European Journal of epractice 12

13 Can Government be a good ebayer? Using online auctions to sell surplus property E-commerce in general, and online auctions in particular, represent important examples of how information and communication technologies have been employed by public organizations to gain benefits in both efficiency and effectiveness. While online auctions have widely been used by governments around the world to drive down procurement costs, they have been seldom used as means for revenue maximization. In this article, we discuss the three-year experience gained by New York State in the use of online auctions for the sale of surplus inventory and property. There are several significant results emerging from this case study. First, this case study illustrates that online auctions provide an opportunity for government agencies to increase the revenue generated by the sale of surplus inventory and property. Second, ebay s feedback mechanism serves as a tool for the introduction of performance incentive systems in the public sector. Third, the case study also sheds light on exercising transparency in government processes as a source of mutual learning among agencies. This case study, besides representing an example of a best practice for other US state and local governments as well as European Governments, also provides an interesting starting point to address a number of research questions such as the ability of governmental organizations to meet private sector standards; the measurement of returns on Information and Communication Technology (ICT) investments; and the new possible roles played by transparency in the migration toward online models. Enrico Ferro Istituto Superiore Mario Boella, Italy Lucy Dadayan College of Computing and Information, State University of New York Keywords ebay, government surplus, transparency, procurement costs, online auctions, ecommerce, efficiency of the public sector The level of governmental use of and involvement in online auctions depends on many factors including e- business, public attitude, legislative and regulatory changes, cultural changes, technology, and inter/intragovernmental cooperation. European Journal of epractice 13

14 1 Introduction Auctions are an ancient practice. The first documented use of auctions was dated at 500 BC, when Babylonians sold young slaves during open markets. As Wyld (2000) noted, the very concept of a fixed price for a good or service is in historic terms a relatively recent development. The reason auctions have survived throughout history may be attributed to a number of benefits it provides. From a buyer s standpoint, auctions represent an efficient allocation mechanism, since they allow items to be sold to bidders with the highest valuation. From a seller s standpoint, they permit a maximization of the revenues stemming from an item s sale. Historically, governments have practiced live and sealed-bid auctions in various domains of their activity. With the advent of information and communication technologies and the implementation of digital government, reverse auctions were seen by many governments in the United States as interesting opportunities for reducing procurement costs. Moreover, the reverse auction system enables governments to purchase goods and services from the standpoint of efficiency, efficacy and accountability (Joya & Zamot 2002). By aggregating demand and increasing competitive pressure among suppliers, it was possible to attain a significant increase in bargaining power. While widely used in cost reduction activities, online auctions have been scarcely considered by governments for revenue maximization purposes. There are a number of reasons for this: the inherent lack of profit orientation present in governmental organizations, the presence of a significant inertia among both state employees and bidders towards the migration of an online model, and the difficulty in reaching critical mass in terms of bidders required for online-auctions to outperform traditional live auctions. This article will focus particularly on the three-year experience gained by the State of New York in selling its surplus inventory and property via ebay, one of the biggest online communities in the world. This case study, in addition to representing a best practice in the use of online auctions for revenue maximization in government, also constitutes an excellent example of complementarity among ebusiness and egovernment activities. 2 Objectives The aim of this paper is threefold: 1. Use the three-year experience gained by New York State to conduct a longitudinal analysis of benefits and barriers related to the use of online auctions in sale of surplus property. 2. Identify lessons learned and provide a concrete working example that may be used as a best practice for the implementation of similar activities. 3. Use the results emerging from the case study to provide preliminary answers to the following questions: Can government agencies meet private sector quality standards? What returns on investments can agencies investing in online auctions expect to enjoy? What new roles can transparency play in the migration toward an online model of government? 3 Methodology The research purpose of this paper is primarily exploratory since it is our intention to investigate how and whether governments can become more efficient and effective in utilizing an ebay model for surplus European Journal of epractice 14

15 auctions. We adopted both a quantitative and qualitative approach, which helped us to understand how the ebay model is used in a government setting. The methodology adopted is a case study. An interview was conducted with the assistant director of the Property and Fleet Administration Department of the Office of General Services in the New York state. Also, quantitative data were collected from both the Office of General Services SAP-pro system, as well as the Office of General Services information publicly available ebay account. New York was chosen as a case study for a number of reasons: 1. It is considered a best practice in the use of online-auctions at state government level. Few similar initiatives are present in the United States, most of which are carried out at the local government level. 2. It constitutes a successful example of collaboration between the private and public sector, thus reinforcing the notion of complementarity among egovernment and ebusiness activities. Finally, we conducted library and online research and gathered relevant data from working papers, journals, newspaper archives, various databases, and other related sources. 4 Literature Review 4.1 The Role of Online Auction Models The New York State experience results are of particular relevance in a time when a number of global trends are generating significant shortfalls in governments budgets. On the one hand, longer life expectancies and low birth rates have contributed to an increase in the percentage of elderly people and their related healthcare costs. On the other hand, citizens and businesses expect the quality of public services to meet more and more private sector standards. These opposing forces have put pressure on public organizations and made streamlining and optimization activities key for their survival. Throughout the last decade, in an attempt to increase the efficiency of government processes, significant investments have been made to promote public organizations digitalization. Nevertheless, to date there is still very little evidence of the returns that these investments have yielded. No agreement has been reached about an objective and comprehensive methodology for return on investment assessments of information technology investments. In this respect, the manageability of information produced by online auctions represents an interesting opportunity to carry out a reasonably accurate analysis. According to Wyld (2000), the auction model can be applied to governmental operations in three different realms: (1) governmental procurement, (2) disposition of used/surplus/seized governmental assets, and (3) internal allocation of resources. The intent to adopt online auctions for the sale of excess property may be dated back to , although the passage from will to action is decidedly more recent. The first research works on this subject assumed that governments would have relied on circuits or communities composed of corporations with the purpose of getting rid of useless and unwanted products (Wyld 2000). The main concern was whether the proliferation of these ad hoc communities would have reached the necessary critical mass to make online auctions to work. Nobody could foresee the use of a more general network such as ebay as a potential solution to this problem. Over the last few years the commercial success of ebay became apparent to the general public. According to Krishnamurthy (2004), ebay s direction of growth is in foreign markets and it is currently European Journal of epractice 15

16 operating in eight of the top ten countries by online market size outside of the U.S. It is gaining users 50% faster in Europe than in the U.S., and gross merchandise sales are growing 135% faster. In the United States, many state and local government agencies have recognized ebay s success as well, and initiated their own online versions of ebay. The Government Liquidation website was created with functions similar to ebay, and is the exclusive partner of the U.S. Department of Defense for the sale of surplus property. However, there are also a number of state and local government agencies that chose to use ebay instead for selling surplus and seized governmental assets. As Wyld (2004) noted, ebay, the largest online e-marketplace, attracts many state and local governments selling all manner of surplus goods, either direct or through intermediaries. A few government entities have been active ebay sellers including states (California, Colorado, New York, Oregon, Pennsylvania, and Texas), counties (Palm Beach- FL, Ventura-CA) and universities (Oregon State University). By 2003 about 15% of cities and counties and approximately 4% of municipal utilities across the United States were already using online auctions for selling surplus equipment and materials (National Institute of Governmental Purchasing 2003). Gradually, ebay has become a platform for the above mentioned government entities, allowing them to turn unclaimed items, end-of-life assets, fleets of vehicles, or other property into monies for treasury. 4.2 The Link Between ebay s Feedback Mechanism and Public Trust and Transparency ebay almost exclusively relies on its feedback mechanism to build trust and encourage good behaviour from its members. Feedback is analyzed, aggregated, and made available to the public through member feedback profiles. Dellarocas (2001) intended to explain to what extent binary reputation mechanisms, such as the one used at ebay, are capable of inducing efficient market outcomes in marketplaces where (a) true quality information is unknown to buyers, (b) advertised quality is completely under the control of the seller and (c) the only information available to buyers is an item s advertised quality plus the seller s feedback profile. According to Dellarocas (2001), binary reputation systems can be well-functioning, provided that buyers strike the right balance between rating leniency and quality assessment strictness. However, binary reputation mechanisms may not function well if buyers do not use the right threshold parameters when they judge seller profiles. Houser and Wooders (2000) found that ebay s seller reputation is a statistically and economically significant determinant of auction prices. Data analyses done by Houser and Wooders (2000), as well as others suggest that reputation building is an important issue in online auctions. Thus, government agencies as sellers shall strive to provide a good service to get a good reputation and, in turn, get higher prices. Finally, as many studies showed, a good reputation is a good predictor of performance and a catalyst for building citizen trust in government which, as Welch and Hinnant (2003) noted, is an important determinant of public action and cooperation. Concluding, the ebay s platform may not be said to provide what in economic terms would be defined perfect information, thus it still gives rise to asymmetries of information between buyers and sellers. Nevertheless, it could significantly contribute to increase the level of transparency in the public sector if adopted in the sale of surplus property, as illustrated in the following case study. 5 Case Analysis European Journal of epractice 16

17 5.1 The Launch of Pilot Project for Testing Online Auctions Many government agencies in the United States as well as in other countries have begun to use online auctions for selling surplus. Moreover, some governments use reverse auctions in which the government advertises some item it wishes to purchase, and potential sellers undercut one another to provide the lowest price (Dysart, 2003). In October 2001, New York State approved a pilot project for the sale of excess property via online auctions. Excess property is state property that is outdated, damaged, unused, or obsolete. It is property that cannot be of any use to the government and should be disposed of. This project was initiated directly by the Governor. Its implementation was highly supported and followed a top-down approach. The aim of the Governor was twofold: 1. Streamline and make the existing process for the disposal of excess property more efficient and effective. 2. Provide an easier access to the public for this type of service, taking advantage of the opportunities offered by information and communication technologies. The Office of General Services is the body in charge of managing the sale of all excess property belonging to the approximately 150 agencies present in the state of New York. All state agencies are obliged by law to go through the Office of General Services for the disposal of their excess property. The revenue generated by these sales is collected in a general fund that is subsequently redistributed among all agencies budgets. Until 2002, live and sealed bid auctions have been the only selling methods adopted by the Office of General Services. Although reasonably effective, these techniques present a number of drawbacks: 1. Live auctions are highly influenced by weather conditions. The number of bidders taking part in a live auction may be significantly reduced by inclement weather. Fewer bidders has an obvious negative impact on the average closing price and overall total revenue. Moreover, due to high transportation costs, live auctions are usually attended only by local bidders. 2. In sealed-bid auctions, bidders are required to advance ten percent of their offer. This means that all non-winning bidders need to be reimbursed. This is both a costly and time-consuming process. 3. Both sealed-bid and live actions have a lead-time of about two months. In October 2001, the Office of General Services launched a pilot project to test the use of online auctions. The ebay community was chosen as a test bed because of its worldwide reach and its capillary diffusion in the United States. The first online sale took place in October of 2002, about a year after a set up time that required involvement of three Office of General Services full-time employees and ebay technical staff. The initial time required to set everything up on ebay and learning the details of ebay mechanism was a challenge not only for NYS s Office of General Services, but also for other government agencies such as Franklin County, Ohio, who also adopted ebay for online auctions (Fleming, 2004). 5.2 The Returns from ebay Online Auction Investment Since 2002 the number of online sales made through auctions has experienced significant year over year growth rates. As evidenced in Figure 1, the Office of General Services sales increased from 153 items in 2002 to 1,215 items in 2004, resulting in a 790% growth increase in only a three year period. European Journal of epractice 17

18 Figure 1: Sales and Revenues from ebay Figure 1 also shows that revenues from ebay s online auctions grew even faster than sales volume. Revenues experienced a fourfold increase in the last year. This may be attributed to a higher level of confidence, which in turn, resulted in the sale of items with a higher unit price. A fast growth in sales was not the only effect of online auctions. The limited number of bidders previously reached through sealed-bid and live auctions did not permit the Office of General Service to sell all the surplus property received by state agencies. This generated additional costs stemming from missed sales and disposal services for unsold property. Online auctions eliminated both of these costs. Additionally, the wide variety of bidders present in the ebay community allows the Office of General Services to get rid of all excess property without exception. This helps to generate extra revenue, as well as helps to eliminate disposal costs. Finally, efficiency gains are a further benefit generated by this new system. The average lead-time for items disposal has shortened from two months to about three weeks. A legitimate question could be raised as to how much a state should expect to gain from implementing a system similar to the one adopted by New York State. Although an exact answer may not be possible, we believe that a good approximation may be attained. By adopting online auctions, the Office of General Services has increased its return on investment by nearly five times. When the sealed bid system and live auctions were in place, the return of each dollar spent was USD in revenues. Now, with online auctions, every dollar spent generates a USD return. However, these figures do not account for efficiency gains and the cost reduction due to elimination of disposal costs associated with unsold property. In this respect, the data presented here represents a slight underestimation of actual returns. Nevertheless, we believe this analysis provides a reasonably accurate estimation of the European Journal of epractice 18

19 returns that the Office of General Services has enjoyed subsequent to its investments mainly in personnel time to set up the new system for the sale of surplus property on ebay. 5.3 The Problems Associated with the Adoption of Online Auction The adoption of online auctions did not only bring satisfying results, but also brought problems that needed to be solved. A first barrier to implementation was a high level of inertia present among traditional bidders, as well as state agencies. To tackle this problem, the Office of General Services organized workshops to explain the advantages of using online auctions. Understanding the amount of time that could be saved helped them to overcome their reluctance. The training provided during these workshops was not just aimed at overcoming inertia. It also served to reduce the workload in terms of communications with interested bidders because of incomplete descriptions provided by state agencies. At first, sales were managed centrally by the Office of General Services, but to reduce transportation costs and provide an incentive for more complete descriptions, logistics have been redistributed. Delegating the communication burden onto state agencies encouraged them to provide more accurate and complete descriptions to the Office of General Services. 5.4 The Outcomes of Online Auction Implementation An important factor that contributed to increased usage of online auctions by state agencies was the presence of a high level of transparency in the ebay system. Having the ability to check the types of products sold by all agencies via the Office of General Services fostered an awareness that a wide number of unused or obsolete items could be sold to generate revenues and avoid disposal costs. Currently, the Office of General Services no longer uses sealed bid auctions. Online auctions represent about 50% of the volume in terms of items. The remainder consists of live auctions (25%) and transfers among agencies (25%). It is interesting to note that general public represents the majority of buyers (about 75%), while corporate customers make up only 25% of buyers. In this respect, adopting a platform like ebay with a wide diffusion among the general public, rather than an alternative platform more oriented towards small and medium enterprises seems to have been a wise choice. Requiring an additional account on an alternative circuit or community would have most likely resulted in a lower potential market. In terms of geographical dispersion, about 90% of buyers are located in New York or the surrounding states, while the Office of General Services has buyers from as far as Sweden. This suggests that ebay s vertical penetration is an important factor and that the introduction of online auctions did not have a significant impact on the geographical composition of buyers. This could be due to a number of reasons. First, it may be because of the structure of the ebay system. The auction company rather than creating a single worldwide community has preferred to create a network of local communities that are interconnected among themselves but with looser ties. It is a firm belief of ebay that context and locality should play a significant role in online communities. Second, the fact that Office of General Services has not provided any shipping service for the goods sold via the ebay account could have also played a role. Although bidders unable to collect the items bought directly from the warehouse may still arrange for a shipping service remotely, the cost in terms of time as well as knowledge required could probably represent a barrier for many bidders. Nevertheless, it must also be noted that for certain categories of products with a high unit value or niche markets (i.e. boats, airplanes, vintage cars), the worldwide breadth of ebay has proven to be a key factor and the lack of a shipping service did not represent a barrier at all. As already stated, online auctions have partially replaced the use of live auctions and completely replaced sealed bid auctions in the last three years. As Moschella (1999) argues, in the long term online European Journal of epractice 19

