Many managers attempt to develop collaborative alliances with other organizations. Such strategies are difficult to implement: they are as likely to fail as to succeeed. Implementing and managing an alliance is harder than deciding to collaborate. This paper explores the topic empirically through a study of one form of alliance -supply chain partnering. It presents an interaction model of partnering which shows seven contextual factors that shape, and are shaped by, human action. This context can both help and hinder the emergence of co-operative behaviour. The model is illustrated through a case study of two organizations (customer and supplier) attempting to co-operate more closely. The case shows how the cultural and other differences between the parties at first caused difficulty. Actions were taken to change aspects of the context to facilitate more cooperative behaviour. Improving interpersonal relations led to further actions to create more formal mechanisms which would support future co-operation. These appear to have contributed to the relationship exceeding the initial expectations of the partners. The interaction model illuminates both the content and process of supply chain partnering.

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BackgroundInvesting in computer-based information systems is notoriously risky, since many systems fail to become routinely used as part of everyday working practices, yet there is clear evidence about the management practices which improve the acceptance and integration of such systems. Our aim in this study was to identify to what extent these generic management practices are evident in e-health projects, and to use that knowledge to develop a theoretical model of e-health implementation. This will support the implementation of appropriate e-health systems.MethodsThis study consisted of qualitative semi-structured interviews with managers and health professionals in Scotland, UK. We contacted the Scottish Ethics Committee, who advised that formal application to that body was not necessary for this study. The interview guide aimed to identify the issues which respondents believed had affected the successful implementation of e-health projects. We drew on our research into information systems in other sectors to identify likely themes and questions, which we piloted and revised. Eighteen respondents with experience of e-health projects agreed to be interviewed. These were recorded, transcribed, coded, and then analysed with 'Nvivo' data analysis software.ResultsRespondents identified factors in the context of e-health projects which had affected implementation, including clarity of the strategy; supportive structures and cultures; effects on working processes; and how staff perceived the change. The results also identified useful implementation practices such as balancing planning with adaptability; managing participation; and using power effectively.ConclusionThe interviews confirmed that the contextual factors that affect implementation of information systems in general also affect implementation of e-health projects. As expected, these take place in an evolving context of strategies, structures, cultures, working processes and people. Respondents also confirmed that those managing such projects seek to change these contexts through observable implementation processes of planning, adaptation, participation and using power. This study confirms that research to support the delivery of appropriate e-health projects can usefully draw on the experience of information systems in other sectors.

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This paper reflects on a three-year EPSRC research project (1994)(1995)(1996)(1997), called "Implementing Partnering in the Supply Chain", that studied the development of collaboration between two companies, IDV Operations Ireland Limited and Killeen Corrugated and the complex processes involved in fostering their business relationship. The paper illustrates strategic motivation; both corporate and local, of the companies involved. The principal theoretical outcome of the research,``A Partnering Change Model'', provides a structure for analysis. The case describes the outcomes according to this analysis and, finally, conclusions and managerial implications are presented.

To control the cost of drugs prescribed by general practitioners (GPs), the Netherlands Ministry of Health decided to implement an electronic prescription system. This paper uses an interpretive perspective to analyse the reasons for limited acceptance of the system. While the promotion campaign focused on the system, GPs based their decision on wider contextual factors.This article examines the limited success of an attempt by a national healthcare agency to implement an electronic prescription system (EPS). The promoters wanted to reduce the cost of drugs prescribed by general practitioners (GPs), and invested heavily in developing the system and promoting it to the intended users. GPs are autonomous, self-employed professionals and they reacted to the system in different ways-some used it in full, some partially and some not at all.The analysis relates these reactions to theories about the acceptance and use of information systems. Trying to understand why an information system is used (or not) becomes interesting especially when the users have a high degree of autonomy. Promoters cannot then rely on hierarchical authority to ensure acceptance, instead they need a better understanding of the users' attitudes to the system. If these attitudes relate to features of the system, then designing a system that will, for example, be easy to use will encourage acceptance. However, if they reflect a wider set of beliefs, such as personal views on the tension between evidence-based medicine and the exercise New Technology, Work and Employment 19:2

Background Interest and investment in e-health continue to grow world-wide, but there remains relatively little engagement with the public on this subject, despite calls for more public involvement in health-care planning.

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