Cathrine E Tømte
email: cathrine.tomte@uia.no

First Author

Markus M Bugge
email: markus.bugge@tik.uio.no

Sabine Woll- Scheid
email: sabine.wollscheid@nifu.no

Third Author

Frida F Vennerød-Diesen

Fourth Author

Ready to go? Schools' preparedness for teaching and learning within a one-to-one program

Keywords: 1 laptop initiative, Implementation, Innovation, School, Teachers

During the years there has been an increasing number of one-to-one programs around the world. In such programs all students are equipped with portable devices, such as laptops, tablets, smartphones and the like for learning purposes. Even if these initiatives are increasing, our knowledge of the impact of such a digital transformation of education are still little studied.

Based on data from a three years longitudinal study on a large-scale implementation of Chromebooks in a municipality, this paper highlights teachers' experiences. Key findings suggest that this initiative has been successful when it comes to the administrative and technical implementation of the Chromebooks, but there is still a way to go to transform pedagogical practices to enhance student-active learning supported by the Chromebooks.

Introduction: Implementation of one-to-one programs

Since the 'one laptop per child-initiative', which originated from the U.S more than 10 years ago, there have been an increasing number of one-to-one programs around the world. Some have been quite successful, while others have failed, and there have been various reasons for the success and the opposite [START_REF] Islam | An international literature review of 1:1 computing in schools[END_REF]; Zheng, Warschauer, Lin & Chang, 2016). In one-to-one (1:1) programs, all students are equipped with portable devices, such as laptops, tablets, smartphones and the like for learning purposes [START_REF] Balankasat | Overview and analysis of 1:1 learning initiatives in Europe[END_REF]. Previous studies on 1:1 implementation suggests various efforts in order to succeed. For example, to ensure that changes are 'systemic and underpinned by pedagogical values' (ibid, pp. 7). Moreover, over the years, teachers' beliefs and views regarding the use of technology in classrooms have been studied by quantitative approaches ( Findings suggest that one-to-one initiatives enhance student-centered teaching and learning [START_REF] Hershkovitz | Borders of change: A holostic exploration of teaching in one-to one computing programs[END_REF][START_REF] Lindqvist Håkansson | Gaining and Sustaining TEL in a 1:1 Laptop Initiative: Possibilities and Challenges for Teachers and Students[END_REF].

Even if 1:1 initiative in schools are increasing, we still have limited knowledge of the impact of such a digital transformation of education. Research has been directed towards the infrastructure, such as types of hardware and software use, Wifi-coverage and the like, and the prevalence of the number of pupils who have received their own digital devices, in English has often been referred to as 1: 1 computing. or 1: 1 coverage. Research has also looked at what is called 1: 1 learning, that is teachers' pedagogical approaches and students learning in contexts where each student has their own digital device (Bocconi Panagiotis & Punie, 2013). In 2013, Bocconi and colleagues examined 29 1:1 programs in 19 countries in Europe to elucidate how such initiatives contribute to different types of innovation in education. One finding was that most of these efforts were primarily aimed at infrastructure, that is to equip schools with 1: 1 coverage and to some extent also to contribute with competence development for the school's teachers. In such studies, much of the attention was focused on getting students more motivated for learning and technically competent. We also find such studies in the Nordic countries (Gilje et al, 2018). Later studies have confirmed that 1:1 coverage enables adapted training (Cauhan, 2018). At the same time, some student groups may be more easily distracted from doing other things than learning [START_REF] Zheng | Learning in One-to-One Laptop Environments: A Meta-Analysis and Research Synthetis[END_REF]). Furthermore, 1: 1 coverage will enable what is often called student-active teaching and learning [START_REF] Genlott | Closing the gaps -Improving literacy and mathematics by ict-enhanced collaboration[END_REF]. This means that the student is placed at the center of his / her own learning and traditional instructor-driven teaching is given less space. Here, researchers disagree about what studentactive teaching and learning in practice entails and what role a teacher should have. Such discussions are often colored by researchers' different pedagogical positions. For example, researchers who are concerned with socio-cultural approaches to learning work are more likely concerned with how technology can contribute as an artefact in such interactions, while researchers with a behavioral approach will increasingly use technology as a resource for repetitions. [START_REF] Zheng | Learning in One-to-One Laptop Environments: A Meta-Analysis and Research Synthetis[END_REF][START_REF] Tømte | Digital laering i askerskolen. Midtveisrapport fra følgeforskning[END_REF]. Moreover, class leadership in technology-intensive classrooms requires different types of competence and skills than in classrooms where technology has less space [START_REF] Genlott | Closing the gaps -Improving literacy and mathematics by ict-enhanced collaboration[END_REF]. Researchers suggest that a holistic approach to change common to all schools in a municipality is important; it enables a larger network, and a shared understanding of the objectives of the change. In addition, it is easier to follow up for school owners, operating costs are kept under control by connecting user support to only one operating system and type of device. At the same time, the schools are different in technology maturity and professional digital competence and the initiatives can thus be experienced as demanding for some, but feasible for others (ibid). Several studies reveal an increased need for knowledge about governance, leadership and educational development work in schools with 1:

1 coverage (Islam & Grönlund, 2016; Genlott, Grönlund & Viborg, 2019).
Based on how these previous studies have addressed what it takes to succeed with the implementation of digital technology for teaching and learning in schools and studies on one-to-one initiatives, the present paper will look at the role of school leaders and teachers within the implementation of one-to-one Chromebooks in a municipality in Norway. The research questions addressed are:

• How were schools prepared towards the one-to-one Chromebook initiative?

• How did teachers' digital competence influence this process?

As technology changes in a fast pace, our study might serve as an updated contribution to the growing body of studies on one-to-one initiatives in schools. With few exceptions, most studies that address one-to-one initiatives do not include longitudinal data, as we do here. Hence, we will present and discuss the results of various stages the one-to-one implementation, including the attitudes, readiness and perspectives of school principals and teachers.

Our study might bring new insights into how one-to-one implementation as pedagogical development/ change are understood and interpreted in schools and in the municipality. For example, knowledge about teachers' perceptions on how to lead classes in technology rich environments, how the digital devices may enhance learning within various subjects and the like can contribute to further understanding of such implementations and be further used in similar initiatives. Moreover, the roles taken by, and the communication with teachers, school leaders and stakeholders from the municipality will be discussed from the perspective of innovations.

Theoretical framework

Rogers' Diffusion of innovation theory (2003) points to critical factors for success in implementing innovations. Such factors include the characteristics of the innovation, those who use the innovation, the communication channels the innovation is communicated through, the time perspective, and what Rogers calls the social system that surrounds those who use the innovation, such as where they live and where they work.

The theory has also gained ground in educational research, and especially in studies of the introduction of new technology. For example, Sahin (2012) studied teacher students' perspectives on the use of ICT in primary school, while Li and Huang (2012) studied implementation of game-based learning in primary school in light of Rogers' theory, and Akin (2016) reveals how school administration interpreted and used the authorities' ICT-based plans and strategies. Genlott, Grönlund and Viborg, explored Rogers' theory to shed light on how to introduce a new ICT-supported educational model in primary school. Through a survey of teachers who have taken a one-year course in the educational method WTL (Write to Learn), they highlighted three general implications: First, the method worked best when teachers use it as a reference point more than a set of standards. This way teachers would enable to use the method in the light of tailored training and student creativity, and to safeguard and further develop their own competence development. Second, Genlott and colleagues recommend establishing an extended social system involving more than one school. Larger school networks add more energy and allow for further dissemination and sharing of ideas and practices. Third, it is important to keep in mind that not everyone can be an innovator and therefore it is important to have a network large enough to handle discussions and knowledge about the new method / innovation. In order to ensure dissemination, it is crucial to involve those with previous experience in using the innova-tion, and those who are good communicators, that is, who are good at communicating the method and the usefulness of the innovation to colleagues. It is also important to allow time for change, while ensuring continuous growth in the network. Of course, the quality of the innovation is decisive, and preliminary studies on the quality of the innovation are often carried out before starting to spread / roll out. This again means that the school management also needs to be well updated on recent research in order to see the results of the innovation.

Research context

Our study, which was designed as a formative dialogue design study comprises a municipality which initialized a large project on enrollment of one-to-one digital devices for all students in the 24 schools (16 primary schools; 1.-7. grade, and 8 lower secondary schools; 8. -10. grade). The students were provided with Chromebooks.

The study run for three years and covered several aspects of the implementation process, such as teaching and learning with digital resources and devices, competence development, institutional learning, development of digital competence and the like.

The present paper address' some distinct topics within the overall study.