20 auctions may work best for surplus items and the pricing online won t be all that different than it s been offline for centuries. Forrester Research anticipates that by 2006 approximately 40% of all business-to-business commerce will be transacted online (Wyld 2000). The application of evolutionary theory to technological adoption and development (Leydesdorff 1998), tells us that substitution effects are only a first step in the process that an organization (or a system) has to go through when adopting a new technology. Second order effects such as innovation and coevolution start to appear over time as the organization adopting the technology becomes more mature. The experience acquired by the Office of General Services from 2002 to 2004 constitutes an important asset that could be used as a stepping stone to diversify or enlarge the Office of General Services activities. As Wood (2002) noted, arbitrage opportunities may exist in online auctions for diversifying investors. The need for diversifying Office of General Services activities is also proved by the fact that they have been asked by several authorities, including the Throughway Authority, to provide the same service offered to state agencies. This, besides recognizing the value and quality of the Office of General Services work, also represents an interesting opportunity to generate new revenue. Another example of potential innovation could be represented by the creation of hybrid live auctions, which are live auctions combined with online auctions. This could be an example of possible future developments in co-evolution terms of live and online auctions. Such practices could take advantage of the benefits that new technologies offer and at the same time guarantee fair access to all citizens without excluding those who lack sufficient levels of digital literacy and computer skills. The level of governmental use of and involvement in online auctions depends on many factors including e-business, public attitude, legislative and regulatory changes, cultural changes, technology, and inter/intra-governmental cooperation among others, as noted by Wyld (2000). Even though the road to becoming a good ebayer for the government is long and potentially risky, the forecasted savings could be significant. It is projected that the private sector can save between 18 to 45 percent with e- marketplaces. And if the public sector could reach half of its forecasted savings potential, this would still be a great success (Wyld, 2004). 6 Conclusions Probably the most significant result emerging from this case study is the opportunity to increase the revenue generated by the sale of surplus inventory and property through online auctions nearly five fold. A second conclusion that may be drawn involves the introduction of performance incentive systems in the public sector. During the interview conducted at the Office of General Services, it was discovered that the presence of a feedback process on each transaction was an effective incentive that raised the quality of their customer service, as well as increased the efficiency of the entire sale process. Although the feedback system present on ebay has been primarily devised as a solution to a trust issue, it also proved to be an effective way for New York State to maintain high customer service standards. As stated previously, high rates of positive feedback are correlated with higher closing prices. All this leads us to believe that a high level of interaction (and perhaps, integration) between state-owned and private organizations, coupled with the appropriate incentive systems, may lead governmental organizations to meet private sector standards in terms of performance in spite of the non-competitive role played in the market. This seems to be feasible, and as Wyld (2004) noted the biggest experiment in public sector reverse logistics today, where the American military is transforming the way surplus is sold through an innovative public-private partnership. European Journal of epractice 20

21 The analysis of the case study also cast a new light on the role of transparency in government processes. In the literature, the transparency of government processes has been conceived as an important objective to guarantee correct management of internal processes. In other words it has been perceived as a control system. Reichard (1998) claims that the more transparent an organization s web site is, the more it is willing to allow citizens to monitor its performance. New York State also revealed transparency to be an important catalyst for mutual learning among agencies. The possibility for each agency to have the opportunity to consult the list of surplus property sold through Office of General Services by other agencies fostered a circulation of ideas and examples, thus generating a mutual learning process. Another interesting aspect that emerges from the New York State case study concerns the choice of the service provider. The choice of service provider is also a mechanism for driving productive efficiency. To answer the question posed in the title of the article, government not only may but should be a good ebayer. To be successful in the ebay community it is necessary to meet two key requirements: (1) generate a high volume of transactions and, (2) perform a good service, which is measured by a high percentage of positive feedbacks. Government consumption in western countries amounts to about 20% percent of the gross domestic product (European Commission, 2006). This generates an enormous amount of surplus due to obsolescence, damage, and/or downsizing. In this respect, government has the potential to be not only a power-seller but a mighty-seller. As a matter of facts it would represent an important opportunity for government organizations to reduce the pressure on their budgets by significantly increasing the revenue generated by the sale of surplus property. Moreover, the New York State experience showed that when the adequate context and incentives are in place, government agencies can meet private sector standards both in terms of efficiency and customer service. In conclusion, it is our belief that the case study presented in this article may constitute a significant lesson for European governments. The diffusion of online auctions in the sale of surplus property could be considered an important complement to the public procurement action plan developed in relation to the i2010 initiative (European Commission, 2004). On the one side, Europe seems to have the necessary characteristics in terms of international breadth and local markets size. On the other side, lessons learned may not always be transferred to different contexts. Thus, a full scale implementation of such an activity would have to overcome a number of hurdles due to the presence of different legal systems, requirements, language barriers, higher postage tariffs for crossing national borders, low technology penetration rates among potential buyers to mention few. Further research should thus aim at identifying possible viable alternatives and adjustments to be made for the European context as well as at deepening the understanding of the full range of costs and benefits in financial, political and social terms. References Bapna, R., et al. (2001). Online Auctions: Insights and Analysis. Communications of the ACM, 44 (11), Dellarocas, C. (2001). Analyzing the Economic Efficiency of ebay-like Online Reputation Reporting Mechanisms, retrieved January 13, 2008 from Dysart, J. (2003). Government Employ Online Auctions to Buy and Sell. Government Technology International, November 2003, European Commission (2004). The EU Single Market, fewer barriers more opportunities: Electronic Public Procurement, European Journal of epractice 21

22 European Commission (2006). i2010 egovernment Action Plan: Accelerating egovernment in Europe for the Benefit of All. Fleming, S. (2004). Online Auctions Help Sell Surplus Property, October 1, 2004, Houser, D. & Wooders, J. (2000). Reputation in Auctions: Theory, and Evidence from ebay, retrieved January 13, 2008 from Joya, L. & Zamot, F. (2002). Internet-Based Reverse Auctions by the Brazilian Government. The Electronic Journal on Information Systems in Developing Countries, 9 (6), Krishnamurthy, S. (2004). A Comparative Analysis of ebay and Amazon. In Gupta, J. & Sharma, S. (Eds.) Intelligent Enterprises of the 21st Century, Idea Group Publishing, Leydesdorff, L. & Besselaar, P. (1998). Technological Developments and Factor Substitution in a Complex and Dynamic System. Journal of Social and Evolutionary Systems, 21 (2), Lucking-Reiley, D., et al. (2006). Pennies from ebay: The Determinants of Price in Online Auctions, retrieved January 13, 2008 from Moschella, D. (1999). Online Auctions: The Exception Not the Rule. Computerworld, 33 (29), 33. National Institute of Governmental Purchasing (2003). Purchasing 2003 Benchmarking Survey, retrieved January 5, 2005 from Reichard, C. (1998). The Impact of Performance Management on Transparency and Accountability in the Public Sector, retrieved January 13, 2008 from Welch, E. & Hinnant C. (2003). Internet Use, Transparency, and Interactivity Effects on Trust in Government. Proceedings of the 36th Annual Hawaii International Conference on System Sciences. Wood C. (2002). Risk and Return in Online Coin Auctions over a Short Horizon, retrieved January 13, 2008 from Wyld, D. (2000). The Auction Model: How the Public Sector Can Leverage the Power of E-Commerce Through Dynamic Pricing, retrieved January 13, 2008 from Wyld, D. (2004). Government Garage Sales: Online Auctions as Tools for Asset Management, retrieved January 13, 2008 from Authors Enrico Ferro Contract Professor Polytechnic of Turin, Italy Senior Researcher at Istituto Superiore Mario Boella (ISMB), Italy Lucy Dadayan Senior Policy Analyst College of Computing and Information, State University of New York European Journal of epractice 22

23 European Journal of epractice 23

24 Best practices in egovernment: - on a knife-edge between success and failure This article is an in-depth exploration of three best practice cases a in egovernment. Findings from the Norwegian portal Mypage, the Austrian portal Help and the Dutch Horeca1 project, all previous European Award winners, indicate that even successful projects face significant challenges. Generic success factors exist, and lessons learned for practitioners include: Achieve leadership buy-in, keep technology as simple as possible, get early stakeholder and user involvement, gain momentum and plan for sustainability. This article is tailored to an audience of egovernment practitioners across sectors. Careful reading will increase awareness of the importance of sharing solutions, lessons, technology and experience with others; indeed, the learning process is equally important to furthering one's excellence. Trond Arne Undheim DG Information Society and Media, European Commission b Keywords Best practice, egovernment, success, failure, good practice, epractice.eu, leadership, Help, Mypage, Horeca1, inscription, enrolment, momentum, science and technology studies, placemaking. The citizen, as a consumer of public services, has the selfconception that I am in charge. If we make good typologies, our systems will have inscribed in them a functionality that matches the demand. But demands change, so systems must be flexible. a The terms 'best practice' and 'good practice' are used interchangeably, as they are largely the difference between US and European traditions of modesty. It was actually Voltaire who first said:" the best is the enemy of the good". See b Opinions expressed here are the author's and do not necessarily represent the opinions of the European Commission. European Journal of epractice 24

25 1 Introduction The exchange of good practice is universally recognised as a major accelerator of achievement. Hence, it is a widespread, systematic global activity. For example, the OECD has developed Best Practices in Local Development, 1 the World Bank provides useful research results and data concerning good practices 2, and the United Nations recently launched an egovernment Readiness Knowledge Base which incorporates good practice learning and knowledge sharing elements 3. In Europe, starting in the Fifth Framework Programme, the Prisma project in 2001 was the first to provide good practice syntheses in egovernment, which was then taken up by the Beep (Best eeurope Practices) project in 2002 covering five Information Society domains including Government 4 and providing inter alia good practice syntheses across 16 areas of egovernment implementation. Also in the egovernment area, more recently the eforum initiative is a European egovernment network which brings together the private and public sectors for the exchange of ideas and information, including site visits or learning journeys, and provides a good practice showcase. 5 eforum also runs PPP (Provide egovernment Good Practice Portability), which has developed ways to conclude agreements between administrations for the transfer of good practice. 6 More importantly, the European Commission started with its Good Practice Framework in 2005, an online database of self-submitted cases, which from 2007 has been joined with the IDABC egovernment Observatory into the epractice.eu portal, building a community of practitioners. The European Commission's current approach is to combine online and offline exchange, enabling government organisations to get the most out of the knowledge of professionals. Practice is highly dynamic, so a good bit of learning can be had from merely following the flow of cases, reading them as they emerge on the portal or at workshops (where you can meet case authors face-to-face). Reflecting on good practice is central to replicating success rapidly and cost-effectively. Likewise, by writing about it you are challenged to think about the challenges encountered. The i2010 egovernment Action Plan (2006) states: "The Commission, together with the Member States, will explore mechanisms to ensure the long-term financial and operational sustainability for sharing experiences, infrastructures and services." 7 The Lisbon Ministerial Declaration on egovernment (2007) reconfirms that commitment: "Continue efforts to ensure effective exposure and exchange of egovernment good practices and their subsequent take-up on a wider European scale by fully exploiting the potential of the egovernment good practice exchange service (epractice)." 8 Sharing good practice is well established as a European policy driver. The next section looks at the research which identifies where best practice is most needed. Section 3 describes the methods used in this article. Section 4 presents leading projects and details their individual experiences. Section 5 summarises broad issues of failure that challenged the projects, and section 6 structures the emerging generic success factors of best practice See 8 See European Journal of epractice 25

26 2 The Research context Recent EU studies show that leadership, citizen-centricity and service delivery beyond borders are among the elements which must be in place to have strong and lasting impact. Likewise, impact should be measured elegantly, so you know and can communicate progress (or lack thereof) to important stakeholders. Finally, science and technology studies have taught us that context matters greatly in egovernment (Heeks, 2005), and has highlighted the key processes of inscription, enrolment, placemaking and momentum. Each of these approaches will be introduced in a brief theoretical scope, to prepare the ground for the case analysis. 2.1 Breaking barriers The Breaking Barriers to egovernment study (BBeGov, 2007) found that leadership failures frequently act as a barrier to progress and that project management must be taken seriously. Networks and communities of practice can contribute to drive successful developments because they inspire, inform, and integrate people a must in any egovernment project. 9 Seven barriers emerge as most distinctive (BBeGov, 2007; Eynon & Margetts, 2007): Leadership failures resulting in slow and patchy progress to egovernment. Financial inhibitors limiting the flow of investment to egovernment innovation. Digital divides and choices, where inequalities lead to differences in motivations and competences that constrain and fragment egovernment take-up and fail to address particular user needs. Poor coordination across jurisdictional, administrative and geographic boundaries that holds back egovernment networking benefits. Workplace and organisational inflexibility impairing adaptability to new networked forms of information sharing and service provision. Lack of trust heightening fears about inadequate security and privacy safeguards in electronic networks. Poor technical design leading to incompatibilities between information and communications technology (ICT) systems or difficult-to-use egovernment services. 2.2 Citizen-centricity The Citizen-centric egovernment study (CceGov, 2007) found that delivering cost-effective, personalised and relevant e-services that enhance democratic dialogue require customer focus and constant monitoring of their needs. Through case analysis, flexible designs that are open to change are found to create the highest public value. Moreover, these are organisational requirements beyond any individual project. Without citizens being viewed as a trusted party, any investment made is significantly less efficient. Trust is "hard to build, easy to destroy" Cross-border scope The Pan-European egovernment services study (Euregov, 2007) argued that service delivery beyond borders requires vision, but also the right incentives - and those are not necessarily widespread. In fact, they seem more prevalent in: Big cities with a mobile, international population; 9 See the Breaking Barriers to egovernment study (2007): 10 See the Citizen-centric egovernment study (2007): European Journal of epractice 26

