Innovation in virtual worlds: System development and delivery of health care services in Second LifeRTM

Three dimensional virtual worlds (VWs), particularly Second LifeRTM (SL) as its most popular exemplar, have emerged as the next new platform for Internet content creation and simulated interactive immersive user activities. VWs provide new opportunities for online interactions as well as 3-D platforms for many current social and business activities done on the two-dimensional web. This early stage of VW technology and its assimilation provides a unique opportunity to investigate how systems are built and how delivery processes are developed in this emerging and novel technological environment. This environment also offers opportunities to explore the creative uses of this platform that have the potential of addressing a pressing issue of our time---healthcare access. This dissertation focuses on SL as the exemplar of VWs and takes advantage of exploring the above opportunities through three research essays.;The first essay investigates unique aspects of building systems and developing processes in VWs by utilizing a multiple case study approach. Information on 21 cases of systems built in SL was collected by visiting the organizations of these SL sites and by interviewing their leader/stakeholders. Using the grounded theory and case study approach, we analyzed the interview data to investigate the unique aspects of system development in VWs. The analysis led to proposing an alternative theory and approach to systems development---the theory of organic emergence of systems (TOES). To our knowledge, there is no published research about the process of creating systems in VWs and contrasting the differences between the development processes in VWs, specifically in SL, and that of traditional systems. As such, this essay makes a novel contribution to the theory of systems development as well as to the practice of system building in emerging environments.;The second essay investigates how this new platform can be creatively used to deliver medical services more effectively and to function as a viable supplement to traditional healthcare delivery systems. We built a medical facility in SL that can substantially increase access to medical services by taking advantage of the unique aspects of this platform and by developing a process for delivering medical services in a group setting. We examined the efficacy of this process by studying the facilitating and inhibiting factors that contribute to the acceptance of this SL-based medical delivery process. This examination was based on a conceptual model developed by extending the technology acceptance model and synthesizing it with the theoretical frameworks of social presence and telepresence and virtual teams. The findings of this study provided empirical support for the extended model. The research method used was controlled laboratory experiments, and the method of analysis was structured equation modeling. Our work contributes to theory in information systems and medical research as well as to practice.;In the third essay, we introduce real-world capabilities to VWs. In this study, we augmented the SL-based medical facility with the opportunity of using real visual capabilities (video) to increase the efficacy of the VW-based medical delivery process. The acceptability of this medical facility and its use was examined using a conceptual model based on the synthesis of theories of media naturalness theory, technology acceptance model, and presence. The research method in this essay was also a controlled lab experiment and the method of analysis is structured equation modeling. The results of this study indicate that augmented SL-based medical facility, by affording a higher degree of media naturalness, enhances the degree of social presence, telepresence, trust in the system, and the final outcome, that is, the expectation to use such a system. This essay makes a novel contribution to coming closer to natural communication in cyber space by synthesizing the virtual and real worlds.;The first essay uncovers the unique aspect of building systems and processes using emerging technologies and proposes the theory of organic emergence of systems. The synthesis of this theory with existing information system development (ISD) approaches allows us to recognize how technology maturity dictates the choice of the appropriate approach for system development. The second essay proposes a process of delivering medical services through VWs that could potentially increase medical access without forgoing the quality of service and physician-patient relationship. The success of using the proposed delivery process could have far-reaching implications by supplementing existing medical services to increase access and reduce cost. The essay also makes a number of theoretical contributions by introducing virtual group-medical-visit sessions as a novel concept of virtual groups and by extending the technology acceptance model to include the usability of such groups. The third essay's contributions are in proposing the augmentation of the virtual with the real world in order to increase the efficacy of the proposed process of providing medical services. (Abstract shortened by UMI.).