Research design, methods and data

The research questions for the present paper are illuminated by a case study design [START_REF] Yin | Case study research. Design and methods[END_REF]. By looking at two distinct schools (8 th -10 th grade) which were equally exposed to the implementation from the school owner side, we are to identify local adjustments and efforts made in order to meet this new situation. We selected schools with different profiles in terms of socio-economic background of students, and with different geographical location in the municipality. Nonetheless, both schools are equal in size in terms of number of students. We conducted classroom-observations in Mathematics and Norwegian and interviews with teachers in these selected subjects and the school leaders from both schools. Table 1. summarizes our data from the schools. In order to grasp how the actual school owner prepared schools, we attended joint meetings organized for school leaders and teachers for 8 th -10 th grade. In addition to observation, we conducted group interviews with participants from these meetings. Moreover, we attended meetings with the coordinator of the one-to-one initiative in the municipality. This gave us insights about the overall processes within the implementation process; such as mutual challenges across schools. From each meeting we produced a short memo including observations notes addressing scope of the meeting, our role as observants and key takeaways including how people were reacting and acting throughout the meeting. Meeting with school leaders across schools (4)

Meeting with school leaders across schools (1) 5

Meeting with coordinator from the municipality [START_REF] Krippendorf | Content Analysis. An Introduction to its Methodology[END_REF] Meeting with coordinator from the municipality [START_REF] Krippendorf | Content Analysis. An Introduction to its Methodology[END_REF] Meeting with coordinator from the municipality (10) 30 Annual gathering for teachers at all schools (1)

Annual gathering for teachers at all schools (1) 2

We analyzed the data by qualitative content analysis [START_REF] Krippendorf | Content Analysis. An Introduction to its Methodology[END_REF]. Notes from interviews, the observation notes from class and memos from meetings were read with different reading techniques, such as wide and narrow reading. Based on this reading we developed several categories and sub-categories emerging as relevant to this study's overall aims and scope. The first and second author of this paper organised these categories, and these were later discussed with the research team and a shared understanding and categories were developed.

Key findings and discussion

The following section presents findings that illuminate our two research questions. In addition to presenting sole findings, we also discuss how these findings might be interpreted within our theoretical scope.

How were schools prepared towards the one-to-one initiative?

A key message from the research literature is that institutional factors matters to succeed with the introduction of new technology in educational institutions. These include anchoring in management, adequate technological infrastructure and a holistic approach to 'get all teachers involved' [START_REF] Tondeur | Preparing pre-service teachers to integrate technology in education: A synthesis of qualitative evidence[END_REF]. These elements are in line with Rogers framing of the users of the innovation, the communication channels, the time perspective, and the social system. In addition, researchers recommend to give individuals or smaller teams responsibility for implementation locally at schools [START_REF] Genlott | Disseminating digital innovation in school -Leading second-order educational change[END_REF]. In the 1:1 program studied here, the implementation of Chromebooks followed a step-by-step process.

Lessons learned from the first years (2017-2018)

As referred to in the theoretical section, researchers recommend establish an extended social system involving more than one school [START_REF] Genlott | Disseminating digital innovation in school -Leading second-order educational change[END_REF]. Larger school networks allow for the spread and sharing of ideas and practices. It is also important to allow time for change, while ensuring continuous growth in the network. In the municipality, resource persons were appointed at each school in addition to a central coordinator of the initiative centrally in the municipality. It was the school management who designated who should be the resource persons at the school. These formed teams of about two to four persons from each school. Initially, the resource persons/team often constituted persons with technical competence more than educational/professional didactic competence, but this changed during the years, so that awareness was raised to include the latter type of competence.

Through interviews and school visits, we found that peer-to-peer learning among teachers took place both unstructured (i.e. as chats in front of the coffee machine) and structured (i.e. in dedicated meetings and seminars) at schools, and in various arenas, such as at their own school and through gatherings organised by the municipality, and to some extent over the web, via the municipality's resource page.

In addition to organizing resource teams and project management for the initiative, the municipality also involved a national agency as knowledge provider. Employees from this agency were present in the initial joint gatherings for resource teams from the schools. Even if teachers reported to appreciate the contributions from representatives of this agency, the topics addressed were most likely to be generic (i.e. cyber ethics and copyright issues), or more technical oriented (i.e. how to share documents in google or shortcuts on the keyboard), and less linked to distinct subjects. This led to that some teachers reported to learn little, since the contents were too basic, while others experienced that the technical focus became too advanced. Moreover, some teachers expressed that due to the generic nature of these topics, they found it less relevant to their actual subjects and /or grades that they taught.

During the first one and a half years of the implementation, an overall impression was thus that despite the initial enthusiasm and positive attitude towards the initiative among most teachers and school leaders, many felt somewhat overwhelmed by the scope of the initiative, both technically and educationally. Several expressed that the implementation went too fast and that they did not have enough time to become acquainted with the potential of the Chromebook, whether technical or educational. This was also confirmed in that the schedule of the joint competence development program for all schools organized by the municipality became delayed. The municipality's aim was to implement two out of five modules during the first spring of implementation (2017), but as the process was delayed, the second module was launched half a year later. In the interviews, one of the resource teachers framed the situation as follows: "I am the captain on a boat floating on a tidal wave, it goes very fast!". Apparently, many principals and teachers experienced that they were given too little time to get used to the technical dimensions associated with the internal logic of the CB itself before they felt comfortable applying it in educational contexts. Interviews with teachers revealed for example that some were uncertain about how the Google versions of word processing tools and spreadsheets worked, and how other cheating and plagiarism functions worked.

Lessons learned from the last years (2018-2019)

During the last years of implementation, we observed that the organization of resource teams and local experience-sharing along with peer-to-peer learning among teachers had spread out and dominated the competence development practices at the schools. Technical and administrative issues linked to the use of the Chromebooks were less apparent, and a renewed attention towards the pedagogical integration of the Chromebook into the subjects were observed in the classrooms. One principal explains how competence development now had become systematically approached at her school:

We have started with joint meetings with all teachers in where teachers who have done something new in terms of technology, i.e. the software, or done something innovative pedagogically with the help of the Chromebook can present their efforts and experiences in a 5-10 minutes time slot.

At several schools, we observed that teachers tested out various opportunities in the Chromebook as part of getting to know it and considered what opportunities it provided for student-active teaching and learning in the classroom. A teacher explains how she worked with video recordings with colleagues before trying them out with students:

We teachers try out how to make video records linked to the topics and subjects we teach. It is very nice that we have tried it out ourselves before we throw the students into it.

We also observed the efforts in pedagogical change from the external bodies, such as the governmental agency mentioned above. Moreover, from the second year of implementation, an external company was engaged by the municipality to speed up the process of using the Chromebooks in for teaching purposes. The company run a fixed program that focused on getting student-active teaching and classroom management into technology-rich learning environments. The consulting company and the national agency had different roles in the implementation process. Where the national agency contributed with content and competence development, the consultancy had a more hands-on approach by implementing a practical scheme of using Chromebooks at each school. The municipality asked schools to provide feedback on the latter through a questionnaire. Although many teachers reported to be satisfied with their intervention, several were not, and the main reason they reported was that they felt they were exposed to an intervention that were either too difficult or to easy, since the consultancy adopted the same scheme to all schools without any adaption to the teachers' actual level of digital proficiency. Other teachers reported that they were given too little time to prepare themselves ahead of participating to the intervention, others were able to join, or they only got parts of it, while others did not think the arrangement was relevant, regardless of whether it was easy or difficult.

During the last period of the implementation, we thus observed that the one-to-one Chromebook-implementation had become integrated in teachers' daily work. Most teachers were using the Chromebook in their teaching, and competence developmentpractices have been set on regular basis in schools and across schools in the joint gatherings organized by the municipality. The technical and administrative efforts to make the Chromebooks work were solved, and teachers were exploring how the Chromebook might support their subject related didactics. However, these processes were colored by their actual professional digital competence.

How did teachers' digital competence influence the process?

At most schools, teachers' professional digital competence varied; from non-users, early adopters to teachers who liked to experiment with innovative teaching. These various types of competence and experiences with teaching with technology influenced the implementation at schools.

Lessons learned from the first years (2017-2018)

One year and a half after the implementation, we observed a technicaladministrative change in the schools where most teachers highlighted that the Chromebook had contributed to better workflow and communication. In the interviews, teachers stressed that their workflow had been improved, in that all notes, files and submissions were stored within the Chromebooks, and not on diverse sheets of paper. However, as for pedagogical change, we observed only a slight development from teacher-directed teaching towards more student-active education, where Chromebook served as an integral part of the learning design. At the same time, we also observed that many teachers experienced challenges with class management in these new technology rich learning environments. One explanation was that such classrooms required a different pedagogical approach (Lindquist, 2015). Teachers had to ensure that students used the Chromebooks for learning and not for non-schooling activities (Zheng et al. 2017). This required awareness of pedagogical use Chromebook, and a balance between digital and analogue teaching. While some teachers seemed eager in exploring new opportunities with the help of Chromebook, others were more hesitant about how Chromebook and digital resources could contribute in their teaching and learning. Some of these teachers called for more time to familiarize themselves with Chromebook and specific digital resources, others were less enthusiastic towards the change of their own teaching that came with the Chromebooks. One teacher put it this way: "I would have started with Chromebooks and spreadsheets earlier, but I just noticed that I have postponed and postponed, because I always have something else that I can do." Nonetheless, some of the tech-savvy teachers were more enthusiastic towards the Chromebooks and stated that they often used their own free time, such as evenings, weekends and holidays to find new opportunities for teaching with the support of technology. One of them expressed his experience of the implementation as follows: "I think I might be an enthusiast about technical stuff, so I just find it fun to try new things." Another observation was the differences in the scope and use of digital resources between subjects; for example, in classes where the subject Norwegian were taught, a multitude of digital resources were explored, whereas in Mathematics, we observed a more traditional analogue teacher-led instruction.