27 Small countries with an open international economy; EU-regions with lots of cross-border activity; Public sector organisations aimed at knowledge workers, especially international ones such as the European Commission Measuring Impact Fourth - measuring impact is not an easy task, but should not be too complex either. There are arguments to measure more and arguments to measure less. In reality, one should always strike a balance measuring elegantly not too much but not too little either. Most importantly, one should measure continuously, not ad-hoc (egep, 2006). In the end, the policy or delivery context should determine your choice The co-construction of technology, people and process Fifth - four concepts from Science and Technology Studies unmask the match between 'e' and 'government': inscription, placemaking, momentum, and enrolment Inscription Heeks (2005) argues that context matters greatly in egovernment. In his view, there is never simply technology transfer. Having studied developing countries he finds support for Akrich's (1992) theory of inscription that all technical artefacts have an embedded user script (one could think of the script for stunts in an action movie). If that script is not followed, things can go horribly wrong. The example he gives is trying to make electoral processes more transparent in Africa using an e-application developed in the US, and failing miserably because the values, staff, skills, and hierarchies worked out quite differently (p.56). He concludes there is a "prevalence of egovernment failure" (p.52). A comparative study of egovernment systems in the US and Europe (Wyatt, 2000) similarly concludes that when designers lack an idea of how their system might be used, not only will the quality of service suffer, but the system itself may fail completely Placemaking All public services are delivered in a given setting. Organisation, people, policy and local dynamics influence what can be done. In a previous study of knowledge intensive work practices, I coined the term placemaking to describe the art of activating the totality of tacit knowledge found in the immediate surroundings to a real-world purpose (Undheim, 2002). Even in the high-tech industry, where my previous fieldwork was done, placemaking required face-to-face presence as well as time because of the intensity and trust required when trying to convince others. The proud civil service traditions in Europe, while partly a guarantee for professionalism and fairness of procedure, may block such bureaucratic entrepreneurship. It would seem that in a bureaucracy, placemaking around actual service delivery extends over decades, even centuries Technological momentum and enrolment Technological momentum is the process whereby a project starts to speed up because it matures and enough elements are in place for it to roll on its own (Hughes, 2004). For Hughes, momentum takes on a deterministic character, it cannot be stopped, as it were, but one need not go that far to use his terminology. Rather, we shall evoke the notion of enrolment (Callon, 1986), the moment when a set of 11 See the Pan-European egovernment services study (2007): However, bypassing borders is also relevant in local service delivery. Success may require collaboration with and connection with citizens, businesses or other stakeholders outside your focus area. 12 See the egep study (2006): European Journal of epractice 27

28 actors accept the interest of another actor as their own (say project, idea or vision). To Callon, project success requires translating other's interests into a common matrix. The result is then a heterogeneous network of aligned interests, controlled by one main actor. Taking into account this brief analytical scope on best practice, and the tools available to understand it, the questions we will try to answer in the following sections are: What is best practice in egovernment? Which, if any, contextual factors are decisive? Are there success factors across context? 3 Methods My analysis tells the stories behind three prize-winning initiatives in egovernment, using the rich, emerging evidence from the epractice.eu good practice portal. 13 The large knowledge base of real-life case studies submitted by portal members is freely available, and grows daily. Projects have an average funding of 1.3 million and represent a total implementation cost of well beyond 1.1 billion. Case authors represent most countries in EU27+, and epractice members are starting to form communities of practice (Jarke, 2007). For this article, I have closely analysed three cases two out of the five European egovernment Awards 2007 winners, and one case which has won numerous awards, notably the 2003 eeurope Award. The methodological reasoning behind focussing on award winners is to have some externally validated rationale for my strategic sample. Beyond this, I chose cases where I had personal access. Other cases that contribute to the identification of best practice will be briefly reviewed. I have personally interviewed most case owners and the actor network around them. In addition, the recommendations are based on an overview of the 800 or so cases on the epractice.eu portal at the time of writing. Secondary sources include the findings of the EU-funded studies egep, CCeGov, Euregov, and BBeGov, 14 and the literature on Science and Technology Studies (Akrich, 1992; Callon, 1986; Hughes, 2004; Undheim, 2002; Wyatt, 2000). 4 Best practice in Europe three frontrunners In the following, I analyse three best practice cases, interweaving what emerges from the epractice.eu case profile with empirical evidence I have gathered myself. The first case is Mypage. 4.1 Over-promise and then deliver Norwegian Mypage The Norwegian national portal Mypage 15 is a citizens portal where users can carry out personalised public e-services in one place. Citizens also can control, and correct, the information held about them by various public agencies, nationally, regionally, and locally. It all sounds so simple, but it took significant effort to put in place A great political idea 13 See epractice (2008), 14 See and and 15 Norwegian national portal Mypage (EU good practice case): European Journal of epractice 28

29 In 2004 the Minister of Modernisation, Morten Meyer, announced his intention to create a one-stopshop for all egovernment services within one calendar year. He said this publicly before anybody inside his own ministry knew about it. There was no feasibility study, no strategic plan, and most importantly, no budget available. Predictably, few believed it would be possible. Industry hailed it as a great but unfeasible idea. Meyer kept repeating the same message. In-house, senior bureaucrats started to worry. It soon became clear that a promise had been made, and something had to be done. By September 2004, Lars Bjørgan Schrøder, a mid-level bureaucrat was assigned the task of project manager, with almost no resources and no team around him. Ad-hoc meetings were held to get the idea to the drawing board. Very soon, he realised that nothing could be done without resources. The Minister wrote to his Conservative Party colleague, the Minister of Local Government and Regional Development, asking for ten million NOKs. 16 He was given eight million, outside of any budget. Needless to say, the project started Things go wrong Almost everything went wrong in the first year. Partly because Morten Meyer had another fixed idea in his mind to crack what he called the eid code. 17 Thus, in parallel, he launched an ambitious project to set up an advanced online security portal. He set a short deadline (the end of 2005) and delegated responsibility to the Brønnøysund Register Centre. 18 The security portal relied heavily on private sector solutions, namely the BBS 19, the joint technology provider for Norwegian banks. Mypage, as the project now was officially called, dropped its plans for a log-in solution. Lars Bjørgan Schrøder noted: "It took a while before we understood how bad things were. But their 15 December deadline was in reality for a test version, and neither customers nor suppliers were enrolled". As Stein Myrseth, Chief Architect at Software Innovation, the technology supplier, said: "There is a deadline. The ship has to set sail. There is no time to study. As a result, we must compromise on the technical side". A change of government in October of 2005 meant that media blamed the new entrants. The new Socialist Minister, Heidi Grande Røys, could easily cancel the project on political grounds, but chose to stay the course. She found that more time was needed. A press release was hurriedly produced: "we will deliver by the end of Q1". A desperate race began. The deadline, however, was pushed once again. This time the mantra was, "we will get it launched by the end of the year". The site was at that point running as a pilot inside the ministries. Myrseth focussed on the strengths: "The unique feature of Mypage is that we do not own any data, we have created a content aggregator. Data ownership remains with each public agency and we avoid even temporary storing their data. We avoid many problems that way. No other country has this solution yet" M NOK = 1.24M. = 926K (as of 24 January 2008). 17 See 18 The Brønnøysund Register Centre is a government body under the Norwegian Ministry of Trade and Industry, and consists of several different national computerised registers. These registers contain information and key data about such matters as: Liabilities and titles in mortgaged movable property, more than business enterprises, more than annual accounts and auditor's reports of limited companies, bankruptcies and compulsory liquidations, and approximately marriage settlements. The Brønnøysund Register Centre contributes greatly towards creating improved and more orderly conditions in business, trade and industry. See 19 See European Journal of epractice 29

30 By April of 2006, Lars Bjørgan Schrøder finally gained full responsibility for both the Mypage and Security projects. He rapidly decided to discontinue all plans in the latter and change course. Mypage started working on a new, temporary log-in solution. "Getting the job of creating the emergency security solution in the summer of 2000 was a breakthrough," says Myrseth. By the summer of 2006, Norge.no, a public agency within the Norwegian Ministry of Government Administration and Reform, took over, and a new era started that of service implementation Launched at last When Mypage launched on 18 December 2006 it was 18 months late, and with PIN-codes 20, not the more advanced security solution (PKI 21 ) which failed in the meantime. 22 At launch, only 23 services were included. 23 These were mostly already existing electronic services now displayed on one page online, with one exception over 20 municipalities were present from day one. Even though the tension had been high, the partnership at local level was not broken. Local actors were more eager than ever. That fact was to prove significant. Illustration I: The Mypage portal 24 In May 2007, after only four months of operation, about 200 services from more than 40 public administrations were serving more than 200,000 registered citizens (around 5 percent of the population). 20 See 21 See 22 The re-vamped security project is still running and will present its findings to the Norwegian Parliament (the Storting) in the spring of At launch, services included: change name or address in the national person's registry, application for Tax card, moving notice, change of primary physician, my vehicles, my debts, application for State funded student loans, employment status, reservation against direct mail advertising, my properties, and some municipal services. 24 Retrieved from 21 January European Journal of epractice 30

31 Although a certain success was in sight, the public profile of the project was not like it once was. Lars Bjørgan Schrøder said: "The media only wants to write about egovernment scandals. Once things start working, or are successful, we lose their attention". The marketing budget of Norge.no, an organisation with only 26 employees, was very small. In fact, Mypage has spent almost nothing on traditional advertising. Myrseth added: "The government strategy to allow equal access to all suppliers through the open standards interface has worked. Neither on the customer nor the supplier side, have we been selling the concept, the services and helping enough public service providers join in." "The most important is not that people log-in to the site every day, but that when they need it, it is simple and straight forward", said Lars Bjørgan Schrøder. Tor Alvik, responsible for Mypage, sees a brighter picture: "While driven top-down with involvement throughout the organisation in state agencies, the project was [also] driven bottom-up with direct contact between Norge.no and the individual municipality." Connecting with stakeholders Exactly how do the Mypage staff interact with municipalities? According to the collaborators I talked to, in practice, they meet interested municipalities one by one, and recruit new players by word of mouth. However, there are also formal forums in place. Alvik says: "The main lesson learnt from the project is the importance of involving all actors from the beginning. This includes the local authorities through their organisation, The Norwegian Association of Local and Regional Authorities, as well as the Government Agencies and their controlling Ministries. The establishment of a coordinating group for egovernment involving the major administrations and the Norwegian Association of Local and Regional Authorities has been important in order to secure support from all public bodies involved in delivering services to the portal. The coordinating group is lead by the Ministry of Administration and Reform." Lars Bjørgan Schrøder supports this view, echoing what Alvik says about the importance of stakeholder involvement. Moreover, Mypage staff had to engage in placemaking (Undheim, 2002), as we recall activating tacit knowledge found in the immediate surroundings. In fact, the staff had to inscribe a new notion of service delivery into the daily practices of the people involved, not only into the systems: "Sectoral barriers had to be broken down. There are two ways to do it, either by decree, which is difficult, or voluntary, which demands both buy-in from the ministerial level and buy-in on the operative level. We had both, and that is why it worked out in the end" [ ] we worked based on our contacts and networks." While Schrøder emphasises the role of informal networks within the bureaucracy, Alvik, from his standpoint in a public agency, values top leadership support: "A committed political leadership has proven to be vital for moving the project to full operation and to get other parties involved." European Journal of epractice 31

32 In the end, leadership buy-in throughout the process was clearly fundamental to the success of Mypage. According to Stein Myrseth, such momentum took time: 25 "The challenges were never on the technical or even on the implementation side, but on the political and organisational side. We had to create enough momentum. We stood up against a public sector model based on non-collaboration across agencies. Mypage represented something new and scary, almost a foreign idea. The competence level in the public agencies was not always sufficient to have a meaningful discussion about the challenges we were facing". To assume that the public sector was the slowest to get how important Mypage could become would be a faulty assumption, according to Myrseth: "It took a while before people at Software Innovation understood the many synergies involved. We received a lot of goodwill, confidence on the security solution, and a head start on our document management system which now is being implemented as one of the services on the portal". We recall that enrolment is the moment when a set of actors accept the interest of another actor as their own (Callon, 1986). While Mypage successfully enrolled the hierarchy, the trickiest challenge of all is to satisfy the user, according to Alvik: "The importance of focusing on users' needs [ ] cannot be overstated. Mypage is a user-oriented initiative and without constantly keeping the citizen in focus the project would probably have failed and ended as yet another good idea never brought to its full potential." However, says Myrseth: "Advanced impact reporting and user profiling is possible, but we are careful. The Data Inspectorate 26 could object, and trust is everything in this business". In early spring of 2007, The Norwegian Board of Technology, a government think tank, talked to focus groups about Mypage. The result was not reassuring. They concluded that the jury is still out on the efficiency gains of the project and pointed out that users have quite high expectations that now must be met. 27 However, the international assessment was very different Winning the prize In the fall of 2007, at the 4 th Ministerial egovernment Conference in Lisbon, MyPage won the egovernment Award 2007 in the category for Participation and Transparency. The fact that what the government knows about you is available online so citizens can review (and contest) it, is unique. The entire Norwegian delegation, from Minister Røys to Project Manager Alvik, celebrated this victory in Lisbon. It is sweet to finally get some recognition. One would think the trouble is over Sustainability concerns However, the prize did not immediately lead to big changes at home. The media reported about it the day after, but then its newsworthiness declined. The budgetary struggles continued, although the project now was in safe hands with Norway.no. The struggle to keep up the momentum continued. "It is challenging to keep the focus and push when everything is based on voluntary action," says Schrøder. Some advertising will be done in the fall of 2007 in connection with sending out new PIN-codes together with the Tax Card, but that is all. 25 Myrseth now works for Sun Microsystems, Norway. Mypage is built on Sun's software platform and portal server. 26 See aspx 27 See especially the results of the citizen's panels: European Journal of epractice 32

33 "Norge.no cannot scale it is too small," says Myrseth, and "in the future, Mypage must get more national registry services and more geographically-based services. People use those services more often, and it is the only way to become their primary page". On the other hand, he also exclaims enthusiastically: "We are interested in sharing the new portal experience at the European level maybe creating a community. In fact, Mypage is going to become more generic. We will put the whole solution out on a community and allow developers to access and build services on top of the system. In fact, we encourage other countries to make use of the solution out of the box". Once successful, it is only natural to want to claim what is yours. But what should that mean when you are in the business of citizen trust? Myrseth is clear: "There are many actors who want to own the citizen Norge.no, the Finance Ministry, FAD 28, Altinn 29, the municipalities, the County administrations, the new Directorate for egovernment 30, among others. In reality they all get it wrong. It is not about owning the citizen. The game is about who should be in the driver's seat. At the moment, nobody is." The idea of Mypage had been launched with bravado. The way there was long and painful. There is an old, Norwegian saying that goes: "nothing comes by itself". The Mypage project reads like a Norwegian folk tale the kind, anti-hero wins in the end, but only having surmounted overwhelming obstacles. 31 Now, let us turn to the Austrian portal, a similar solution, but ten years earlier in the making. 4.2 Success through rigorous planning Help The Austrian portal Help, the brainchild of Arthur Winter at the Ministry of Finance, was launched in pilot version in January Designed around eight different 'life situations' like birth, marriage, travel and death, rather than around administrative structures, it is one of the first one-stop-shops for egovernment services. Sylvia Archmann, who was a key player from inception until 2005 says: "In 1997, our first users were around 70 percent male and in their 30s to exaggerate a bit our services could have focused mainly around cars following our polls. Two years later, in 1999, our users were 50 percent male/female and the average had risen to year olds." We recall the notion that all technology has an embedded user script (Akrich, 1992). From the beginning, Mr. Stergar, from the Austrian company Net Value, inscribes the initial IT concept behind the portal, soon fixating on life events, far from the only logical choice. 32 Net Value has been involved in the development of the Help concept since the start some ten years ago. According to Stergar, some of the factors which made this project such a success from the start were; a strong project owner at the ministry, the strict citizen orientation, the life situation approach, the strict central approach and the fact that technique was supporting, but never leading. Outsourcing content development to a private and independent company was important in achieving the above goals. Also, the pragmatic approach ruled: "trying before long term planning", which also could backfire. 28 FAD = Norwegian Ministry of Government Administration and Reform. 29 Altinn is the portal for egovernment services to business, partly integrated with Mypage, but still insisting on their own identity, see 30 The Directorate for egovernment was created as of 1 January 2008, and encompasses Norge.no 31 If your interest in Norwegian folk tales has been triggered, please see 32 Stergar presented his experience at a 2007 epractice workshop. See the workshop report: European Journal of epractice 33

