BackgroundThe public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa.MethodsNinety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information.ResultsNoteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace.ConclusionThe research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.
We express our unease with one-sided invitations into the Northern mainstream, as well as with Southern critics’ retreat into indigenous enclaves of organizational scholarship. We use this dichotomy to theorize the role of context in organizational theorizing by linking scholarly conversations on context, analogical reasoning, and problematizing assumptions. This creates the opportunity to more carefully consider how not just our theoretical backgrounds but also our contextual life-worlds provide the assumptions and analogies we bring into our theorizing. We use this platform to consider in more detail systematic biases in both the Northern mainstream (erasing and imposing biases) and the Southern critique (scapegoating and valorizing biases). These biases have in common that they essentialize context. To address this risk and to facilitate contextual reflexivity, we propose a form of dialogical scholarly engagement to generate complementary spaces to fruitfully question our contextually embedded assumptions.
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