Teachers professional digital competence thus varied a lot during the first years of the implementation. The efforts made by the municipality, the external agencies and the school leaders did not seem to work too efficiently in terms of raising the digital competence among teacher staff. One explanation might have been the way the implementation of the Chromebooks were communicated (Rogers, 2003); as demonstrated, most gatherings and joint arenas for competence development were dominated by a 'one size fits all'-approach, which did not meet the actual competence need for teachers; not for the innovative digital competent ones, nor for those who were lagging behind. Following this, another reason could be that the competence development lacked a distinct connection with actual subjects and their distinct knowledge domains.

Lessons learned from the last years (2018-2019)

In 2019 late fall, three years after the implementation started, we observed that schools still needed more time allocated to 'get all teachers involved'. This means structural challenges along with challenges that comprise teachers' 'pedagogical beliefs' [START_REF] Genlott | Disseminating digital innovation in school -Leading second-order educational change[END_REF], meaning that teachers must be convinced of the usefulness of conducting educational development as such, and of the opportunities that comes with digital resources in subjects, in order to change their teaching. The role of the school leader is central to this work (Tondeur etal. 2012). During the three years we observed increased involvement by the school leaders.

These processes mentioned here address what we have called 'second order change'. During the last year of the implementation, we observed that teachers increasingly reported new opportunities to facilitate student-active teaching with the support of technology. At the same time, there was still a way to go to unleash the potential that lies in overcoming to teach as usual but with the use of the Chromebook, so called 'first order change'.

We observed the role of the professional, digitally competent teacher, and what it implied in practice. A central dimension of such teachers was how they managed to adopt varied and adapted teaching, and how they included various digital and analogue resources in this work. The good balance between analogue and digital was emphasized by many teachers, such as from this teacher:

I have become more aware of when it is beneficial to use digital resources and when it is most beneficial to use handwriting on paper in teaching. Sometimes, when drawing graphs on the Chromebook, you can see trends and explore changes. This is nice when doing geometry. Because then you can perform some changes and observe that the rule remains. It would have taken too much time to do the same tasks by hand. (teacher, 10. grade) However, some teachers let students choose themselves whether they wanted to work digitally or by analogy. This indicates that there is not yet enough awareness in the schools when it comes to awareness of a balance between analogue and digital learning. This could have unfortunate consequences in the form of being overweight by either analogue or digital teaching forms depending on the school and teacher and the preferences of the students. Several dilemmas thus emerge when teachers aim to reach out to all students. While some students quickly understand the technology, others may strive to make it work. This applies especially to software that is typical of school work, such as Excel and Geogebra in mathematics and word processing programs in other subjects. This way, teachers will have different starting points for taking the leap into new forms of teaching.

Moreover, some teachers referred to the new technical-administrative equipment as demanding, and that limited resources have been devoted to this development work beyond normal working hours. Given that there are considerable differences between teachers in terms of how tech savvy they are, one should not underestimate the challenge it will be to implement of new teaching methods based on the opportunities offered by 1: 1 coverage of Chromebooks. Furthermore, we also observed different practices in the competence development work regarding teaching and learning with the support of Chromebooks -both among teachers and across schools within the municipality. These differences reflect the organization and anchoring of the development work as well as the teachers' emphasis on digital versus analogue learning forms respectively.

Conclusion

The overall implementation process initiated and conducted by the municipality included a comprehensive approach for all schools in the district. This way all schools were offered joint competence development courses, and the teachers could benefit from networking across schools, in professional groups.

If we look to the concepts of 'first order' and 'second order barriers' [START_REF] Genlott | Disseminating digital innovation in school -Leading second-order educational change[END_REF], where so-called first order barriers refer to putting the technical solution in place, while 'second order barriers' are about cultural change and teaching practice, it can be said that the comprehensive and coordinated commitment to the municipality has accomplished the first order barriers successfully. The introduction of the technical-administrative part that works on the Chromebooks went smoothly, and there were few technical issues related to infrastructure. We demonstrated how the research literature points out that understandings of change can also be seen as two-step processes, in which so-called 'first order change' is often about doing the same, but with new technology, while 'second order' change ', on the other hand, means that the activities themselves are redefined. In our study, we have shown that the work of addressing what we have called 'second order change' is in the form of an emerging maturation process in which teachers see new opportunities after they have begun to explore and understand the educational possibilities. by digital learning resources. At the same time, there is still a way to go to unleash the potential that lies in overcoming the 'power of analogue practice', i.e. 'first order change'. In the further development and implementation work in the schools in the municipality, this disparity between the teachers, the need for coordination and coordination across schools, as well as the extra work required to radically change teaching forms, should be considered. The work of addressing 'second order change' and new teaching methods will be even more demanding as 'first order change'. In sum, this is likely to represent a need for higher priority and increased resources for the further educational development work in the municipality. Nonetheless, none of the teachers or school-leaders want to return to PC-trolleys and PC rooms.

  Scherer, Siddiq, & Tondeur, 2019; Tondeur et al., 2012; Tondeur, van Braak, Siddiq, & Scherer, 2016) and by qualitative approaches (Prestidge, 2012; Tondeur et al., 2012; Genlott, Grönlund & Viborg, 2019). Moreover, studies on such initiatives have looked at learning outcomes, and changes in workstyles for students and teachers.

Table 1 .

 1 Data collected from schools 8. -10 th grade.

	8. -10.th		2017		2018	2019		Total
	grade
		Norwegian	Mathematics	Norwegian	Mathematics	Norwegian	Mathematics
	Observation	4	4	6	6	4	4	28
	in class
	Interview	4	4	6	6	5	4	29
	Teachers
	Interview	2		2		2		6
	School leader
	Total	10	8	14	12	11	8	63

Table 2 .

 2 Table 2 summarizes types of-and number of meetings attended. Overview meetings attended

	2017	2018	2019	Total
	Meetings with resource-	Meetings with resource-	Meetings with resource-
	teams with teachers across	teams with teachers across	teams with teachers
	schools (3)	schools (1)	across schools (1)	4

  Students and teachers on 8.-10. grade received their devices early spring 2017, students and teachers on 4.-7. grade early autumn 2017, while students and teachers in 1.-3. grade received Chromebooks fall 2018. Ahead of handing out the Chromebooks, the municipality had made preparatory work on technical facilitation and started a process of competence development of all teachers. The municipality had also allocated personnel resources and a binding collaboration with each school. The initiative was coordinated through regular meetings with school leaders and resource teams of teachers from each school. Few schools reported technical problems, such as the lack of broadband capacity or technical failures. Thus, much of what is referred to as "first order barriers" was avoided. Most teachers demonstrated positive attitudes towards the initiative, and many of them were well motivated when starting up with the program.


Themba Makubalo

Brenda Scholtz
email: brenda.scholtz@mandela.ac.za

Temitope O Tokosi

Blockchain Technology for Empowering Patientcentred Healthcare: A Pilot study

Keywords: Blockchain, Healthcare, Patient-centred

Patient-centred care allows patients to have complete autonomy in managing their health information and encourages patients to be proactive. Unfortunately, most patients do not have access to their complete health information as they are stored across the various institutions that they have visited over their lifetime. The purpose of this paper is to report on an investigation into developing a mobile system for patient-centered healthcare using blockchain technology. A design science research approach was used to design, develop and evaluate a prototype that implemented a three-tier architecture using blockchain. Formative evaluations of the prototype revealed that the system could successfully support patient-managed healthcare. The implications of this project would be changing the way patients and healthcare practitioners interact with each other by improving the quality of clinical encounters by allowing patients access to their health information, sharing the information with healthcare practitioners and both parties collaborating in the development of a treatment plan.