34 Moreover, initially, there were different understandings of project organisation and the importance of targets among the key constituency, something he attributes to the Austrian Federal Chancellery's organisational culture. Also, there was little attention on the creation of good and understandable content, and a heavy focus on technique. To Susanna Rihs, Austrian Federal Chancellery, for instance, quality assurance is crucial: 33 "To ensure that Help s information is always up to date, cooperation with the public administration offices is necessary. At the beginning, only a few volunteers from this sector were prepared to cooperate with Help. In 1998 a resolution was adopted by the Council of Ministers stating that each ministry must nominate a Help coordinator to act as a contact person." In the first years, the coordination network was smaller, but it soon consolidated at around 70 people. The vast team of contacts engage in placemaking (Undheim, 2002), providing face-to-face representation of the online portal around the ministries, making it "real". Sylvia Archmann recalls: "Finding the right content was a challenge. We settled on the concept of life events, but had to find out which of them to focus on first. Our approach was to ask our partners, on the business side, the Chamber of Commerce (for SMEs) and the Industriellenvereinigung for large industry. In fact, in the beginning, we were running two parallel tracks, one portal for business and one for citizens. This was abandoned after a while. We also had other challenges. It was tough to achieve the needed visibility, and not to mention, to convince the different levels of government to cooperate. We especially had to strike a partnership with Mayors around Austria, a very powerful group. I have to say we succeeded. In my term, we went from 30 municipalities (2001) to 800 municipalities (2005). Initially, we thought we had to fight about the content, but no, the solution was to involve them in the future development and to allow them to create their own look and feel." A "communication portal" Not everything goes smoothly. According to Stergar, Help encountered many barriers both in terms of launching and running the site, and in terms of learning from others or sharing with others. Public servants are not trained for selling or marketing: "In-house, there was not a clear idea of what our good practice was: what needed to be shared? Was it the concept, the technique, or the organisational model? There was also insufficient attention for the start up phase in which the concepts and strategies are developed, to effectively identify and target the specific demands of public administration." 34 The Austrian public sector has many lawyers. However, staff felt that content on the portal had to be appealing to the masses. NetValue was charged with re-writing a lot of public servant's speak and legal terminology into plain, simple text. The lawyers had to adjust to that, and it took some convincing. In this first period, users were very forgiving and engaged. Sylvia Archmann remembers: "We were perceived as fast and friendly. When we answered questions online, giving a 72 hour response guarantee, people came back to us and said 'it is hard to believe this is a government solution'. We were one Help team, contractors included. People would stay throughout the evenings on their own time if things needed to be done. This was the pioneer spirit." The focus in the Ministry shifts from communication well to delivering on policy matters. In the years from 2001 to 2003, Help becomes accessibility compliant, following the WAI AAA criteria. In 2003, a nine language strategy comes into effect, which receives wide acclaim. The accessibility turns out to be 33 All quotes from Susanna Rihs are from the case entry at 34 Source: Stergar's presentation at (2007). European Journal of epractice 34

35 quite inexpensive, in partnership with institutions like the Austrian Association for the Blind, while the language strategy is costly, and does not last for long Winning the Award In 2003, Help wins the e-europe Award, in the category A Better Life for European Citizens. The motto is modest by today's standards: "Help is a virtual guide to Austrian authorities, offices and institutions that provides citizens with information on official proceedings, dealings and fees, as well as forms that can be downloaded or completed on-line". 35 The award gives an international push. Austria gets a large amount of public administration tourists, eager to copy their success. The award also helps in the branding and visibility, towards municipalities, but the effect is hard to measure. The Citizen Card concept, a digital authentication solution (not always a physical card), 36 is launched in 2000 and has since then increasingly taken shape. In March 2004, the Austrian egovernment Act enters into force. The Act which sets the obligation for public bodies to be capable of full electronic transactional service delivery by 2008 provides a clear and solid legal basis for the country's egovernment programme and initiatives. It covers all electronic communications, procedures and proceedings within all layers of government. Among other things, it sets the legal basis for the use of the Citizen Card, electronic signatures, sector-specific personal identifiers, electronic payments and electronic service delivery. It also provides for closer cooperation between all authorities providing egovernment services. Austria was one of the first EU Member States to adopt comprehensive legislation on egovernment. 37 In September 2005 a new federal organisational structure ensures a coordinated approach with no overlaps. This strategy proves successful: In the annual benchmarking of 20 basic egovernment services Austria steadily moves up to a leading position, improving its overall ranking from 11 in 2003 to 4 in 2004, and runner-up in By now, there are only two languages left on the portal, German and English. Cost-cutting and shift of emphasis towards core business is now more evident. One could say the project has matured. In 2006, Help 38 provides services to all those who deal with Austrian institutions. It is organised as a onestop-shop covering about 150 life events (such as birth or marriage) as well as topics like housing or starting a business. Help is offered in German and English and extends its reach to people from other countries that live, work or take an interest in Austria. With time, success, and organisational changes, the portal's inscripted user (Akrich, 1992) begins to include policy makers. The focus is shifting A "serious IT project" Help's applications were initially developed to be implemented only once. However, in the last few years, the portal has been a motor for administrative development, and the open standards architecture is offered free of charge to organisations in other European countries. Peter Reichstädter: 35 See 36 The concept defines the necessary requirements to carry out electronic administrative procedures securely, see 37 Source: epractice egovernment Factsheet for Austria (up-to-date as of 29 June 2007): 38 See Help's English website: and Help's EU good practice case entry: European Journal of epractice 35

36 "Help has contributed substantially to the standardisation, transparency and clarity of administrative processes in Austria." Fully integrating the service delivery of more than 2,358 local communities on a national portal is a significant achievement. The page views increased from 12 million in 2004 to 22 million in Top topics in 2006 have been passports, taxes and driving licences 39, but motor vehicles, residence and visas, benefits, birth, housing, residence registration and marriage are not far behind in the top ten list. Rising take-up figures of Help are an indicator for the impact of the portal. It enjoys 380,000 visits with an average duration of minutes per month. 40 In June 2006, as a first achievement of the renewed e-government initiative of the Federal Government, Austria finished first in the annual egovernment benchmarking survey published by the European Commission. 95% of basic public services are at the transaction stage and 83% are fully available online. Later that year, in December 2006, Help is awarded the BIENE 2006 in Gold for the best barrier free German language information portal. A 2006 egovernment initiative spread knowledge about how to enable effective and efficient e- government services at all levels and in all institutions of the administration, where success is: Linked to a massive content strategy and a support staff including editors. Widespread through the use of open standards. Achieved through constant positioning in the marketplace (among users). As of summer 2007, Help provides quick single access to administrative procedures, and as an interface between local authorities covers 12 federal ministries, 9 federal provinces, 80 local authorities and 2,359 municipalities. The portal is still structured according to life situations, refined after user input, and with functionality from information, to communication and transaction services. After ten years, Help is a worthy predecessor to the one-stop service concept, handling 200 life situations, 1,000 public forms and executing more than 250 online administrative procedures. The Euregov (2007) project describes its benefit this way: "The portal centralises knowledge that otherwise would cause a lot of search activities and cost if a public administration encounters requests that go beyond its usual scope of tasks and expertise [ ] In some cases questions are starting to be answered by citizens themselves." 41 In fact, the users forum for "Questions and Suggestions" (info@help.gv.at) gets 1,000 requests per month, most of which are answered by the editorial team of Help or specialists. 39 Source: Peter Reichstädter at the epractice workshop Source: 2007 National Progress Report (Austria) internal EC document. 41 See: (page 2), retrieved on 11 December European Journal of epractice 36

37 Illustration II: Screenshot of Help Momentum kicks in In the fall of 2007, it becomes clear that Austria tops the EC benchmarking of online public services for the second year in a row. Austria is the first to achieve 100% fully online availability, which means that for every service measured in the survey, each citizen or business has the possibility to access the service via a fully transactional electronic channel. Austria scores 99% on online sophistication, even with a new 5 th level on that indicator. Help is a crucial component in the success, but does not score as high in terms of personalisation, since login is not yet in place. Moving into transaction services, the portal has different procedures with over 650 partner authorities all over Austria, integrating e-signature (Citizens Card), e-payment and e-delivery. By now, the national portal Help is the centrepiece of eservice delivery in Austria. Lessons from Help were used both in the German provinces of Bayern, Baden Wurttemberg and Saxony 43, and in the Swiss national portal, Guichet Virtuel. We have here a significant European success story. 42 Retrieved from 10 December See service-bw.de in Baden-Württemberg and amt24 in Saxony European Journal of epractice 37

38 4.2.5 Sustainability challenges Despite the success, challenges remain, as policy, people and technology move on. Budgets are also a constant concern. As of autumn 2007, in-house, they include: Semantic Ontologies E-Gov Service Catalogue Multi channel delivery Content Syndication Tackling semantic ontologies is an emerging challenge because the life situations that build the basis for the portal s structure are interpreted differently. Multi-channel delivery in terms of mobile communication is currently being explored. Finally, content syndication is amongst the very next steps of Help: Due to the fact that every ministry is providing content, this content can and should be shared with other websites and authorities. Another issue concerns quality assurance: How to present information understandably? The development of an egovernment Service Catalogue is not only meant to benchmark what services are provided, but also to find out how these services can best be shared. Among the experiments going on, the presence in the 3D online virtual world Second Life 44 is maybe the most controversial, and is not necessarily proving to be only a positive experience, according to Stergar. Help also now has a front towards youth and children, and tries to tailor content to different age groups. To this day, Help remains one of the most successful implementations of the online one-stop service concept, even though others have come along. Over the course of 10 years, the portal has shifted hands between various agencies at the federal level. Whatever the future holds, it seems certain that the portal will remain a focal point for some time to come. Help is ingrained in Austria s service delivery, enjoys considerable momentum, and has strong stakeholder support. But, in the business of people and politics one never knows therein lies the rub. Trust is hard to build and easy to destroy (CceGov, 2007). 4.3 Making tacit knowledge more explicit Horeca1 45 Periodically, the city of Amsterdam asks a group of local entrepreneurs what they can do for them. The clear message in 2005 was to reduce their administrative burdens. For a bar, hotel or restaurant in Amsterdam, one needs to obtain licences and permission from more than 18 different authorities 46, creating a difficult obstacle for those setting up their own business. In addition, entrepreneurs in the hotel and restaurant business need to renew licences every three years, which obviously creates considerable stress and administrative burden. Two city officials asked themselves: can we do anything about it? 44 See 45 See and As for the name, Horeca is a business term which refers to a sector of the food service industry, to establishments which prepare and serve food and beverages. The term is a concatenation of the words Hotel/Restaurant/Café (or Hotel/Restaurant/Caterer, or Hotel/Restaurant/Canteen. This term is used in the Netherlands where it is thought to have originated, though it is also used in Portugal and Belgium and international beverage companies specializing in this sector. See 46 These 18 authorities include 17 national authorities plus that each applicant deals with one out of the 14 autonomous city municipalities in Amsterdam. European Journal of epractice 38

39 4.3.1 Enrolling support The idea brewed throughout 2005, and in January 2006, the Horeca1 project got going with support from the government innovation programme Inaxism, with a start-up-cost of 175,000, and an additional 120,000 inserted in On the national level, the focus on reducing administrative burden has been in place since May 2004, when the first progress report from the Dutch Advisory Board on Administrative Burden (ACTAL) was submitted to Parliament. 47 Only four people were in the project team. Coen Boot, who was involved from the very beginning as member of the government innovation programme Inaxis 48, and provided Horeca1 with start up capital and advice, explains: "The reason to start the project was the increasing administrative burden because of the differences in procedures and forms an entrepreneur needs to go through when he or she wants to start a business. [The root of the problem is] the fact that the city of Amsterdam is divided into 14 partly autonomous acting municipalities. The central city of Amsterdam cannot force them and tries to seduce them. The tricky thing for Maurice and his club is how to convince those 14 municipalities to join the solution he is developing. The answer is mostly a practical one: showing them in practice how good it works and putting all the energy in those who want to go along." In the beginning, the project had several challenges: "We were being viewed as one city among many, we had lack of access to certain national records, and very small resources," says Maurice Van Erven, from the Economic Development Department in the City of Amsterdam. The lessons for egovernment projects are to: "Make your design in steps and limit the scope of your project. Work towards a concrete example at an early stage of the project and continue from there through an iterative process. With a first mock up it will be easier to create support." When the project started, the city of Amsterdam was not aware of any experience in Europe that would help them set the course. Quick internet searches were performed, but having found nothing, they proceeded using their own devices. 49 Horeca1 was envisioned as a project only for existing entrepreneurs tackling the renewal of licenses. However, as this proved quite difficult, and since the information was starting to emerge on how to help emerging entrepreneurs, they opted to put this in place first. Van Erven says that 80% of all knowledge of civil servants has not been formalised and the task of egovernment projects is not to reproduce existing procedures in an online form, but to simplify them: "There is a large grey area between laws and regulations and the actual service provision based on them. Digital service provision makes this grey area explicit and visible. It therefore forces the governmental organisation to address contradictions and overlaps within this grey area which contributes to better governance by making decision making and assessment criteria transparent and the information equally accessible for all." What about the importance of stakeholder buy-in? 47 See the epractice Factsheet for The Netherlands (up-to-date as of ): and 48 See 49 The European Good Practice Framework for egovernment was in place from 2005, unbeknown to Horeca1. This shows the importance of increasing PR for public sector good practice sharing efforts. European Journal of epractice 39

