Ever more researchers have been concerned with the role that Information Technology (IT) plays in the healthcare organizations either reducing medical errors, improving organizational performance or, allowing better healthcare delivery and patient safety. Though the value attributed to IT in healthcare, many attempts at Healthcare Information Systems (HIS) implementation have failed. Case studies, relating to an organization-wide information system (IS) project were conducted in two Portuguese hospitals. The purpose of the research was to understand the role of top-management commitment in HIS implementation and its effect on users' commitment, as well as on the way they use that technology. A qualitative, interpretative and case-based research strategy was carried out employing semi-structured interviews and document analysis. Findings revealed that top-management commitment is important in influencing users' commitment towards a project of HIS implementation, as well as in the way they use the IS contributing to the achievement of the expected benefits.
A melhoria na qualidade do atendimento dos pacientes é a grande preocupação e o que impulsiona o uso de Tecnologia de Informação na Saúde. Apesar da grande expectativa do uso das tecnologias de informação nesse setor, muitas tentativas de implementação falharam. Vários estudos revelam a importância do compromisso das partes interessadas bem como o contexto organizacional quando um sistema ou tecnologia de informação é implementado. Este artigo apresenta dois estudos de caso que analisam ambientes hospitalares após a implementação de um sistema de informação, tendo como principal foco de análise o compromisso das partes interessadas. Procura-se perceber como o compromisso da alta administração e o contexto organizacional influenciam as partes interessadas para a realização de benefícios da implementação de um sistema de informação na saúde. A pesquisa segue uma abordagem qualitativa, interpretativa e baseada em casos. Foram realizadas entrevistas semiestruturadas e análise de documentos. Os resultados revelaram que o contexto organizacional e o comprometimento da alta administração podem ser particularmente importantes para aumentar o comprometimento dos usuários do sistema e, assim, o alcance dos benefícios esperados.Palavras-chave: Tecnologia de Informação na Saúde; Compromisso da Alta Administração; Contexto Organizacional; Benefícios. USERS' COMMITMENT IN INFORMATION SYSTEM IMPLEMENTATION: THE ROLE OF TOP-MANAGEMENT COMMITMENT AND ORGANIZATIONAL CONTEXT ABSTRACTThe improvement in quality of care is a primary concern and driving force in the use of Healthcare Information Technology (HIT). Notwithstanding high expectations for the value of IT (Information Technology) in healthcare, many attempts at HIT implementation have failed. Various studies of the implementation of change programs have demonstrated the importance of stakeholders' commitment as well as organizational context when Information Systems/Information Technology (IS/IT) is implemented. Here, two case studies following the implementation of a HIT in a hospital setting are analysed, focusing on stakeholders' commitment to the IS/IT. An understanding is sought as to how top-management commitment and organizational context influence stakeholders' commitment to benefits achievement from HIT implementation. A qualitative, interpretative and case-based research was used employing semi-structured interviews and document analysis. Findings revealed that organizational context and top-management commitment can be particularly important to the commitment of users in achieving the expected IS/IT benefits.
ResumoConsiderando a escassa investigação em que o objeto de análise são os futuros decisores (estudantes), avalia-se em que medida a intensidade moral, e as suas dimensões, está associada à tomada de decisão ética. Foram igualmente consideradas as variáveis ideologia ética, religiosidade e sociodemográficas (idade e género), como fatores potencialmente associados. Desenvolveu-se um estudo quantitativo, com recurso a questionário. Os resultados confirmam parcialmente as expetativas dos autores e do quadro teórico subjacente, dado que identificam algumas associações entre a intensidade moral, a religiosidade e os atributos sociodemográficos e a tomada de decisão ética. São apresentadas reflexões sobre as implicações na estrutura curricular dos cursos de gestão e recomendam-se estudos adicionais, para melhor compreender os fatores subjacentes à tomada de decisão ética.Palavras-chave: tomada de decisão ética; ideologia ética; intensidade moral; religiosidade. AbstractConsidering the scarcity of research about students as future decision-makers, this study aims to assess to what extent moral intensity, and its dimensions, is associated with ethical decision-making. The variables ethical ideology, religiosity and sociodemographic variables (age and gender) were also considered as potentially associated factors. A quantitative research method was used and data was collected using a questionnaire applied to 87 management students. The findings partially confirm the authors' expectations and the underlying theoretical framework, suggesting some associations between moral intensity, religiosity and sociodemographic attributes, and ethical decision-making. Reflections on the implications of the curricular structure of management courses are presented and additional studies are recommended to better understand the factors underlying ethical decision-making.
Purpose: This study aimed to reflect on the challenges of Health Information Systems in Portugal at a time when technologies enable the creation of new approaches and models for care provision, as well as to identify scenarios that may characterize this practice in the future. Design/methodology/approach: A guiding research model was created based on an empirical study that was conducted using a qualitative method that integrated content analysis of strategic documents and semi-structured interviews with a sample of fourteen key actors in the health sector. Findings: Results pointed to the existence of emerging technologies that may promote the development of Health Information Systems oriented to “health and well-being” in a preventive model logic and reinforce the social and management implications. Originality/value: The originality of this work resided in the empirical study carried out, which allowed us to analyze how the various actors look at the present and the future of Health Information Systems. There is also a lack of studies addressing this subject. Research limitations/implications: The main limitations resulted from a low, although representative, number of interviews and the fact that the interviews took place before the pandemic, so the digital transformation that was promoted was not reflected. Managerial implications and social implications: The study highlighted the need for greater commitment from decision makers, managers, healthcare providers, and citizens toward achieving improved digital literacy and health. Decision makers and managers must also agree on strategies to accelerate existing strategic plans and avoid their implementation at different paces.
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