Introduction

South Africa plans on implementing the National Health Insurance (NHI) scheme to provide cost effective access to healthcare for all citizens. Once the scheme is in place, it is believed that the focus of the healthcare industry will shift towards preventative care and health promotion. This would require the industry to become patient-centred. Paper-based filing has major risks such as being vulnerable to damage by elements such as fire and water and medical records being lost [START_REF] Kleynhans | Is South Africa ready for a national Electronic Health Record (EHR)?[END_REF]. In addition, backups are time and resource intensive and security of paper-based filing is limited to locked storage, with minimal capabilities of logging access to medical records. Various types of electronic records exist, each having a different purpose [START_REF] Mostert-Phipps | Improving continuity of care through the use of electronic records : a South African perspective[END_REF]. For example, an electronic medical record (EMR) typically contains detailed patient encounter information such as an encounter summary, medical history, test results, and allergy details. EMRs are owned and managed by professionals from a single institution. An electronic health record (EHR) is an aggregated collection of a patient's health information collected from mul-tiple professionals at multiple institutions [START_REF] Vennik | Personal health communities: a phenomenological study of a new health-care concept[END_REF]. It ensures that a patient's complete medical record is available to an authorised practitioner during patient encounters. No country in Africa has been successful in implementing a nationwide EHR system [START_REF] Katurura | Electronic health record system in the public healthcare secor of South Africa: A systematic review research methodology[END_REF]. EHR and EMR are used interchangeably in the literature but the term EHR is used to refer to all electronic records for health information in this study.

Literature Overview

Paper-based filing has major risks such as being vulnerable to being damaged by elements such as fire and water; medical records being lost and creating backups requiring time and intensive resources [START_REF] Kleynhans | Is South Africa ready for a national Electronic Health Record (EHR)?[END_REF]. The security of paper-based filing is limited to locked storage, with minimal capabilities of logging access to medical records. A major issue with paper-based filing is illegibility. Illegibility causes delays in treating patients as time is wasted by trying to understand what is written, contacting the author or redoing the procedure to reproduce the results. The problems associated with paper-based filing are solved with electronic records. Electronic records such as EHR use secure information systems to store and access patient health information and to ensure that the information contained is up-to-date and available when needed [START_REF] Mostert-Phipps | Improving continuity of care through the use of electronic records : a South African perspective[END_REF].

The challenges of implementing EHR systems are a lack of consistent supply of electricity, governmental support and the required infrastructure [START_REF] Katurura | Electronic health record system in the public healthcare secor of South Africa: A systematic review research methodology[END_REF]. Despite these challenges, various vendors in SA have attempted to implement their own EHR systems, built on differing architecture which fail to interoperate with each other [START_REF] Katurura | Electronic health record system in the public healthcare secor of South Africa: A systematic review research methodology[END_REF]. Disinterest stems from the belief that measurable benefits (such as finances) are better realised within their own organisation. Thus, to gain the benefits of an EHR system, patients are limited to clinical encounters with organisations that utilise the specific EHR system. This devalues the effectiveness and efficiency of patients managing their own healthcare. The biggest challenge preventing the adoption of EHR systems in the health industry is the resistance from practitioners [START_REF] Mammen | Electronic medical record (EMR) technology acceptance by healthcare professionals in South Afica[END_REF].

An Accenture study on SA patients clearly indicated that electronic records are viewed as being more reliable than paper-based records [START_REF] Mostert-Phipps | Improving continuity of care through the use of electronic records : a South African perspective[END_REF]. It was indicated by 51 % of respondents that time was wasted when having to recount their medical history to all the practitioners that they visited. Surprisingly, those with medical aid are willing to spend up to R100 extra per month to have their health records maintained electronically [START_REF] Mostert-Phipps | Improving continuity of care through the use of electronic records : a South African perspective[END_REF]. Muchangi and Nzuki [START_REF] Muchangi | Determinants of Electronic Health in Developing Countries[END_REF] revealed that patients are not confident in using EMR systems that do not comply with established standards as they fear that their medical confidentiality and security might be compromised. Currently, the SA government lacks legislation and regulations regarding EMR implementation which has led to misuse and poor compliance by organisations [START_REF] Katurura | Electronic health record system in the public healthcare secor of South Africa: A systematic review research methodology[END_REF]. Until the government develops standards for EMR, common guidelines must be followed in developing such systems.

Various technologies can be utilised to create patient-centred healthcare systems but blockchain offers a unique solution. Blockchain makes use of features (security, stability, fault-tolerance) to allow a network to remain fully functional even if a node has failed [START_REF] Singhal | [END_REF]. For example, each time a transaction occurs, a transaction request is transmitted to all the nodes, making each node aware of the fact as well as the time the event took place. Nodes then validate the authenticity of the block through a majority consensus and then several transactions are put together into a block. The block is then inserted into the ledger by linking to the last block that was inserted into the ledger. Thus, as blocks are continuously inserted to the ledger, a long series of blocks is formed, hence the term blockchain. Each block is marked with a timestamp and a hash of the previous block, preventing alterations from being made to the previous block [10]. An example of blockchain is the cryptocurrency Bitcoin.

Centralised systems exhibit at least one of the following shortcomings: instability due to having a central point of failure, security shortages due to being more vulnerable to central attacks and greater potential of unethical operations due to the presence of a central authority [START_REF] Singhal | [END_REF]. Decentralised systems do not have a central authority. Instead, authority is shared amongst each computer (node), with each of them having equal authority [START_REF] Raval | Decentralized Applications -Harnessing Bitcoin's Blockchain Technology[END_REF]. Distributed systems divide computations into smaller computations to be performed by multiple nodes. Distributed and decentralised systems are highly secure as a central point to attack is lacking. This feature also makes them stable and faulttolerant. Since each node has equal authority, unethical operations are unlikely to be performed [START_REF] Singhal | [END_REF]. Blockchain makes use of these features and benefits to allow the network to remain fully functional even if a node has failed.

The purpose of this paper is to report on an investigation into patient-centered healthcare and the potential of blockchain technology for supporting this system. Its contribution is the development of a blockchain technology and lessons learnt that can support other research into patient-centered healthcare.

The structure of the paper is as follows: The next section provides an overview of the design methodology adopted in the research. Section 3 illustrates the proposed requirements and design of the prototype whilst Section 4 discusses the design and development thereof. In Section 5 the pilot study protocol is explained. The formative evaluation that was conducted is highlighted in Section 6. In Sections 7 and 8 a discussion of the findings and conclusions are presented.

Methodology

The project made use of the Design Science Research (DSR) methodology as proposed by [START_REF] Hevner | A Three Cycle View of Design Science Research A Three Cycle View of Design Science Research[END_REF]. This methodology creates new knowledge in a given domain through the design and creation of an innovative system that solves relevant problems or achieves substantial improvements [START_REF] Vaishnavi | Design science research methods and patterns: innovating information and communication technology[END_REF]. In this study, DSR was used to examine the shortcomings of existing EHR systems and to design a mobile system that utilises blockchain technology. The five steps of DSR were iteratively conducted namely, problem awareness, suggestion, development (circumscription), evaluation and conclusion (operation and goal knowledge). A prototype was designed and developed as a proof-of-concept and the usability of the system was formatively evaluated in a pilot study.

Proposed Design

Documentation analysis is a requirement elicitation technique that collects, reviews and analyses existing documentation to gather requirements [START_REF] O'leary | The Essential Guide to Doing Your Research Project[END_REF][START_REF] Preece | Interaction Design: Beyond Human-Computer Interaction[END_REF]. These two activities formed part of the problem awareness stage of DSR in this project.

System and Data Requirements

The system requirements were identified from a literature review and an extant systems analysis of existing systems and then grouped into core and support components. The requirements of the first core component was to facilitate the storage of and access to a patient's health-related information. This information consists of a patient's personal information, medical practitioner information and health information. Personal information includes full name, date of birth, family history, emergency contact person(s), allergies and medical aid. The practitioners' information includes the full name of the practitioner, the profession, the medical practice number, place of work, years of experience and any malpractice claims. Information related to the patient's health consists of diagnoses, prescriptions, treatment plans and medical test results.

The requirements for the second core component is to facilitate medication adherence for patients. The purchase of prescribed medication should be logged. The data generated from the medication adherence component should be aggregated and form part of a patient's health information. The system should be able to interface with an external medication website that provides details of active ingredients, pricing etc.

The support component should facilitate communication between the two parties (patients and medical practitioners), which is achieved through a personal health community (PHC). Using a PHC gives patients control over who is a member of the community. This prevents any unwanted entities from contributing or collecting information for their own purposes. This component should also provide functionality for an Online Health Community (OHC). OHCs are an example of how social media can be incorporated into healthcare [START_REF] Aarts | Using Online Health Communities to Deliver Patient-Centered Care to People With Chronic Conditions[END_REF]. OHCs unite individuals with a shared goal or interest in healthcare. OHCs comprise of patients with a condition (such as ALS patients), a group of practitioners with a shared medical interest (such as neurologists), or a mixture of both. OHC members interact using modern communication technologies such as blogs, chats, forums, and wikis. OHCs can be classified into open and closed communities. Open OHCs are public and its contents can be accessed by anyone. All members of the community can contribute to its content.