40 "It is important to actively engage them in the project at an early stage and to spend a considerable amount of time in knowledge transfer, training and explaining. Make your project their project!" in fact "parties were seduced to contribute a small part", because "in public administration, once people give you their information, they are afraid to become obsolete." Online momentum The technology behind Horeca1 is quite simply an online-forms solution, which is built on an existing platform. The application itself is built by in-house technical staff, while the designer is hired externally. The real difficulty lies elsewhere. The conceptual phase, gathering the necessary information about existing regulations and convincing officials to give up information takes a full six months. Designing the solution is a bit quicker. Building the form itself only took two weeks, and in January 2007 there is a pilot version online. By April 2007 the entire form is online. Through the HoReCa1 one-stop-shop an entrepreneur can easily find out which among the selection of 40 governmental documents has to be obtained by answering 20 questions and filling out a single form for seven local licences required in the City of Amsterdam. The first milestone has been reached. Is it all well? No, because nobody loves it Caught in politics Even though Amsterdam was viewed as a technological pioneer in the 1990s, that momentum is lost. The Digital City Amsterdam project failed to become a sustainable information and communication infrastructure (Besselaar & Beckers, 2005). 50 Amsterdam's online portal, introduced only in late 2006, is largely an information source, rather than a service providing communication or transactions. 51 Hence, in the beginning, only two out of the 14 city municipalities of Amsterdam go online with Horeca1. After a while it becomes clear that one of them fails to attract any applicants; the other, the centre of Amsterdam, which represents 50% of the industry in the city, decides that it does not want to attract more applicants - city policy says there are enough restaurants and bars. They refuse to promote it. It would seem Horeca1 is headed for full collapse. However, that depends on which political context is in focus. Horeca1 now begins to gain national and European recognition Winning an award In September 2007 Horeca1 wins the European Award in egovernment in the category Better public services for growth and jobs. Amsterdam discovers there are, in fact, at least two other projects that do similar things, in France and in Spain. 52 In December 2007, they have seven of the 14 municipalities with them and are aiming to integrate others at rapid pace. About 30 entrepreneurs have used the system successfully. An initial budget of 250,000 and a boost of 550,000 in 2006 have had clear effect. 50 While financed by the the city of Amsterdam and national Ministry of Economic Affairs, De Digitale Stad was an independent foundation from See Amsterdam Answers 52 The two are the Spanish case Circe: and the French case Admin24 European Journal of epractice 40

41 Illustration II: Horeca National challenges With savings per applicant of 1,506, it is possible to save some 30.2 million a year in administrative costs in The Netherlands, while reducing the burden for both the authorities and the individual businesses, if the service were to become national. The administrative burden focus, setting concrete targets and measuring progress is a Dutch forte. 54 In addition to a simpler, more effective service with real financial benefits for both the provider and the user, the project has proven its flexibility and transferability to other municipalities and other sectors. However, there are challenges as well. Coen Boot says: "Developments on national level influence the Amsterdam project. For example the different laws made and carried out by ministries which influence the content of the forms and thereby the goal of reducing the administrative burden. We intend to help Amsterdam on this point by addressing this problem and bringing the problems Amsterdam encounters under the attention of the ministries on national level. The maintenance of the (Amsterdam) solution which is available to the rest of all the municipalities in The Netherlands [is also problematic]. Amsterdam is a front runner and we hope others will take over their solution. Some already are. Maintenance then becomes an issue, because Amsterdam can't and won't do this for them all. The solution to this problem can probably be found on national level." Implementing egovernment projects at the city level has specific challenges. The Horeca1 experience teaches us to: 53 Retrieved 11 December 2007 from 54 See European Journal of epractice 41

42 Take one step at a time, dividing the project up into smaller, more manageable tasks and goals. Harness internal knowledge, much of which is not formalised, thereby increasing transparency and efficiency. Invest in the organisation and its people to increase the acceptance and subsequent take-up of a solution. However, Coen Boot challenges the notion that taking the project beyond its initial scope is something one should wait with until the end: "Let other cities participate in your project as early as possible. Look for broad support. Make sure the project benefits everyone" Sustainability and transfer Horeca1 will run until 2009 with current funds. Meanwhile, Maurice Van Erven, the project manager, has been promoted. The Horeca1 method has been adopted and spread across the city of Amsterdam and is now to be included in building applications for online public services around events (from barbeques to the Gay pride parades), work in the public space, building permits and towards expatriates and Maurice is responsible. They are working directly with two other Dutch cities (Nijmegen and The Hague) who want to copy the system. As for Nijmegen, it has no canals, and a different terrace policy. The classification of a fast food restaurant is also different. The system will have to adapt. The national ICT agency, ICTU, has been assigned to transfer the Amsterdam system to other local governments. In fact, the methodology can be transferred to other sectors (healthcare, education, civil matters, funding programmes, etc.), and to other European cities. Amsterdam has created a toolkit with all you need to get going, making it available as an open standard, and partly available in English. As the initial problem is still being solved the online solution for existing entrepreneurs renew their license will be ready in spring 2008 a new project, called Horeca2 is seeing the light of day. The aim is to attack the back-office. While Horeca1 only took the entrepreneur's vantage point, Horeca2 will tackle the city official's day-to-day. Again, critics say it is impossible legacy systems are too ingrained. A proof-of-concept must be ready by January This time, the city of Amsterdam puts in 400,000 of their own resources and will develop everything using open standards. 55 Maybe this time, Amsterdam will keep the momentum? 5 Government projects- confronting the threat of failure Having exposed cases which, while highly successful, always had failure as a possibility, we may ask more generally why do projects fail? 56 The literature abounds with descriptions and the media is full of it. IT projects are often very attractive targets for a media hungry for scandals and failures. As it turns out, these are barriers to correctly prescribing solutions before implementing them, to enrolling actors in your actor network, and to achieving the necessary momentum, recalling Akrich (1992), Callon (1986) and Hughes (2004). Some failures are specific to public sector and three in particular are important: 55 Amsterdam is also active on Open Source front. In an attempt to save costs and achieve interoperability, several Dutch cities in 2007 announced they will test Linux and Open Office (see 56 Our factors resonate with, but go beyond earlier studies (BBeGov, 2007; Heeks, 2005; Wyatt, 2000). European Journal of epractice 42

43 Lack of financial incentive: Why save money when that will reduce next year's budget? Why set a stop-loss rule when there is new money next year? The attitude can often be that a project has to succeed at all costs. Changes in the political agenda: Typically, election years can force things to go wrong as politicians and their staff are rushing contracts or partnerships. Promising too much publicly can lead to a premature launch, as in the case of Mypage. Outside events: In a public setting, lots of things can happen. There could be unforeseen budget effects or debates, shifts in public attention, or media campaigns. The latter is what happened to Mypage after its delayed launch, causing immense pressure from media and industry. Some reasons for failure are more generic, notably: Groupthink 57 : Decisions are taken within a small hierarchy and few outsiders are kept in the loop, narrow expertise is consulted, and end users only glanced at. If simply transferred from someone else, the consequence can be that the software design does not match user realities, or it is unfit for the local context. Another consequence of groupthink is the lack of an interdisciplinary approach. Poor management: A faulty management approach could lead to lack of transparency, structure, deadlines, or follow-up (or any number of these). A project may have been run by an IT department or conversely, by managers without IT competence both of which is equally destructive. Clear goals are not established: If one does not decide exactly what to do and has the procedure in place, takeover by new managers becomes difficult, which is in various phases what happened to the Help portal. Putting in place a too centralised or too locally-specific approach can be equally problematic. Horeca1 was labelled a "local" project until they broke through the ice. Re-inventing the wheel can be another problem if you do not consult best practice. You may end up with simultaneous paper and online procedures, which in fact often is the case in the European Commission, probably for fear of getting completely rid of the paper trail due to the risks involved. 58 All egovernment projects will therefore have the risk of failure embedded in their setup. The difference is actually how the risks are managed, a process to which we will turn now. 6 Succeed regardless of setting From our case material, factors that interplay and complicate the transfer of best practice include: 59 Need (Ministers, parties, bureaucrats, users) Time and Place (political agendas, policy window) Degree of knowledge and experience (team, leader, users) 57 The term was coined by social psychologist Irving Janis (1972), see 58 Internal procedures run a myriad of systems, including Adonis, iflow, Adonis, Sysper2 etc. which are only partly integrated and with a highly challenging interface for people who grew up in the internet generation (as well as others). 59 Beyond the set of three cases studies (Mypage, Help, Horeca1), these recommendations build on a cursory glance at the around 800 good practice cases within the epractice.eu database, as well as upon almost four years of egovernment experience with the European Commission. European Journal of epractice 43

44 Available budget (too little, sufficient, abundant compared with the task) Legacy (organisation, technology, legal framework, culture) The technology available (in-house, open source, or on the market) Stakeholder involvement (who and how intensely) Taking these factors into account, and reviewing the case material, the following seven recommendations may to a certain extent transcend the setting and provide for a recipe for egovernment success: Start with a clear vision Successful projects come from good ideas. Then, one should always perform a sound analysis of requirements (along with others). The vision must then be written into the solutions (inscribed) otherwise it will have no effect. Mypage is the example of a glorious, clear vision. Horeca1's vision to simplify and Help's vision to guide were more moderate and not so clearly formulated, but the projects were equally successful. 2. Introduce innovations slowly build momentum While it can be tempting to launch with huge bravado, the public sector is maybe best served with some modesty. Once you see the effects (enrolment), you can add steam until momentum builds. Incremental steps reduce risk and give a sense of accomplishment. Be adaptive you can then turn failure into success. Capitalise on opportunities underway. Do not expect quick wins. The real, sustainable impact emerges slowly. Help is ten years in operation and the most significant transformation effects have just started to show. Mypage, Help and Horeca1 all started with pilots and then built more advanced solutions, which indicates that size or context does not change that particular dynamic in the innovation process. 3. Achieve leadership buy-in Involve all stakeholders early, present choices and hear people out. Do not use too much force, even if you can force is counterproductive. Let new entrants opt in do not launch by decree. Achieve crossparty commitment. Keep a professional dialogue with the IT supplier and industry overall, where you treat them and are treated on equal terms as a respected peer. Although only Mypage started with high level political commitment, all three cases, Mypage, Help and Horeca1 demonstrate the importance of some kind of buy-in early on and in order to sustain the effort. 4. Monitor stakeholder needs continuously Design the solution knowing what users want. Release often and release early (an open source software development principle that works well as long as you can take criticism 61 ). Be aware that PR and marketing needs are huge. Do not underestimate the helpdesk function, and make it multi-channel (online, phone, face-to-face, TV). The Help portal is the best example of doing all of this. Enrolling users takes time and is hard work. 5. Track progress elegantly Do measure but measure the right things. Do not measure too much. Act on the results otherwise you need not measure in the first place. Do not ignore bad news (or bad progress on impact metrics). 60 However, as with all recipes, they are impossible to follow exactly as given. Therefore, a disclaimer up-front: results will vary. 61 See European Journal of epractice 44

45 Good examples to use are egep, Mareva 62, Wibe , and the EU benchmarking results 64. The aim is to be able to adjust to circumstances. Help is the most advanced solution in this regard, and the results show. 6. Be up to date but use the simplest technology possible Use proven components to reduce the risk of failure or delays. Use established standards, ideally open standards so the solution is re-usable (for others). In fact, Horeca1, Mypage and Help are built with an open architecture, and Mypage is now going completely Open Source. 65 Solutions should be interoperable with legacy systems and future proof (or at least flexible enough to adapt to new plug-ins and technologies. 66 The best example of keeping it simple is, in fact, Brasilian evoting, which uses an extremely simple software tool developed in the 1980s but runs voting across this vast country with little complaints. 67 The UK portal Directgov 68 may be another example. It provides only information, not transaction across its solution, but focuses on being a simple, timely, and accurate source of information, and does that well. 7. Ensure sustainability over time Unless you fail, chances are your solution will outlive its creators make sure there is a succession plan. A great solution which operates for a year is not a lasting improvement and can be counterproductive find benefactors or alternatives. The EU-wide collaborations that the European Commission's Tax and Customs service runs in the customs area is a good example, as is the Help portal. Mypage will be with the Norwegian government for decades as will Horeca1 for the city of Amsterdam they will, in turn, represent the new legacy which others are forced to build upon. 7 Conclusion This paper set out to explain three things: What is best practice in egovernment? Which, if any, contextual factors are decisive? Are there success factors across context? Best practice says to start with a visionary idea, design your solution as simply as possible, gain top leadership buy-in, adjust to circumstances, track stakeholder needs, understand the policy context, gain momentum, withstand criticism, and ensure sustainability. Now, that was the easy part [sic]. The real story is that success and failure is never far away from each other one can turn into the other. Context, such as (1) Need, (2) Time and Place, (3) Degree of knowledge and experience, (4) Available budget, (5) Legacy, (6) The technology available, and (7) Stakeholder involvement, matters, there is no such thing as a fail proof list of success factors. People's and projects' lessons learned can be useful, but must be used wisely. This is why our three case studies each explore different facets: Mypage shows how to succeed starting with grand, political visions, Help 62 See 63 See 64 See 65 What Open Source means is hotly contested, see and 66 See 67 See 68 See European Journal of epractice 45

46 shows one can succeed with policy entrepreneurship within a federal bureaucracy, and Horeca1 shows that city officials who listen to stakeholders can bypass criticism and succeed beyond all odds. All actors were engaged in placemaking, carving out a niche for themselves, and defending it fiercely. That process never ends. Clearly, in any real situation inside an organisation, things will not present themselves as straightforward as in the examples and recommendations given in this article. Leadership which lifts the challenge at hand out of the realm of day-to-day problems and into the scope of strategic decisions is required to succeed. While the schematic I presented here is empirically based, it is likely to only scratch the surface. It can still be of invaluable use. The mega trend of users having a larger impact on public services through choice, criticism, suggestions, walk-ins or walk-outs (CCeGov, 2007), will manifest itself in ever so many ways. The citizen, as a consumer of public services, has the self-conception that I am in charge. If we make good typologies, our systems will have inscribed in them a functionality that matches the demand. But demands change, so systems must be flexible. In the end, since we are talking about winning hearts and minds, and dealing with the fairly volatile attitudes and behaviours of citizens and businesses, best practice in egovernment hovers on the knifeedge between success and failure. Earlier research by Wyatt (2000) resonates with this. In this article, the case evidence allows us to go one step beyond. Near failure can be turned to success, as in the case of MyPage. One cannot be too afraid to fail, yet there is no point in taking excessive risk in the public sector. Failure leads to public scrutiny and, more importantly, the loss of the taxpayer's money. Trust is a relationship, and like all relationships it must be nurtured carefully. It should be clear from this article that egovernment enabled service delivery is far, far more complex than ecommerce. But the rewards are also greater in that one contributes to the common good, if successful. 8 Future research While this article has used three cases for an in-depth exploration of the generic success factors in egovernment projects, the rich empirical material available on epractice.eu presents a research challenge for a more extensive mining. First, any best practice portal needs to embed within it a process of reflection and research this paper is only a first stage in trying to understand what all this material tells us. Second, the identification of generic success factors presents the epractice.eu portal (or indeed any other best practice initiative) with an emerging mechanism to structure content and advice. In fact, what I am doing here is to start building an ontology 69 of best practice a model that explains the relationships between concepts and practice. Third, and most challenging of all, is to understand how this material actually helps existing and emerging projects to succeed faster. In that context, a best practice portal also should see itself as a user-driven service facility. Then, best practice in effect becomes part of a process of learning that both helps its users learn, and learns from its users. References Akrich, M. (1992). The De-Scription of Technical Objects. In Bijker, W. & Law, J. (Eds.) Shaping Technology/Building Society, Cambridge, Mass: MIT Press 69 For a brief definition of 'ontology', see European Journal of epractice 46

