Industry 4.0 is increasingly being promoted as the key to improving productivity, promoting economic growth and ensuring the sustainability of manufacturing companies. On the other hand, many companies have already partially or fully implemented principles and tools from the Lean management approach, which is also aimed at improving productivity. While the two approaches use very different strategies, they share some common principles. The objective of this article is to highlight the links between the principles and tools proposed by Industry 4.0 and those proposed by the Lean management approach, with a particular focus on how some of Industry 4.0's technologies are improving the implementation of Lean principles, depending on the technologies' capability levels. As such, this study aims to provide a characterisation of the impacts of Industry 4.0 technologies on Lean principles according to targeted capability levels. The results obtained show strong support for Industry 4.0 technologies for Just-in-time and Jidoka, but little or no support for waste reduction and People and Team work. There is, therefore, a clear need to pursue the deployment of Lean management while improving certain Lean principles using Industry 4.0 technologies.

BackgroundManaging appointments in private medical practices and ambulatory care settings is a complex process. Various strategies to reduce missed appointments can be implemented. E-booking systems, which allow patients to schedule and manage medical appointments online, represents such a strategy. To better support clinicians seeking to offer an e-booking service to their patients, health authorities in Canada recently invested in a showcase project involving six private medical clinics.ObjectiveThe objectives pursued in this study were threefold: (1) to measure adoption and use of the e-booking system in each of the clinics over a 2-year period, (2) to assess patients’ perceptions regarding the characteristics and benefits of using the system, and (3) to measure the impact of the e-booking system on the number of missed appointments in each clinic.MethodsA mixed-methods approach was adopted in this study. We first extracted and analyzed raw data from the e-booking system deployed in each of the medical practices to monitor adoption and use of the system over time and to assess the impact of the system on the number of missed appointments. Second, we conducted a Web-based survey of patients’ perceptions in the spring of 2013.ResultsThe patients and physicians targeted by this showcase project showed a growing interest in the e-booking system as the number of users, time slots made available by physicians, and online appointments grew steadily over time. The great majority of patients said that they appreciated the system mainly because of the benefits they derived from it, namely, scheduling flexibility, time savings, and automated reminders that prevented forgotten appointments. Importantly, our findings suggest that the system’s automated reminders help significantly reduce the number of missed appointments.ConclusionsE-booking systems seem to represent a win-win solution for patients and physicians in private medical practices. We encourage researchers to replicate and extend our work in other primary care settings in order to test the generalizability of our findings.

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This paper measures the technical efficiency of 54 public road transport operators and investigates the degree to which various factors influence efficiency levels in these firms. The study makes an attempt to provide an overview of the general status of different operators in 18 countries. Stochastic Frontier Analysis (SFA) methods are applied to our sample over a twelve year period from 2000 to 2011. To our knowledge, this is the first comprehensive analysis of technical efficiency of public road transport operators in 18 countries using parametric method. Our empirical results indicate that investment, operating profit and firm size have a significant influence on technical efficiency levels. We find that technical efficiency level of public road transport operators varies between 0.458 and 0.95. We also observe that large-size operators with more investment capacity tend to be more technically efficient than small-size operators. Finally, we find that operators from developed countries are technically more efficient than those of developing countries.