For the data design, the data classes were based on those of the Fast Healthcare Interoperability Resources (FHIR) standard, which is a draft standard describing data formats and elements (known as "resources") and an API for exchanging electronic health records [START_REF]Homepage[END_REF]5]. The standard was created by the health level seven international (HL7) healthcare standards organisation.

In the extant systems analysis conducted in this paper, six systems were reviewed. Nine criteria were used in reviewing each system namely database, multiple users, communication, notifications, data sharing, flexible scheduling, community type, visual aids and statistics and charts. AidIT was the only system identified that provides data storage and access and is a mobile EMR system that allows patients to manage their records and facilitates the exchange of these records between patients and practitioners [START_REF] Lamprinakos | Using FHIR to develop a healthcare mobile systemlication[END_REF]. The AidIT system provides patients with a personal health folder that organises a patient's data into five separate categories namely: the patient's personal information (e.g. address, date of birth, photograph and information regarding his/her insurance profile); the patient's general medical history (e.g. past injuries, chronic conditions, allergies and healthcare encounters); the patient's past examinations and relevant diagnoses along with ordered lab tests and their results; the patient's current and past medication prescriptions, along with the quantity and dosage instructions required for each medication; and the patient's care plan. The patient's care plan is designed by the patient's practitioners as a list of actions to be carried out by the patient. AidT's shortcomings includes non-functionality for tracking and monitoring a patient's adherence to their medication schedule. In addition, EMR presentation does not indicate what is important and professionals can amend prior medical records which can create inconsistencies.

System Architecture

The system used a three-tier architecture, which consists of three layers: the application, storage and logic layer. The benefits to using a three-tier architecture is to provide security, performance and code maintenance [START_REF] Elgendi | A three-tier SDN architecture for DenseNets[END_REF]. The architecture is illustrated in Fig. 1. The application layer is where users (patients and professionals) interact with the system to perform tasks such as registering to the system and posting messages. How the information is presented to users is also handled in this layer. The storage layer was split between a database and a blockchain network. The variability, relevance (null voids) and design of blockchain complexity of the structure of health records can limit how they would be stored in a blockchain environment. Each node in a blockchain has a replica of all information stored in the ledger. It would be impractical to have each node store all the health records as they can consume a considerable amount of space, require intensive bandwidth usage and would be wasteful on network resources.

Rather, in the adopted design, the blockchain functions as an access-control manager for health records. Only the personal and professional information of patients and professionals is stored on the blockchain and the patients' health data is stored on a database with the blockchain having encrypted index pointers to the data contained in the database.

The logic layer is spread across the separate components (application, database and blockchain network). For this layer to function seamlessly, the three components must communicate with each other effectively, which is achieved by using a combination of APIs, and private-public key encryption protocols.

Design and Development

Design is iterative in nature, cycling through design-evaluation-redesign activities [START_REF] Preece | Interaction Design: Beyond Human-Computer Interaction[END_REF]. In DSR, iteration is an important part of the process. In this study the design and development of the system (the artefact), was iteratively designed, developed and evaluated. Two alternative wireframe prototype designs were proposed. A walkthrough evaluation was conducted on both wireframes by an expert reviewer as proposed by [START_REF] Dennis | System Analysis Design UML Version 2.0: An Object-Orientated Systemroach[END_REF]. AdobeXD was chosen to prototype the two alternative designs as the software is a free, simple to use platform that allows for designing high fidelity wireframes that can be interacted with to simulate the system's usage. The feedback received indicated that the first wireframe was too cluttered while the second wireframe had a professional feel and made better use of hand gestures for navigation. The second wireframe design was therefore selected for further development and sample screenshots are shown in Fig 2.

A second walkthrough of the second wireframe was undertaken by a second expert reviewer. The primary feedback received was to limit the viewing of the professionals' information to only those that have been referred to by one of the professionals in their community. The choice of expert reviewers was because of their availability within short notice as opposed to a typical end-user (patient) and medical practitioner which requires lengthy ethics clearance application and approval.

Fig. 2. Wireframe design.

Android was the chosen mobile platform for developing the system because it has the largest market share of smartphones [START_REF]Itfirms Homepage[END_REF], and allows for a wide audience to be reached. Java was selected as the programming language since the Android development kit is best suited to Java's libraries and Java's previous release for mobile environments makes it well suited for developing for different devices [11]. The medical information is stored in a MongoDB database, which is a NoSQL document-based database that stores its records in a JSON-like document where fields in each document may differ [START_REF]What is MongoDB?[END_REF]. Flexibility in the structure of a document is required for the system as some data may not always be present in certain circumstances; such as there being no end date in a period object. The FHIR API, which the system makes extensive use of, provides support for mapping its data objects to JSON files, and vice-versa.

Pilot Study

The first iteration of developing the system began with developing the two wireframes and the second wireframe was selected for implementation. The selected wireframe was

Diagnoses are grouped by health communities

Sub-options on main menu.

Swipe to move to next item able to artificially simulate how the final system could work and provided a good reference point for the development of the system. The second iteration followed soon after selecting the development environment. The major changes from the first iteration were the use of floating action buttons, making extensive use of native mobile features and incorporating labelled tabs for grouped items and efficient login credential persistence. Floating action buttons perform a primary action on a given screen [START_REF]Material Design Homepage[END_REF]; these buttons appear in front of the screen's content for clear visibility and use menu icons that the user is familiar with to assist in identifying what the button's purpose is. Android's native contacts and calendar features were utilised as a service to simplify adding emergency contacts and including reminders for medication adherence. Efficiently persisting the login credentials of the user was accomplished by incorporating Google's smart lock feature which is accessible by using permissions on Android smartphones. Persisting user credentials is very important, as the system will make use of blockchain addresses and private keys as the credentials. Blockchain addresses and keys are very lengthy and stored as hexa-decimal values which are not user-friendly. Thus, the burden of having to remember login credentials is absorbed by Google smart lock from the user. The updated system after these changes were made and the benefits are for registering and creating a new medical record while smart lock is for registration and login.

The third iteration occurred during the implementation of the blockchain related aspects. Notifying users of important events (include invites to a community; receiving messages and medication schedules, being informed of non-adherence to medication) were a problem. The solidity development environment supported functionality for logging events, such as medication adherence and invites, which play an integral part of the notification functionality; not all blockchain networks support this functionality (logging events). The workaround to this was to restrict the medication schedule to a patients' native calendar; thus, removing the functionality of viewing a patient's adherence to the medication schedule. A second solution workaround is using the QR codes which was embedded with the smart contract's details and used to send invites to a patient's PHC. The QR codes could also be used to save a user's blockchain credentials for when they first register on the systems database.

Formative Evaluation

A formative usability study is an almost scientific process where test users evaluate the system by interacting with it in a controlled environment [START_REF] Dennis | System Analysis Design UML Version 2.0: An Object-Orientated Systemroach[END_REF]. Users are given a specific set of tasks to accomplish, preferably without the assistance of the facilitator.

Evaluation Objectives

The goal of the evaluation was to assess the user interaction of the system to identify any shortcomings that could be modified to provide an engaging experience for the user. Evaluation of the system served three objectives. Firstly, to identify which functionalities of the system were implemented correctly or cause the system to fail com-pletely. The second objective was to quantify the usability of the system and gain feedback from the evaluators. The third objective was to use the feedback to make improvements to the system. The tasks to be completed by the users cover all the system's requirements. These tasks were chosen to evaluate functionality completeness, navigability, users' subjective satisfaction and user performance; such as comprehension and learnability. The users could directly interact with the system's interface by tapping buttons, swiping to move between screens or scrolling to view lists or enter data.

Evaluation Methodology

An expert panel of two participants was used; both were researchers in the field of Computer Science. An expert panel utilises participants who were specifically chosen to be part of the formative study [START_REF] Preece | Interaction Design: Beyond Human-Computer Interaction[END_REF]. The first expert was a post-doctoral researcher with a PhD in Computer Science and the second expert was a doctoral candidate. The evaluation was conducted inside a computer laboratory, which is a controlled environment allowing for the capturing of data in an accurate way without the users being distracted or interrupted by external factors, while also ensuring that the predefined tasks are performed and completed within a reasonable time frame. The participants were separated from each other and only interacted with each other when necessary.

Each expert was provided with an Android smartphone to complete the tasks. One expert completed tasks related to the practitioner use cases and the other the tasks related to a patient's use cases.