47 BBeGov (2007). Breaking Barriers to egovernment study, retrieved 7 December, 2007 from Besselaar, P. & Beckers, D. (2005). The Life and Death of the Great Amsterdam Digital City. In Digital Cities III. Information Technologies for Social Capital: Cross-cultural Perspectives: Third International Digital Cities Workshop, Amsterdam, Besselaar, P. and Koizumi, S. (Eds.), Volume 3081, 66-96, Heidelberg: Springer Callon, M. (1986). Some Elements of a Sociology of Translation: Domestication of the Scallops and the Fishermen of St Brieuc Bay, pp in Power, Action and Belief: A New Sociology of Knowledge, edited by John Law. London: Routledge & Kegan Paul. CCeGov (2007). Citizen Centric egovernment study, retrieved 7 December, 2007 from egep (2006). egep Measurement Framework, retrieved 7 December, 2007 from epractice (2008). epractice - good practice case, retrieved 21 January, 2008 from EureGov (2007). Pan-European egovernment services study, retrieved 7 December, 2007 from Eynon, R. & Margetts, H. (2007). Organisational Solutions for Overcoming Barriers to egovernment, European Journal of epractice, No.1, Fages, R. & Sangüesa, R (2007). State of the art in Good Practice Exchange and Web 2.0, retrieved 7 December, 2007 from Heeks, R. (2005). e-government as a Carrier of Context, Journal of Public Policy, 25 (1), Hughes, T.P (2004). Human-Built World: How to Think About Technology and Culture, Chicago: University of Chicago Press. Jarke, J. (2007). Knowledge sharing in a distributed community of practice: a case study of epractice.eu, European Journal of epractice, No.1, Undheim, T.A. (2002). What the Net Can't Do. [Ph.D. thesis], retrieved 7 December, 2007 from Wyatt. S. (2000). ICT in Central Government: Learning from the Past, International Journal of Innovation Management, 4 (4), December, Author Trond Arne Undheim National Expert egovernment DG Information Society and Media, European Commission European Journal of epractice 47

48 Making the clinical process safe and efficient using RFID in healthcare The Fondazione Istituto Nazionale dei Tumori (the Italian National Cancer Institute) in Milan can be considered a forerunner in the usage of Radio Frequency Identification (RFID) in the European healthcare sector, as it is moving towards this technology in many clinical areas. The Istituto had a need for greater efficiency in the management of the transfusion process, as it had no information system for the detailed monitoring and control of the process; the transfusion service did not have instant access to all the necessary information and for some procedures operators only have access to hard-copy aids. Using RFID the Istituto can now achieve a greater capacity for controlling and monitoring the transfusion system, with the aim of enhancing safety, transparency and quality. RFID tags are sticked on blood bags and patient wristbands. Staff is provided with RFID identification cards and PDAs (with an application developed by the project team) and thus enabled to register patients at their arrival, verify the patient-blood match and recognise at any time patients and transfusional units. Each event is automatically traced by the system and sent to the Transfusion Centre, providing an essential informative feedback which was not available before. The extension of the system to the whole transfusion process (including e.g. the match of blood sample tubes, haemovigilance reporting and functionality enhancements) as well as its implementation to all the Istituto s wards and to pilot wards at Ospedale Niguarda (the most important hospital in Milan) has been founded by the Regional Administration of Lombardy. Moreover, the Istituto asked the project team (which includes also Fondazione Politecnico di Milano) to exploit the achieved experience in a new project about total traceability over time- and temperature-sensitive surgical specimens from the operating table to the Oncological Tissue Bank, as well as for tracking surgical instruments. Elena Sini Italian National Cancer Institute Paolo Locatelli Fondazione Politecnico di Milano Nicola Restifo Fondazione Politecnico di Milano Keywords blood transfusion, transfusion safety, RFID technology, bedside transfusion errors, Oncological Tissue Bank, surgical instruments, tracking, hospital management The application using RFID technology allows the interaction of two existing compartmentalised systems and supports operators involved in the transfusion process. European Journal of epractice 48

49 1 Introduction This paper aims at presenting a case of excellence in the field of RFID applications in the Italian and European hospital sector regarding both methodology and project outputs. At first, we will illustrate a brief overview on the state-of-the-art of RFID applications in the healthcare sector, underlining the value of an approach based on a systemic model of change management: this is the scenario in which the case study we are going to describe has to be contextualized. The Istituto Nazionale dei Tumori di Milano (the Italian National Cancer Institute in Milan) has developed an ICT strategy in which RFID technologies play an important role. This paper will mainly focus on the first project being set up for granting safer transfusion in the Institute, describing the initial process configuration, critical issues addressed, the first pilot intervention, the achieved results and following developments. Afterwards, we will also describe some other key projects in the clinical area, underlining how they are bound by a coherent strategy and a shared approach to technological and organizational evolution. 2 The importance of RFID technology in the healthcare sector A year-by-year increasing number of new projects reveals that the Italian healthcare sector is more and more interested in RFID technology 1. For all, the application of this technology is still at an experimental stage, thus counting to grow both in new pilot and executive systems. General benefits ascribed to RFID can be summarized as follows: Speed of data access and multiple item identification without need to have the tags on the line of sight; Safety of electronic matches, item identification and data transfer; Automation of some process activities and information flows; Chance to implement workflow management rules, bounding health workers to follow the implemented procedures; Remote item/people tracking and real time process monitoring. These issues usually lead to overall benefits on terms of process efficiency and effectiveness. The most important application areas in the healthcare sector are: Identification and geolocation of people or objects; Operations support; Logistics. As the School of Management of the Politecnico di Milano Technical University states (Osservatorio RFID, 2005; 2006; 2007), RFID technology reveals a potentially powerful means, as it can be used to ensure fast and unambiguous identification of patients and asset location within the hospital complex. Applications to people usually implement disposable passive tags embedded in the employees identification cards or patient wristbands, usually activated and assigned during hospital admission. Hospital staff can therefore use its cards to log in to the hospital information system, access restricted areas and digitally sign documents. Patient wristbands can be checked during the practitioner s visit or 1 For general information on RFID technology, see: for detailed information on RFID technology, see: Auto-ID Center, Massachusetts Institute of Technology, and The UK Institution of Engineering and Technology, European Journal of epractice 49

50 before undergoing a sampling or an operation (like dialysis, surgery, a transfusion and so on). The tag may store data ranging from the single pointer to a record in the hospital information system database, to a complete dataset about the patient (personal data, patient record identification number, blood type, allergies, ongoing therapy, etc). A second feature of RFID technology is the implementation of active tags in a WiFi environment: this enables a more effective patient location and real time monitoring of patient flows and of their progress in the care process (particularly in the diagnostic phase or in the First Aid station), thus also acquiring important data for process and layout optimization. As a matter of fact, RFID and geolocation tools are important means enabling new advanced applications and tools for coordinating wards, optimising operational costs and reducing patient waiting time. The same technology can be used also for asset location and management of maintenance operations: e.g. portable devices (defibrillators, monitors, pulmotors, etc), surgical instruments, surgical samples and valuable items at high risk of loss or theft. Similar remarks can be made about patient record identification: folders often don t follow the patient during his transfers through the wards and there are often problems related to documents retrieval. Also beds and perambulators are often scattered along the buildings: item tracing reduces wasted searching time and can lead to speedy intervention. Other systems, coming directly from operations support systems in the machinery sector, are for example: sample tagging for automatic processing in the laboratory, item tagging for blood bank or pharma cabinets control both in the replenishment and in the picking phase, systems for automated issue of medicine doses. A third high potential cluster regards applications implementing combined identification of people and items, thus enabling a patient-to-object crossmatch. These applications can be successfully implemented for example to control drug administration, in the operating theatre and in the transfusion area. Annual surveys of implementations in Italy issued by the Osservatorio RFID (2005; 2006; 2007) outline: a small but growing series of applications characterized by a reduced number of functionalities (compared to the potential range of achievable support) and a narrow process coverage, with low pervasiveness in process activities. In fact, although operations support is considered a quite well-established application area in the industry, in the Italian healthcare sector it is still at an experimental stage of development. This is quite peculiar, if we consider that the healthcare sector is mainly demanding quite complex functionalities, including sensoring, active tracking, high safety standards and multiple combined person-item crossmatches. In general, setting aside specific ambits, we can say RFID technology shows three stages of application, which are incremental steps on a scale about process reengineering: the higher the depth of the change brought out on activities, the higher the potential exploited and the organizational impact (see Table 1). An integrated and systemic approach to technological and organizational evolution like the Business Process Reengineering Framework B.P.R. (Davenport,1993; Ernst & Young, 1997) is essential to fully realize this potential, because it helps to identify all possible areas of impact on processes and on the organization, so to enable an all-round process and management following a new viewpoint. Time Frame Area of intervention Examples of applications Target Range of action Now Intervention on support processes: near existing technologies Patient identification EPR access Ward safety Access control Enhancement in current activities, with low organizational impact Narrow Tomorrow Intervention on single core processes ( stand alone solution) Error reduction (patient/drug/meals/etc) Blood bags tracking Internal logistics (e.g. drugs) Patient monitoring Efficiency / Effectiveness / Safety of single process BPR project on a single process European Journal of epractice 50

51 Future Whole organization Clinical process control and workflow management Extensive tracking in logistics Safety systems More effective management control Overall efficiency and effectiveness Extended BPR project covering the whole organization Table 1: Current and future opportunities for RFID implementations in the Italian healthcare sector. 3 Integrated RFID strategy at the National Cancer Institute in Milan Founded in 1925, the Fondazione IRCCS Istituto Nazionale dei Tumori is recognised as a Scientific Research and Treatment Institution (IRCCS) and was recently awarded Foundation status. This means the organization has achieved excellence nationally and internationally in the field of pre-clinical and clinical oncology. More than 350 research projects are currently under way, many of these being undertaken with the most prestigious international institutions, in addition to various collaborative projects with universities and health organizations. About 2,200 patients pass through the Istituto every day; there are approximately 14,000 ordinary admissions (39% relating to patients from outside Lombardy) and about 12,000 Day Hospital admissions. There is an annual average of 900,000 outpatient treatments and more than 15,000 surgical treatments (including 28 liver transplants). The number of accredited beds is 418. The Foundation s researchers publish about 300 scientific papers each year, mostly in international scientific journals. The Foundation also manages the Lombardy Cancer Network (ROL). The Istituto can be considered a forerunner in the usage of RFID in the European hospital sector, as it is moving towards RFID technology in many clinical areas, aiming at implementing a series of applications than can be considered quite advanced in the framework described before. As a matter of fact, these activities are an integral part of the CIO s strategy, which focuses on the development of a common infrastructure to enable the spread of IT tools to support core clinical processes in the Institute. The guidelines are, for example: adoption of a coherent and integrated approach to technological and organizational evolution, implementation of a wireless LAN, use of standard programming frameworks and to spread ergonomic devices (like PDA) in the wards.. Focusing on RFID technology, current key projects address: a) General patient identification, b) Safety and traceability of blood transfusions, c) Tissue bank operations, d) Management of surgical instruments. 4 Safe transfusions and total blood traceability in the ward thanks to RFID technology 4.1 Transfusion safety It has been recognized that blood transfusion errors remain under-reported, owing to a lack of awareness about transfusion-related adverse events among hospital staff and inadequate feedback system in most of the transfusion centres (Sharma et al., 2001). In spite of this, the medical community acknowledges that the main risk of transfusion adverse events is mainly process-related rather then European Journal of epractice 51

52 infectious. As stated by the scientific community, infective risk related to transfusion is sinking more and more as a result of ever increasing past expenditure on blood safety, while less attention has been paid to improving the safety of the transfusion chain within hospitals (Murphy et al., 2001; Bush, 2003; Murphy et al., 2004; Stainsby, 2005). Based on reports issued by the authoritative Serious Hazards of Transfusion (SHOT-UK Scheme) between 1996 and 2003, the risk of an error occurring during transfusion of a blood component is estimated 1:16.500, an ABO incompatible transfusion at 1: and the risk as a result of an incorrect blood component transfused (ICBT) is around 1: (Stainsby et al., 2004). The chart in Figure 1 shows the distribution of adverse events related to transfusion as reported from Shot-UK Scheme in There is a number of critical stages in the transfusion chain, starting with the decision to transfuse, prescription and request, patient sampling, pre-transfusion testing and finally the collection of the component from the blood refrigerator and administration to the patient, consistently the most common error in successive SHOT reports. Figure 1: Adverse events related to transfusion as reported from Shot-UK Scheme in (Source: The Serious Hazards of Transfusion Steering Group, Background and original process configuration The Institute s Transfusion Centre (SIMT) belongs to the Department of Experimental Oncology and provides blood bags and other services to all other wards. The staff dealing with the transfusion process consists of six laboratory technicians and six biologists/physicians. Each transfusion uses a bag containing the blood component required by a specific patient, and is prepared according to a precise procedure. A label is affixed to the bag, showing all the necessary information, and then the laboratory technician does a final check and consigns it to an operator who takes it to the destination ward. On arrival, a physician supervises the transfusion, as it is carried out by a qualified nurse, and records on the patient s notes the transfusion. The basic architecture consists of three information systems: the analytical laboratory (DN-Lab), the central clinical and health system (legacy), and the application which controls all the regional transfusion organizations (EmoNet). However, the three systems do not operate in an integrated way. There is also a lack of detailed reporting on the final part of the process: for example the Transfusion Centre has no information about the status of the units delivered (if transfused, if stored in the ward, if wrongly issued and so on). Figure 2 shows a diagram of the transfusion process in the TMO ward of the Istituto and indicates the main critical points emerged during the process analysis. These critical points can be summarized in three key topics: European Journal of epractice 52