The instrument used was the Post-Study System Usability Questionnaire (PSSUQ) as proposed by Lewis [START_REF] Lewis | Psychometric evaluation of an after-scenario questionnaire for computer usability studies: the ASQ[END_REF], which is a comprehensive questionnaire that provides a host of insightful information from analysing the results of the usability study. PSSUQ is comprehensive in that it provides a set of selected questions and the user does not have to add in extra comments if he/she does not want to, since the questions provide sufficient information. The questionnaire is reliable, free and addresses the usability characteristics of system usefulness, information quality, interface quality and overall satisfaction [START_REF] Tullis | Measuring the User Experience[END_REF]. Additional questions were included to obtain the experts' views of interacting with the system. PSSUQ was the more available questionnaire during the study period because of its ability to meet the researchers study objective. A new questionnaire known as the mHealth app usability questionnaire (MAUQ) was recently developed by [START_REF] Zhou | The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study[END_REF] after the completion of this study and so could not be used.

Dummy blockchain accounts were created and provided for each expert so that they were able to register their details on the system. Additional patient and practitioner accounts were provided for the experts in case of a failure of registration, creating and joining a community. The background, goals and tasks of the system were explained to the panel and they were encouraged to ask questions. Support were provided to the participants if they struggled to complete a task, and a note was made of which tasks required assistance.

Results

The results revealed that the primary concern for the system were the register (practitioner), accept community invite and update details use cases. The code that performs these use cases needs to be re-examined and may require recreating the circumstances for the failure to identify the cause of the problem and then making relevant changes to solve the problem without requiring massive changes to the remaining aspects of the system. The majority of the errors made occurred when the participants attempted a new task without a reference point as to how to successfully complete it; this is also where the facilitator was required to assist the participants in completing the task, which increased the task time. However, as the participants got used to the system, fewer errors were made, and the task times were reduced when attempting tasks that have similar steps, indicating that the system can be learnt over time. The user satisfaction results indicated that the user interface for the patient use cases had higher satisfaction levels than that of the practitioner use cases. The patient expert perceived the consistency in the layout of the system's user interface to be the most helpful component in successfully completing tasks and found the use of icons helpful in understanding the meaning of some of the information presented to the screen. The practitioner expert perceived the system to provide poor user satisfaction due to the user interface being dis-organised and the icons being too domain specific resulting in some confusion. The practitioner expert also found it hard to keep track of the current position in the system which resulted in errors being made. The panel both mentioned that the system takes too long to respond, and that more feedback should be provided to the user when performing actions.

The major problems related to providing clarity on how to navigate the system to complete tasks, a lack of feedback from the actions the participants performed and the system's slow response time. The slow response of the system was due to having to query both the blockchain network as well as the database that stores the data. The smart contract hosted on a blockchain network contains the indices of the patient's medical records which are stored in the database. Thus, the smart contract is first queried to obtain the correct indices and then the indices are used to retrieve the medical records from the database. Converting the data from its representation in the data layer to its representation in the system layer, and vice-versa, also contributed to the lag in response from the system.

The system design made use of tabs, whereby, when a screen that requires data from the database is opened, a query to obtain all the necessary data is performed. This affected the community screen the most as all the patient's medical data must be queried before displaying the screen. A redesign of the system should thus restrict the queries to only be executed when necessary. The system's layout needs to be improved to emphasise frequently performed tasks by making the components used to complete those tasks the most prominent on the screen. Related functionality needs to be grouped together to avoid complex navigation steps being performed by users.

The system's redesign emphasised the incorporation of dialogs to the layout of the user interface while reducing the focus of using tabs. Dialogs provide a convenient method for solving most of the issues affecting the system. Dialogs are modal windows that appear at the forefront of a system's content to provide users with important information or requesting decisions that need to be made [START_REF]Material Design Homepage[END_REF]. By utilising dialogs instead of tabs, only the selected type of medical information will be retrieved from the database; thus, reducing the response time as well as saving the amount of memory required to store the retrieved data. Also, all options will be clearly seen by users instead of having to scroll through tabs to get to the appropriate screen.

Discussions and Future Research

Having piloted the system and taking notes of issues experienced by the expert panel, future research study will conduct a summative usability evaluation of the system as well as provide a discussion of the results. Summative evaluations assess the success of the system accomplishing its functional requirements [START_REF] Tullis | Measuring the User Experience[END_REF]. Unlike a formative evaluation, test users are given a list of all the tasks that can be performed using the system, which serves as a primary criterion for evaluating the system. The results will be discussed in future research output(s) where the blockchain technology app will be applied to a broader community of a larger population.

For future research and improvements, this system will be tested again on a sample population of larger size within an academic institution community. This will enable the researcher(s) assess users' satisfaction with an understanding of what patients' and medical practitioner's perceptions are of the system. All ethical considerations, applications and approvals are in processing for this second test.

Fig. 1 .

 1 Fig. 1. System Architecture.


Temofe Isaac Akaba
email: temofe.akaba@taltech.ee

Alex Norta
email: alex.norta.phd@ieee.org

Chibuzor Udokwu
email: chibuzor.udokwu@taltech.ee

Dirk Draheim
email: dirk.draheim@taltech.ee

A Framework for the Adoption of Blockchain-Based e-Procurement Systems in the Public Sector A Case Study of Nigeria

Keywords: blockchain, procurement, smart contract, interoperability, project-monitoring

Public procurement constitutes a core government function for providing goods and services to citizens. The overall success of a digitized public-procurement function yields progress and economic growth for the nation. In this research, we analyze the potential of blockchainbased systems to enhance effectiveness, ease, and transparency in public procurement in the case of Nigeria and identify the current challenges facing public procurement, i.e.: lack of trust and transparency among critical stakeholders in the procurement process, systems that only weakly support transaction recording and documentation, complex process structures, corruption in institutions involved in the procurement process. To address these issues, a blockchain-based framework is developed to enable interoperability of information-systems involved in the procurement process, increase citizen participation in eliciting project requirements and to enable a more transparent project monitoring and auditing. We apply the framework to a case study with respect to identifying on-chain activities that enable system interoperability, e-participation and project auditability.

Introduction

Public procurement is a core function of government activities that catalyzes economic growth and development, if conducted efficiently and transparently. Despite these benefits of e-procurement, developing nations, including Nigeria, still struggle with issues ranging from lack of trust and transparency among the important participants in the process, systems that only weakly support transaction recording and documentation, complex process structures and massive corruption in institutions within the process. The exchange of corruption money between companies and government officials to be awarded government contracts is estimated to comprise 15% of the contract value.

With respect to these challenges, an innovative approach for tracking all aspects of public procurement for trust, transparency, and ease within the system is essential. Thus, blockchain technology [START_REF] Udokwu | The state of the art for blockchain-enabled smart-contract applications in the organization[END_REF] creates a decentralized platform for validating transactions, data and information that are independent of any third party control in a verifiable, secured transparent and permanent set-up. Therefore, blockchain technology [START_REF] Abodei | Blockchain technology for enabling transparent and traceable government collaboration in public project processes of developing economies[END_REF] has the potential to be adopted to offer solutions for public e-procurement.

In this paper, we propose a blockchain-based e-procurement framework that takes into consideration key success factors in public procurement using Nigeria as a case [START_REF] Akaba | A framework for the adoption of a blockchain-based e-procurement system: a case study of nigeria[END_REF]. We commence with a thorough analysis of the procurement system in Nigeria by conducting semi-structured interviews with twelve high-level stakeholders and experts. Based on the findings of this analysis, the framework elaboration yields a set of concrete recommendations as a concept study, i.e., we provide a first evaluation of the framework's feasibility with application to the Nigerian case.

The remainder of the paper is structured as follows. In Section 2, we discuss related work and in Section 3, we explain details of the used research method. In Section 4, the case selection, subject description and results of the interviews are presented. Next, in Section 5, we elaborate the framework and Section 6 provides a mapping of the current procurement process to a blockchain-based solution. The paper finishes in Section 7 with a conclusion, limitations, open issues and future work.

Related Work

Public procurement is a vital part of government processes that present value for citizens [START_REF] Khan | Public Procurement Fundamentals: Lessons from and for the Field (Includes A Simple Step-By-Step Generic Procurement Manual[END_REF]. The normal flow of a public procurement process includes: crafting an annual budget with the different estimated needs of government agencies, making a plan for the procurement of the items listed in the project, issuing a call for tender for interested contractors, conducting financial-and technical evaluations of participating firms and finally, award and implementation of projects. The objective of these activities is the delivery of high-quality and timely services to citizens through public programs and projects.

Blockchain innovations and application are an emerging area of technology research that is on a steady rise [START_REF] Norta | First workshop on blockchains for inter-organizational collaboration[END_REF][START_REF] Norta | BIOC & FAiSE 2019 -Joint workshop on blockchains for inter-organizational collaboration and flexible advanced information systems[END_REF]. Research on this technology is very diverse and previous work includes the application of blockchain in regular currencies and centralized-banking systems to curb corruption in the finance industry [START_REF] Nicholson | The library as a facilitator: How bitcoin and block chain technology can aid developing nations[END_REF]. In [START_REF] Kuo | Blockchain distributed ledger technologies for biomedical and health care applications[END_REF], it is suggests to apply blockchain technology for handling and securing patient records, recording an audit trail and securing data due to its decentralized features, compare also with [START_REF] Azogu | A framework for the adoption of blockchain technology in healthcare information management systems a case study of Nigeria[END_REF]. As another example, blockchain research related to supply-chain management focuses on reducing counterfeiting and accuracy in document-validation processes [START_REF] Toyoda | A novel blockchainbased product ownership management system (poms) for anti-counterfeits in the post supply chain[END_REF]. Within the context of e-Government, research in blockchain technology is explored in various fields, i.e., in the area of identity management [START_REF] Norta | Safeguarding a formalized blockchainenabled identity-authentication protocol by applying security risk-oriented patterns[END_REF] and document authentication [START_REF] Ølnes | Blockchain in government: Benefits and implications of distributed ledger technology for information sharing[END_REF], compare also with [START_REF] Abodei | Blockchain technology for enabling transparent and traceable government collaboration in public project processes of developing economies[END_REF] versus conventional approaches such as [START_REF] Draheim | The design of the Estonian governmental document exchange classification framework[END_REF], or in specialized fields such as land registration [START_REF] Lazuashvili | Integration of blockchain technology into a land registration system for immutable traceability: A case study of Georgia[END_REF].

Blockchain technology application in procurement processes is on a slow but steady rise since technology infusion in this process is still vision-and experiment-oriented rather than a solution-based scientific endeavour [START_REF] Nicoletti | A Business Model for Insurtech Initiatives[END_REF]. According to [START_REF] Geissbauer | Procurement 4.0: Are you ready for the digital revolution? Strategy& -part of the PwC network[END_REF], blockchain technology has a high potential to significantly improve procurement systems, in particular, with respect to data integration across business functions. Thus, the infusion of blockchain technology causes a positive shift in the way organizations carry out procurement, thereby creating more possibilities for growth and expansion on a global scale.

Research Methodology

We perform semi-structured interviews with twelve stakeholders and experts in public procurement, private-sector procurement, blockchain technology and advocacy for transparency and technology adoption in the Nigerian public-sector procurement. The respondents are made up of fourteen experts from relevant procurement-related organizations including the National Identity management Commission (NIMC), private firms, civil societies and the National Assembly.

The idea for this diverse pool of respondents is to acquire a holistic compilation of ideas from a diverse set of knowledgeable stakeholders. The interview data we analyze with thematic analysis, supported by RQDA (R package for Qualitative Data Analysis) 4 . In the data analysis, we follow six well-defined steps proposed by [START_REF] Maguire | Doing a thematic analysis: A practical, step-by-step guide for learning and teaching scholars[END_REF].

The Case of the Nigerian Procurement System

Information about Nigeria and the procurement context, we first present in Section 4.1. Next, Section 4.2 gives the interview results.

Case and Subject Description

The Nigerian government has encountered severe problems in public procurement [START_REF] Adewole | Governance reform and the challenge of implementing public procurement law regime across nigerian state and local governments[END_REF][START_REF] Ezeh | Public procurement reform strategies: Achieving effective and sustainable outcomes[END_REF]. According to [START_REF] Olatunji | Nigeria's public procurement law-puissant issues and projected amendments[END_REF], these problems have existed despite of -and even due to -the enactment of the Public Procurement Act in 2007 to ensure transparency, competitiveness, value for money and professionalism in the public-sector procurement system. The Procurement Act guidelines demands from stakeholders following strict rules and provides guidelines for the establishment of an approving body, i.e., the National Council on Public Procurement, as well as a regulatory body, i.e., the Bureau of Public Procurement.

Still, the objectives of the act are in far reach due to the poor implementation of the relevant directives that can ultimately be traced to the harsh economic, social-and political environment in the country. According to [START_REF] Fayomi | Public procurement and due process policy in nigeria: Trust, prospects and challenges[END_REF], public procurement in Nigeria remains the most common means through which public funds have been misappropriated and stolen for personal and individual gains. Although the adoption of e-procurement is a goal, most of the functions are still operated manually and as such prone to corruption and fraud.

Interview Results

The interviews are structured in different sections. The first section is concerned with gaining background knowledge of the respondents to assess the validity of their responses. The other sections focus on gathering interview findings we categorize into the themes existing procurement system, stakeholder involvement and role, influencing factors for adopting blockchain-based procurement, criteria for assessing effectiveness. The project log 5 shows the detailed interview transcript for this research.

Existing Procurement System The respondents express that, although the regulators aim to introduce e-procurement, the existing manual procedures are still used extensively. Furthermore, the respondents state unnecessary emphasis on rule compliance is detrimental to fair and transparent procurement processes.

Respondents mention the lack of clear structure of project planning and execution within the ministries, departments and agencies (MDAs). This structure absence renders it impossible for the Bureau of Public Procurement to install improvement plans. Approximately 50% of our respondents mention that corruption currently exists in all phases of the procurement process from project planning via bidding to the project implementation stage.

Stakeholders Involvement Investigating stakeholder involvement indicates the impact on their roles and duties of adopting automating systems. To acquire a holistic understanding, we gather responses from private-sector respondents who mention that planning is a very crucial success factor of the procurement function as they perform a thorough analysis of the intended goods, services, or project. The study further explores the specific steps taken by contractors and suppliers who provide goods and services for clients who communicate via emails, or phone calls. Most respondents indicate they do not move beyond a re-order level to have stock available in cases of emergency. In cases where the procuring entity is a large organization such as a government ministry, respondents usually place orders directly from the international manufacturers as opposed to using intermediaries. This reduces the delivery time and enables specific demand of the procuring entity to be met.

The role and involvement of the Bureau of Procurement is also explored during the research. A senior official of the Bureau mentions that, apart from acting as a regulator, the bureau also advises the government about the procurement and disposal of public goods and services. Finally, the role of civil-society organizations is considered, in particular, to monitor and track public-sector procurement, funding and financing. Two respondents who work with different civil-society organizations explain despite challenges, the government is aims to ensure a more transparent and open system. With the slow progress of change, the respondents wish the government adopts technologies and systems for ease, efficiency, and transparency to meet the global standard for public procurement.

Influencing Factors for Adopting Blockchain-Based Procurement In this section, we analyze the factors that hinder the effective implementation of a blockchain-based solution as well as how these issues can be addressed. The areas of a hindrance include a poor infrastructure set up, lack of political will of the government to implement necessary technology policies needed, lack of funding for a full implementation, resistance to change by public officials, and poor knowledge of blockchain technology by stakeholders involved in the process.

A number of 33% of the respondents specifically mention the epileptic power situation in Nigeria as the main challenge to fully implement blockchain technology that can not effectively run. Additionally, three respondents mention the need for political will both from the executive and legislative arms in ensuring total compliance with the requirements needed for functioning blockchain use. Poor technology knowledge is another challenge to adopt a blockchain system. Similarly, another respondent mentions that although these stakeholders would stall blockchains and use traditional methods of moving files to manipulate figures and engage in fraud and corruption that an advanced and digitized system restricts.

To correct these identified issues, respondents unanimously point out the need for training all procurement staff and other stakeholders to gain a better understanding of what the proposed blockchain technology entails and how it functions. One respondent particularly stresses the government ensuring maintaining and sustaining blockchain technologies.

Criteria for Assessing Effectiveness It is also crucial understand appropriate effectiveness-assessment criteria for novel blockchain-technology based systems. In summary, the following points are mentioned by the respondents: ease, transparency, affordability, communication-and feedback mechanisms, knowledge of blockchain systems and interoperability with existing databases. All respondents express the opinion that any successful new blockchain system must be easy to use and needs to support public servants in their daily routines. As the current processes are usually stressful and time consuming, a novel blockchain system is expected to solve these problems to gain full acceptance.

With respect to transparency, 67% of the respondents agree that a successful blockchain system must adequately take into account transparency and open-ness with respect to all aspects of the procurement process. One respondent suggests that the possibility of linking the procurement system with other national databases such as of the Corporate Affairs Commission, creates significantly more monitorable openness about the ownership of firms that win bids to execute contracts. According to the respondents, these criteria must be present and evaluated continuously to ensure that novel blockchain technology for eprocurement is active and functional.

A Framework for Blockchain-Based Procurement

Based on the findings in Section 4.2, we propose a novel framework that aims at enabling public organizations to implement and increase the adoption of blockchain-based procurement systems. In crafting this framework, a blockchain system is considered mainly because it possesses a shared, immutable and decentralized ledger for recording transactions and tracking assets in a network. Assets in this sense are anything of value and may be tangible, e.g., land and buildings, vehicles and machineries, or intangible such as intellectual properties, patents, copyrights, etc. These assets can be recorded, tracked and traded within a blockchain network.