53 - Lacks in process controlling capability due to poor information record and communication within actors belonging to different departments; - Absence of fast, safe and unambiguous identification system for patients, sample tubes and blood bags; - Paperwork and manual activities scarcely supported by existing IT systems. Thus, the Istituto had a need for greater efficiency in the management of the transfusion process, as it had no information system for the detailed monitoring and control of the process. The doctors in the transfusion service did not have instant access to all the necessary information and for some procedures operators only have access to hard-copy aids. The answer to the problems was the development of a monitoring and control system for the procedure, all the way from the selection of a bag to the completion of a transfusion, ensuring the traceability of the transfusion process. Figure 2: The transfusion process with critical points in highlight 4.3 The pilot project From October 2005 to December 2006 the management of the Istituto set the objective of reengineering the transfusion processes, using Radio Frequency Identification (RFID) to provide traceability in the interests of safety and efficiency. So, a pilot project has been implemented in the Allogenic Bone Marrow Transplantation Unit (TMO), a ward belonging to the Department of Oncology since 2001, which represents one of the excellence Departments of the Istituto. This excellence is true also for the blood transfusion process: in fact the compliance with recommended guidelines enables the ward to return only 2% of unused blood bags every year, against an average of the Istituto of 11%. The ward uses 9,1% of the total number of transfusion units (1.177 out of throughout the entire Istituto), but they account for 26% of total value of managed blood bags: i.e. the average value of blood European Journal of epractice 53

54 units they use is higher than the average of other departments; therefore the potential impact in terms of higher efficiency and effectiveness is deeper. The project team started by carrying out a major analytical operation based on interviews with users in various departments and tracing flows, after which an ad hoc solution was outlined with the aid of the partners Fondazione Politecnico di Milano and HP. Testing started soon after. The application using RFID technology allows the interaction of two existing compartmentalised systems and supports operators involved in the transfusion process. Working with the Fondazione Politecnico and the Istituto s ICT staff, the HP engineers have identified the most suitable materials (wristbands, tags, labels, printers), aiming to achieve technological integration and develop an interface as simple and intuitive as possible. When patients are admitted, their names are checked against the data in the registers of the central information system by using handheld terminals, fitted with RFID antennae. The nurse then gives the patient a wristband and initialises the bedside tag, so that the patient can be safely identified (no batch tagging procedure is allowed to avoid swaps of patients). Physicians and operators then use PDAs to transmit and acquire information, by means of RFID labels affixed to each bag by the Transfusion Centre as it is assigned. The nurses receiving each bag use their PDAs to record the time of arrival and read the patient s wristband to match the data, thus ensuring that the correct transfusion bag has been received. The transfusion operator also uses the PDA to identify himself by means of a badge, and then continues with the procedure, recording both the starting time and the finishing time of the process, also having the opportunity to enter a set of other clinical notes relating to the event. The new RFID system makes transfusions absolutely safe: if there is a conflict between the data read from the specimen or from the bag and the patient s wristband, the system immediately issues a visual and acoustic alarm and halts the application (thus covering two phases which are proven to be the most common source of error). Finally, when the patient is discharged, the staff is responsible for deleting information embedded in the disposed wristbands. The developed system consists of four main elements, as represented in Figure 3: a) The transfusion management application running on PDAs; b) The newly developed application, which allows the staff to perform all operations described above (patient check-in, patient identification, self-identification, blood bag identification, bedside crossmatch) supporting critical steps of the transfusion procedure; c) TMO ward client application to download to the PDA the admitted patient s data and to download from the PDA the data on performed transfusions; d) Transfusion Center client integrated with EmoNet system for seamless print of standard and RFID labels simultaneously on the two printers; e) HTTP daemon filling the XML interchange file on the ward client and managing EmoNet s database seamless alignment via the internal communication network. European Journal of epractice 54

55 Figure 3: Schema of the system issued to INT in its pilot configuration Thanks to this architecture, staff in the Transfusion Centre is now able to receive electronically information from the ward about the transfusions performed and to monitor the status of delivered blood bags. While the staff badge contains only a personal identification number and the operator s name, tags affixed to patient s wristbands and to blood bags store more important information. The first contain the health record number, the patient s name and birth date, his blood group and phenotype. This data is used to crossmatch the blood bag to be transfused, with a tag including: the unique bag identification code, type of blood component, blood group and phenotype, recipient s name and birth date. The transfusion management application tracks each event regarding the use of the PDAs and stores on the device the data read from the tags and manual data entries performed by staff (near-miss events, messages from the physicians or nurses, reasons for misuse..). This information is subsequently forwarded to the ward application in order to generate the interchange file for the alignment of the Emonet system. This means that, while at first the Transfusion Centre had no feedback about the status of the delivered units, now a continuous information flow has been established starting from the patients beds, feeding the transfusion information system with reliable and timely data. In accordance with best practices in management theory, the project team has established a complete KPI (Key Performance Indicators) panel for process monitoring and evaluation. The schema in Figure 4 shows the map used to evaluate returns of the project, grouped in material and immaterial benefits. It is important to underline that, being a case of a pilot study, it has little meaning searching for margins and efficiency returns, goals that will be surely achieved in the next development phases. The partner s skills and the highly cooperative attitude of physicians and nurses were important factors in the achievement of outstanding results in the provision of a service, as stated by the KPI process monitoring panel audit. In brief, business benefits can be summarized as follows: European Journal of epractice 55

56 - Total traceability of the transfusion process; - Rationalisation and improved efficiency of the transfusion process; - Improved safety of patients and medical staff involved in the transfusion process; - Non-invasive technology for patients, with increased and improved capacity for intervention where patients are unable to interact with the medical staff; - Enhanced process awareness by staff; - Cost reduction by enabling blood bag monitoring and better control on blood consumption in the ward; - Enhanced capability of process monitoring and controlling, through a continuous flow of information between the departments involved. Figure 4: Key performance indicators map. Highlighted (in dark frames) the benefits achieved (Adapted from: Osservatorio RFID, 2006) Back to the themes of safety and quality assurance, team members have performed a high-level analysis to estimate the impact of the new application in terms of risk management, based on the guidelines of the Health care Failure Mode and Effect Analysis (DeRosier et al, 2002; Trucco, 2000). Being a pilot project, this assessment regarded an overall investigation of potential sources of errors in the original process configuration (to be addressed by specific features in the application to be developed) as well as in the reengineered process, to evaluate the effectiveness of the intervention and possible critical points connected to the new solution. During the system roll-out, some team resources were dedicated to safeguard ward operations, solving contingent problems and also revising readily some functionalities to meet clinical needs. An extensive risk analysis will be performed in subsequent project steps described in the next paragraph. European Journal of epractice 56

57 Thanks to the RFID solution, the Istituto has been able to introduce a further safety mechanism in the transfusion procedure: the reliable identification and crossmatch between patients and blood bags, enabling process control as well as the identification of potential weak links in the service chain. This is particularly true if we consider that the developed application implements a workflow management engine to guide operators through the different steps of the transfusion procedure in form of a wizard. Thus so-called coverage errors as well as invalid data entries can be effectively avoided. Furthermore, using wristbands, nurses and physicians can achieve a fast and unique identification at any time, regardless of the patient s condition, allowing them to intervene with treatment at the correct time. With the RFID system, the staff now operates in a highly integrated and advanced IT environment, providing better management of the transfusion process, based on a high degree of control of the process itself and the facilitation of employees work. The results of the pilot project have been surprising also in terms of feedbacks received by staff: managers are well impressed about the quality and quantity of information, which makes the processes efficient and well supervised, guaranteeing a high quality of service to patients. Also medical staff and nurses feel quite comfortable with the system and claim for its availability: the ward head nurse is a very proactive advocate of innovative ICT solutions and acts as a focal point for the ICT department. The System Usage Rate is a particularly meaningful indicator among those recorded: it indicates in form of percentage the number of RFID transfusions compared to the number of total transfusions carried out in the ward. As shown in Figure 5, from the beginning of the test phase, a continuous improvement of the usage rate has been registered. Mean usage rate in September October November 2006 is 83% but from the fourth month of testing the mean usage rate has shown above 90%. If we purify these data from incidental events occurred during testing phase (system unavailable, patients transferred to detached ward areas and so on) the mean usage rate indicator points to 98,4%. 100% 80% 64,3% 84,1% 74,6% 93,3% 90,0% 60% 40% 20% Mean usage rate - 83% 0% jul aug sept oct nov 2006 Figure 5: Overall system usage rate indicator (data referring to Sept-Oct-Nov 2006 trials). As Figure 6 shows, high system usage rate was experienced in both wards (TMO and Transfusion Centre). This points out to: - A user-friendly application, - A well engineered interface easy to use and with step-by-step operational guide, - A successful medical staff training, European Journal of epractice 57

58 - An effective project team support to medical staff, - Proactive staff attitude. % on delivered blood bags 98,4% 98% 99,6% OVERALL SIMT TMO Figure 6: System usage rate experienced in the two wards (data referring to Sept-Oct-Nov 2006 trials) Estimates were made to better represent the results in terms of informative feedback to Administrative staff and Transfusion Center: in one of these we see a projection of the performance achieved with the help of the new transfusion application in the TMO ward on overall Istituto s transfusion volumes in September, October and November The aim is to see on how many units the Istituto would have received an informative feedback (and so how many units the Istituto would have under control) if the application was extended to all departments. Data refer: - To units delivered by Transfusion Centre in September, October and November 2006 (2.405 units delivered); - To the estimated return rate of non-transfused units registered in TMO ward in the test period (13,2%); - To the system usage rate registered in TMO unit (98,4%); - To excellence quality standards followed by TMO Unit staff. Figure 7 shows an abstract of this analysis results: on units delivered (estimated value: over ), the Istituto would have been able to have an informative feedback (and thus keeping under control) on units (98,4%). The Istituto would actually have become no informative feedback on 1,4 % of the sent units, this caused by incidental events or non-use of the systems by nurses as it happened in the TMO ward. It is important to notice that the value of this little 34 units is over 6.700! In conclusion, the project enabled to achieve two aims: safety for patients and detailed information for doctors and operators in a context of advanced knowledge management. Figure 7: Pilot s results projection on overall Istituto s activities (data referring to September October November 2006 Istituto transfusion activities) European Journal of epractice 58

59 4.4 The new project for extended transfusion traceability The excellent results from the pilot project culminated in the IDC EMEA 2007 Award for ICT Innovation and in a selection in a European Call For Ideas for official presentation at the RFID Conference & Exhibition "Towards a European Policy on RFID" in Lisbon promoted in November 2007 by the Portuguese EU Presidency. This project has also been invited in 2007 for presentation both at the ID World International Congress 2007 in Milan (an annual event about RFID, biometrics and smart card technologies) and at the Risk Management in Healthcare Forum of Arezzo (an annual event organized by the Italian Ministry of Health, the National Institute of Health and Gutenberg, in partnership with Regione Toscana). Thus, the Istituto will receive a new round of funding from the Regional Government of Lombardy for a 2-year initiative to extend the solution to the entire cycle of transfusion and to collaborate with other hospitals in Milan (like, for example, the Niguarda Hospital 2 ), which the regional government is pushing to adopt the same model. As a matter of fact, the new phase of the project will aim at (see Figure 8): Mapping transfusion processes in all involved Institutions and developing a high-level parametrical application model of high significance, that can be customized through parametrization; Reengineering the RFID pilot application, including new functions (like tracing of blood sample tubes in order to close the entire loop of transfusion), improving system integration with the laboratory application (DN-Lab) and the regional blood bank network information system (EmoNet), implementing a WiFi network to enable real-time synchronization of data between servers and handheld devices; Validate the achieved results extending the reengineered RFID system to the entire Transfusion Department of the Istituto (i.e. to apply tags to all 13,000 blood bags dispatched every year) and also to selected wards of other partner hospitals in the Region; Extend the RFID platform infrastructure to other processes using the same approach (see next paragraph for some examples on new projects which are already started); Extensive evaluation of the impact of project activities in terms of Clinical Risk Management, deepening the preliminary analysis performed during the pilot project. This will be done using an extended version of the Health care Failure Mode and Effect Analysis the HFMEA model (DeRosier et al, 2002; Trucco, 2000). The HFMEA model allows toquantify the risk profile associated to the analyzed process, identifying and valuing the possible criticalities and failure modes that feature it, considering both clinical issues and technology-related risks. In fact, this innovative model allows to make comparisons between different configurations of the activity flows or with any comparable process, considering quantitatively at the same time also the probable efficacy of the risk barriers introduced by the employment of ICT systems and the risk introduced when implementing such technologies. A further project has been submitted to the Italian Ministry of Health for further funding aiming at: Addressing critical issues related to the use of RFID/WiFi systems in critical environments (like e.g. intensive care units, the operatory theatre, outpatients and domiciliary care); 2 The Ospedale Maggiore Niguarda Ca Granda is the leading public hospital in Milan since It is national reference hospital for emergency events and the only regional point of care qualified to perform any kind of tissue and organ transplant. The Hospital has doctors and 740 nurses, yearly admissions (both ordinary and Day Hospital) and 3 millions First Aid Station treatments. European Journal of epractice 59

60 Developing and implementing a tool for supporting new regulations on transfusion traceability and haemovigilance (see Italian Legislative decree 09/11/2007 n.207, actuating EEC Directive 2005/61/CE and 2002/98/CE), thus experimenting a new instrument for adverse events reporting based on digitalization of clinical documentation related to transfusions (transfusion request, LIS (Laboratory Information System) report on sample analysis, haemovigilance forms,..); implementing also digital signature (CRS-SISS regional system) for transfusion validation. Legenda: Data entry: manual data entry Info: information not being recorded, or stored locally without forwarding to other actor ID: univocal and safe item identification problem Process: process improvement potential to be exploited Figure 8: Diagram of the transfusion process being reengineered, with planned actions and critical issues being solved. European Journal of epractice 60

61 5 The Tissue Bank project: active monitoring through RFID A biobank is a collection of biologic specimens stored for later analysis under conditions which permit efficient retrieval and optimal stability of the sample. Its main goals are to store and process samples collected from ongoing studies in a way that maximizes the amount of information obtained from each sample, makes possible future analysis for currently unknown biomarkers and minimizes research costs for future studies. Department of Experimental Oncology and Laboratories collaborates with the Department of Pathology in the Tissue Bank of Istituto Nazionale Tumori, a project of the Scientific Direction dedicated to the collection and distribution of samples of neoplastic, preneoplastic and normal tissues from human subjects. The Tissue Bank stores the specimens coming from the Department of Pathology and makes them available for the research projects active in the Istituto. Since the quality of research outcome strongly depends on specimen quality, it is of primary relevance to trace and monitor the path from patient sampling in the operating theatre to deep-freeze storage in the biobank, where cells ischemia due to devascularisation is stopped. At the present time quality control over the process is hard to perform, because many activities need IT support and organizational enhancements, for example to monitor process lead time, to enable information exchange between the involved departments, to significantly reduce paperwork and related current communication problems. Some critical issue are: the absence of a process owner and process orientation of the involved resources; the absence of integration between the surgery legacy IT system, the Department of Pathology system and tissue bank repository; the lack of a unique accessible digital repository supporting efficient biobank operations and research activities. Answering these and other needs, the new project on RFID technology focuses on: The exact identification of specimen, Tracing the process and transport lead times, Monitoring the specimen condition by tracing via active/semiactive sensors environmental conditions, Implementing reviewed high quality standards for processing and storing biobank samples, also investing on new hardware; Constituting a single data base where to collect all the relevant information to support diagnosis and scientific research. Project activities started in fall 2007 and will end in Tracking surgical instruments in the operating theatre The management of surgical instruments is a major problem for most healthcare facilities. In addition to the loss issue (ranging from simply lost or misplaced instruments to outright theft), there has been a need to track both the instruments themselves and the entire process associated with them, aiming at optimizing instrument inventory and utilization and patient safety. The surgical instrument cycle includes procurement, assembly, packaging, sterilization, storage, distribution, utilization in the surgical suite and other clinical settings, and the decontamination process. Most of the systems available today have the ability to track instrument sets throughout the entire processing cycle including the sterilization cycle, a particularly critical issue in the healthcare environment. The Istituto Nazionale Tumori is now evaluating the extension of the RFID platform to this core process, starting with internal management of surgical kits and single item checks before and after surgical operations. The current system is based on barcode and manual handwritten labels used only to report European Journal of epractice 61

62 kit-patient assignments on the patient record when they are used during surgery. No other support is provided to the staff to check items such as missing or damaged instruments before starting surgery, to monitor the presence of instruments left in the room from previous operations, to support counting of all items before and after a surgery and so on. Thanks to the tag's memory, important data could be stored in the instrument and could be modified or updated according to the evolution of the instrument's journey, for example: part number; GS1, HIBC or proprietary code; last maintenance or repair date; last sterilization date and so on. Each instrument becomes a unique part, thanks to its codification and the reliability and longevity of tags. In this field, RFID technology offers many advantages: flexibility and fast reading, reliable and durable identification of instruments, instrument identification possible even through packaging, identification of medical assets even if the tag is wet or dirty (blood, liquid,...), facilitated follow up of instrument maintenance or repair. 7 Conclusions Potential benefits of RFID technology in the healthcare sector are well known especially in terms of safety and efficiency on day-by-day operations (e.g. internal logistics, transfusion process, etc). Nevertheless, to exploit this potential an integrated and systemic approach to technological and organizational evolution is essential, as always in case of process innovation connected to Information and Communication Technology. The Istituto Nazionale dei Tumori in Milan can be considered a forerunner in the usage of RFID in the European hospital sector, as it is moving towards RFID technology in many clinical areas, aiming at implementing a series of applications than can be considered quite advanced in the framework described. Focusing on RFID technology, current key projects address: 1. General patient identification, 2. Safety and traceability of blood transfusions, 3. Tissue bank operations, 4. Management of surgical instruments. Measurable and sustainable results, thanks to the innovative formula of the projects, are: 1. The need to reconcile a high degree of safety with a technology that is non-invasive neither for patients nor for staff, and which is also easy to deal with, because it will be used by all the personnel involved; 2. To support the information flow all over processes, creating a link between applications which were completely non communicating and enabling process control; 3. The change management activities and the user-friendliness of the applications succeed in rising great user interest and high usage rates; 4. The initial experimental use of RFID technology with a primary focus on traceability, process safety, compliance with procedures and immaterial benefits will now be deepened with actions targeted at other key elements like efficiency and cost performance improvement; 5. The use in the Italian Healthcare sector of new technology focusing on the enabling role of Information Technology on process governance instead on the diagnostic aspects of technology (machinery); 6. The challenge of developing a comprehensive application standard model for process management and operations running, which can be diffused at a regional scale; European Journal of epractice 62

63 7. The developed common RFID platform is an integral part of the existing IT application portfolio, thus integrated. References Bush (2003). Current and emerging infectious risks of blood transfusion. Journal of the American Medical Association, 289 (8), Davenport, T.H. (1993). Process Innovation. Reengineering Work through Information Technology. Boston: Harvard Business School Press. DeRosier, J. et Stalhandske, E. et Bagian, J. et Nudell, T. (2002) Using Health care Failure Mode and Effect Analysis. Journal on Quality Improvement, May Ernst & Young Consultants (1997). Innovazione dei processi. Riprogettare il lavoro attraverso l Information Technology. Milano: Franco Angeli. Murphy, M.F. et Kay, J.D.S. (2004). Patient identification: problems and potential solutions. Vox Sanguinis, 87(Suppl.2), S197-S202. Murphy, M.F et Staves, J. (2001). Improving the safety of blood transfusion by re-engineering the hospital transfusion process with patient ID systems (John Radcliffe Hospital of Oxford), retrieved July 2006 from Osservatorio RFID - School of Management of the Politecnico di Milano (2005). RFID tra presente e futuro, I risultati 2005 dell Osservatorio RFID. Milano: Politecnico di Milano, Dipartimento di Ingegneria Gestionale, retrieved January 15, 2008 from Osservatorio RFID - School of Management of the Politecnico di Milano, (2006). RFID alla prova dei fatti, I risultati 2006 dell Osservatorio RFID. Milano: Politecnico di Milano, Dipartimento di Ingegneria Gestionale, retrieved January 15, 2008 from Osservatorio RFID - School of Management of the Politecnico di Milano (2007). RFID alla ricerca del valore, I risultati 2007 dell Osservatorio RFID. Milano: Politecnico di Milano, Dipartimento di Ingegneria Gestionale, retrieved January 15, 2008 from Reason, J. (2000). Human errors: models and management. Cambridge: Cambridge University Press. Sharma, R.R. et Kumar, S. et Agnihotri, S.K. (2001). Source of preventable errors related to transfusion. Vox Sanguinis, 81, Stainsby, D. et Russell, J. et Cohen, H. et Lilleyman, J. (2005). Reducing adverse events in blood transfusion. British journal of Haematology, 131, Stainsby, D. et Williamson, L. (2004). Six Years of shot reporting - its influence on UK blood safety , Transfusion and Apheresis Science, 31, The Serious Hazards of Transfusion Steering Group (2005), Annual report Serious hazards of transfusion scheme, Manchester: Royal College of Pathologists, retrieved (retrieved January 15, 2008 from Trucco, P. (2004). Strumenti per l analisi ed il miglioramento della sicurezza del paziente nei processi di cura. Indagine sperimentale sugli effetti in termini di qualità e riduzione dei costi sanitari. Rapporto finale della ricerca. Cod. IReR 2004B037. Regione Lombardia: IReR Regione Lombardia. European Journal of epractice 63

64 Authors Elena Sini CIO Fondazione IRCCS Istituto Nazionale dei Tumori (Italian National Cancer Institute) Paolo Locatelli Project manager Fondazione Politecnico di Milano Nicola Restifo Junior Analyst in support to the Area Manager Fondazione Politecnico di Milano European Journal of epractice 64

65 Surfing, creating and networking: Tampere City Library drives into the Information Society In Tampere (Finland), Information Society for all has been a strategic goal since the beginning of New ways to approach the matter have been applied, and the Tampere City Library has been an active member in these tasks with the implementation of the Internet bus Netti-Nysse, which is described in detail in this paper as well as the challenges ahead to prevent the digital divide and the role that libraries can have in preventing them. In a modern information society like Finland we know that the access to Internet is not enough; the everyday Information Society is about learning, culture, community and meaning. It is about support and interpreters. It is about equal opportunity and constant public commitment. The key issues for the success of the Internet bus have been a good atmosphere and image, pedagogical solutions, focus on everyday life, networking and commitment of the city. At the Tampere City Library we are hoping to be interpreters of the information society and to encourage adults to find new ways to express, share and understand through hands-on media education. This paper is based on six years of experience working with the Tampere City Library Internet bus, a half year scholarship and work with Community Informatics at the Graduate School of Library and Information Science at University of Illinois at Urbana-Champaign and the ideas that professor Jan van Dijk presented in his book The Deepening Divide. Keywords Elina Harju Tampere City Library - Pirkanmaa Regional Library Information society for all, Internet bus, basic skills, digital divide, public library, everyday life, pedagogical solutions Finding partners from the private sector is an important part of the work. A dialogue between the Netti-Nysse and businesses in the fields of education and ICT is essential. European Journal of epractice 65

66 1 Background learning locals 1.1 City Of Tampere The third biggest city in Finland, Tampere has a strong industrial background, which has more and more turned towards high technology and innovative research activities. We have 200,000 inhabitants, 30,000 students and many ICT companies, with Nokia as the biggest employer. The City of Tampere has committed itself to the development of the information society at the highest level. The city strategy is based on the idea of a citizens' information society. Empowering citizen participation is another important strategic aim. A large etampere programme took place between ( to speed up the development. That programme was also the start of new library services like the Internet bus and NetSquares. 1.2 Library and Information Society Tampere City Library consists of the main library house and a newspaper reading room, 14 branches, two mobile libraries and the web bus Netti-Nysse. In 2006 the number of loans per inhabitant in Tampere was 25 and the PIKI network library was visited 4 million times. PIKI is the regional, computerized library system. The system serves 21 municipalities, covering 90% of the population of the Tampere region. In addition to their traditional work, libraries have an important role as the centre of a citizens information society. One of the major tasks of libraries is to ensure the availability of information network services to all population groups. All libraries in Tampere and the new mobile library offer access to information networks. There are two Net Squares and an Internet bus with permanent staff. The Net Squares have about 20 computers each. Net Squares are places in two branch libraries where people can use computers free of charge. The service is supported by special staff. A total of 123 free Internet access points are available for library users in both fixed and mobile library facilities. Finns have a positive attitude towards technology, and the first Internet access stations came to Tampere libraries in According to a survey done in 2006 in Tampere, 86% of the inhabitants use the Internet, and in al Finland the rate is 77%. (Kuutoskaupunkien 2006) Considering this background, it is relatively easy to jump at the new learning challenges that informacy - the literacy skills of the new digital era - presents. At the same time basic skills/knowledge levels are better/higher than before. New challenges are set to literacy. Interactivity, integration, selectivity and complexity are new demands that are not familiar from older media. People between 35 and 40 years old have not used computers in school. Computers and the Internet are still new tools. For tomorrow, basic Internet skills will no longer be enough. Jan van Dijk (2007: 6) says that (digital) divides are by-products of old inequalities, digital technology is intensifying inequalities, and new inequalities are appearing. The axiom Those who already have, will get more is very much true in the information society. European Journal of epractice 66

67 Figure 1 & 2. Sampola Net Square 2 Main ideas of Internet bus Netti-Nysse The new media and their new challenges need new approaches. The Internet bus Netti-Nysse is an example of a new, approachable, non-formal way to help people to learn and see the possibilities and then make their own choices concerning their role in the information society. The word Netti-Nysse is a very local Tampere-way to say Internet bus. The bright yellow bus is familiar to all and frightening to none. That is a good place to start. The purpose of the Internet bus is to lower the threshold of the information society by providing instructed access to information technology for all. 2.1 The Building of the Netti-Nysse I and II At first there was an idea which the City of Tampere believed in. The City consequently provided the project with an old, articulated, public transport bus in autumn Through cooperation with local vocational schools, the City s IT department, the library and some private businesses, the bus was transformed into the Netti-Nysse, Tampere city Library s Internet bus. The bus is owned and funded by the City of Tampere; private funding accounts for less than 10% of the total operating funds required. Technically, the first bus was an innovative combination of an old articulated bus, electricity and hi-tech ICT. The technical solutions and the concept proved to work in the hard weather conditions of Finland. The best Internet connection is through WLAN antennas. Ten of these antennas can be found around Tampere. If a point cannot be accessed, a connection can be made using mobile phones, the network or a mobile WLAN antenna. The bus is equipped with an auditorium and access points for 10 people. There are 12 computers on the bus all together. By the end of the etampere programme the first Netti-Nysse was getting old and it was not sure for how long it would be able to run. Therefore, the City of Tampere decided to build a brand new bus. The new Netti-Nysse started its service The old bus went to the media museum. The basic technical and operational ideas stayed the same, but applied into a brand new bus. European Journal of epractice 67

68 Figure 3&4. Netti-Nysse I (The Mother) and Netti-Nysse II (TheSon) Figure 5. The Auditorium of Netti-Nysse 2.2 Netti-Nysse The Heaviest and Yellowiest Mobile Service in the World? The purpose of the Internet bus is to encourage the residents of Tampere to start using computers and the Internet and to give them the initial instruction necessary to do so. Groups of neighbours, clubs, societies or any group of people who want to learn to use the computer and the Internet can book the Netti-Nysse and have it come to their own neighborhood. Basic instruction is 8 hours and the group meets four times. Instruction is free of charge. Netti-Nysse is on the road two shifts a day from morning until evening. A normal day consists of meetings with four groups, and the Netti-Nysse will meet them wherever a 15 metre bus is able to park. Flexibility is important and that is why four out of five trainers also drive the bus, so that meeting times are not necessarily dependent on the availability of the driver. If the nearest antenna is in a nearby neighbourhood, the bus picks up the group and drives closer to it. This is a mobile service, is it not? To get the connection we can use public networks, but also some private and mobile networks available. There are always two instructors with a group of 10 clients, as personal instruction is essential. Our tutors are a new kind of professional. A clear, understandable language and a spirit of encouragement and empowerment play an important role in the project. A good sense of humour and patience are the instructor s most important tools, because learning is different for everyone. For example, the mouse is a European Journal of epractice 68

69 new tool and a key to the world of the Internet; learning how to use it can be challenging in various ways and the instructor has to recognize those difficulties and adapt accordingly. When the mouse has been mastered or at least somewhat tamed, clients move on to the Internet. The Internet is like a treasure chest to those just discovering the computer. Everyone finds something interesting: the library s web services, information on those who lost their lives in the war, horoscopes, roadside cameras, lace-making instructions, timetables and Internet banking all awaken an itch for the Internet. is the icing on the cake; each participant learns how to open his own account. Frightening participants about the dangers of the Internet is not done, however a critical and cautious approach to the Internet is emphasized. The most important thing is not to get clients hooked on the Internet but to show them its possibilities. The Netti-Nysse does not take clients away from other adult education providers. On the contrary, participants are usually keener to continue on with another computer course after this encouraging introduction. The staff of Netti-Nysse has actively developed basic learning materials as well. Catch the Mouse is an online edutainment type of program to practice the use of the computer mouse. At the moment it is available in Finnish, Swedish, Spanish, French and Polish. In development are From the Cottage to the World, an Internet navigation learning tool, and Hands on, a keyboard learning tool. All the tools are situated in a Finnish cottage environment and a humorous tone has not been overlooked. Also the Computers for Help and Joy ABC leaflet was made by the staff of Netti-Nysse in cooperation with a plain-language specialist. All materials are free for anyone to use. Computers for Help and Joy II encourages people to take the next step and to start using the computer as a tool to create digital stories, photos, online writing and so on. Netti-Nyse participates in different types of events, and functions as an Internet access point. During events, the Netti-Nysse and its staff try to lower the threshold to the information society by teaching visitors how to access EU materials, by enjoying media art, by setting up accounts with the electricity company or by helping potential students apply to educational institutions electronically. Many different types of citizens visit the bus. Figure 6. Catch The Mouse European Journal of epractice 69