The concepts of immutability, decentralization and trust renders blockchains a very transparent and efficient system for recording transactions as all relevant stakeholders maintain a level of equality and access in tracking processes. Blockchain technology provides security, ensures anonymity and enhances data integrity of transactions without any third party involved [START_REF] Yli-Huumo | Where is current research on blockchain technology? -a systematic review[END_REF]. In addition, there is a time-stamp for data that is stored in a block linked to the preceding block for validation to create a chain of blocks. These features render blockchains a veritable choice for a secured and trusted systems in business applications. The framework is presented as a set of recommendations in Table 1. Three recommendations are presented and each recommendation is associated to a problem category. The first recommendation addresses the issue of corruption in existing processes due to the absence of interoperability in the systems that support the current procurement process. The proposed framework recommends using blockchain-enabled smart contracts [START_REF] Norta | Self-aware smart contracts with legal relevance[END_REF] to facilitate interoperability of current systems. This results in increased automated processes and, thereby, reduces corruption cases in the procurement processes.

The second proposal involves engaging stakeholders in the procurement process and establishing clear communication channels. With roles that are clearly defined and assigned to all stakeholders, the citizens participate in eliciting service requirements before a particular project proposal is submitted. Thus, ensuring that, all stakeholders involved in the procurement processes behave according to legislation.

The final recommendation addresses the issue of assessing the effectiveness of the procurement system, processes and completed projects. The framework proposes a blockchain-based solution that is capable of tracking and monitoring the projects that are executed under the procurement. This increases the transparency and openness of the procurement processes and also provides an avenue for feedback mechanisms on executed projects.

Permissioned blockchain systems possess restrictions that limit the actions that can be taken by participants within a network to yield a strong option for future public sector application [START_REF] Baliga | Understanding blockchain consensus models[END_REF]. In addition, a private blockchain ensures that only parties involved in the e-procurement process can participate in the blockchain network, thereby ensuring the privacy of information, or data shared in a public procurement process. The study [START_REF] Ladleif | Modeling and enforcing blockchainbased choreographies[END_REF] shows how privacy can be ensured in public networks and thereby demonstrates the possibility of implementing this public procurement process in public blockchain.

Mapping the Existing Procurement Process to Blockchain

We apply the proposed blockchain-implementation framework presented in Section 5 for mapping on-chain activities for the current public procurement process. First, we present the AS-IS version of the procurement processes using BPMN (Business Process Modeling Language) [START_REF] Chinosi | Bpmn: An introduction to the standard[END_REF] diagram notation and then show the activities that are executed on-chain based on our proposed framework. Section 6.1 shows the AS-IS version of the procurement process and Section 6.2 also comprises the on-chain activities.

AS-IS Procurement Process

The process begins with a procurement plan crafted by the MDA to ascertain current infrastructural and project gaps that need to be filled and provided for.

Next, a budget is specified and sent to the National Assembly for appropriation. Projects that are not needed are cancelled and after the budget is passed by the National Assembly and signed into law by the executive, the projects are executed. Here, the budget is sent to the Parastatals Tender Board (PTB), or the Ministerial Tenders Board (MTB) for further checks and approval, in particular, on whether the price is within the approval thresholds. Once, the tender boards then approve the budget, a call for tender is placed in the news dailies for potential contractors. Otherwise, the budget is sent to the Bureau of Public Procurement. Once the latter receives the budget, they perform further reviews and approve if a budget is within their approval limits. Otherwise, the proposal is sent to the Federal Executive Council for further consideration and approval. Once there is an approval for the project to be executed, a call for tender is issued on national dailies and contractors are expected to submit their bids. After the submission of bids, a technical-and financial evaluation is conducted, and the contract is awarded to the most qualified bidder with a certificate of no objection issued. Alternatively, the bid is declined if any irregularities are found during the technical and financial evaluation stage. Once the process flow is completed, the project is implemented.

On-Chain Activities in the Procurement Process

These on-chain activities show the procurement activities that can be executed on the blockchain to achieve the goals of the recommendations in the proposed framework. First, we identify tasks in the existing process as shown in Figure 1 that enable interoperability of all the silo systems of the organizations involved in the procurement process when they are implemented on a blockchain system. Thus, assets associated with these tasks are stored on the blockchain and accessed via the information systems of the collaborating parties. We further identify additional tasks for on-chain implementation to enable stakeholder involvement in outlining service requirements of submitted projects. Finally, we identify procurement tasks that need to be monitored on a blockchain by the citizens to increase transparency and auditability of the procurement process. Enabling Stakeholders Systems Interoperability: Table 2 shows the executed tasks on blockchain and resulting assets also stored on-chain. This results in the interoperability of information systems of collaborating parties in the procurement process. Access to the assets are only granted to stakeholders that are associated to the task. Therefore, only a single version of an asset exists that cannot be illegally modified, or tampered by any malicious, or corrupt stakeholder in the procurement process.

Enabling Stakeholders Engagement: The current procurement process depicted in Figure 1 does not show how stakeholders such as citizens are actively engaged in the procurement process. Based on our proposed framework, the citizens engage in the process by eliciting requirements included in a project. The call for tender shows the service requirements of the project and bids are submitted by contractors based on the requirements contained in the tender. As depicted in Table 2, to engage citizens in the procurement process, an additional on-chain activity must be implemented such that citizens are able to vote on project requirements that are prioritized in the call for tender. The result of a vote is stored as an asset on the blockchain and the stakeholders involved are represented by the MDA and concerned citizens.

Enabling Project Auditability and Monitoring: The current procurement process does not show any activity resulting in transparent monitoring and an evaluation of completed projects. This is another main source of corruption in the existing process, since projects are not properly monitored and payments are issued to contractors that already failed to execute according the requirements listed in the project tenders. Therefore, an additional on-chain activity is required to render the evaluation of completed projects more democratic and transparent. Using blockchain-enabled smart-contracts, citizens can track projects based on the requirements on the tender and vote 'success' when the executed projects successfully satisfy the requirements in a tender. Otherwise, the project is considered as failure. As per Table 2, further actions can be taken by the MDAs based on the citizens' project assessment result.

Conclusion

This research explores the existing public procurement processes to understand the overall structure, complexities and challenges that need to be faced in proposing a workable blockchain-based framework. Twelve high-level stakeholders and experts we interview for this purpose. The main challenges that we identify are corruption and a lack of transparency within the procurement process. An indepth analysis reveals the underlying structural-and communication issues. On this basis, we recommend an implementation framework that aims at interoperability of all the silo systems of the involved organizations. Thus, all assets associated with crucial tasks are stored on a blockchain and accessed via the collaborating parties -creating more openness, transparency and trust. As a further outcome, we discover that the current procurement process does not adequately support citizen engagement. For this issue, we propose an additional on-chain activity so that citizens can vote on project requirements that are prioritized during the call for tender stage. Finally, we seek to find answers to the important aspects of project monitoring, evaluation and auditability. Our respondents mention that most of the budgeted projects are only poorly executed, or not completed at all. With respect to this, we propose an additional on-chain activity that renders the evaluation of the completed projects more democratic and transparent -by giving citizens access to track projects based on the tender requirements and allowing them to give feedback about the success, or failure based on these requirements.

A limitations of this research is the generalization power given the focus on one e-procurement case of Nigeria. Secondly, the cost of implication for the proposed blockchain-based system is also not fully considered, especially additional costs associated to blockchain activities, i.e., commonly referred to as transaction fee. As future research, we consider investigating the factors and challenges that deepen, or affect citizen involvement in the usage of blockchain technology. Secondly, the aspect of security and privacy for blockchain technology is not fully considered in this research.

Fig. 1 .

 1 Fig. 1. Current AS-IS stae of the public procurement process.

Table 1 .

 1 Recommendation for blockchain implementation and -adoption in procurement processes.

	Problem category	Findings	Recommendation
	Existing procurement	Corruption resulting from manual	Blockchain integration
	system	processes, because existing systems	into existing systems
		involved in public procurement are
		not interoperable
	Stakeholders involvement	Lack of a clear channel of	Blockchain-supported user
	and roles	communication and an effective	engagement and
		system that can track the process	collaboration
	Criteria for assessing	Lack of transparency and openness of	Blockchain-based project
	effectiveness	procurement processes, affordability,	auditing and monitoring
		feedback mechanisms, knowledge of
		the system

Table 2 .

 2 Enabling on-chain tasks.

	Associated task	Assets stored on-chain	Stakeholders
	On-chain tasks enabling system interoperability
	Specify procurement plan Procurement plan	MDA/BPP
	Specify budget	Budget	BPP/FEC
	appropriation
	Submit call to tender	Tender	All Stakeholders
	Award contract	Contract	MDA/Contractor
	Submit bid	Bid	MDA/Contractor
	Additional on-chain task enabling stakeholders engagement
	Vote on project needs	Prioritized project requirement	MDA/Citizens
	Additional on-chain task enabling project auditability and monitoring
	Vote on completed project project assessment result	MDA/Citizens

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