Factors Influencing the Adoption of Health Information Standards in Health Care Organizations: A Systematic Review Based on Best Fit Framework Synthesis

Abstract

Background Since the early 1970s, health care provision has experienced rapid growth in the investment and adoption of health information technologies (HITs). However, the development and deployment of HITs has often been conducted in silos, at different organizational levels, within different regions, and in various health care settings; this has resulted in their infrastructures often being difficult to manage or integrate. Health information standards (ie, the set norms and requirements that underpin the deployment of HITs in health care settings) are expected to address these issues, yet their adoption remains to be frustratingly low among health care information technology vendors. Objective This study aimed to synthesize a comprehensive framework of factors that affect the adoption and deployment of health information standards by health care organizations. Methods First, electronic databases, including Web of Science, Scopus, and PubMed, were searched for relevant articles, with the results being exported to the EndNote reference management software. Second, study selection was conducted according to pre-established inclusion and exclusion criteria. Finally, a synthesized best fit framework was created, which integrated a thematic analysis of the included articles. Results In total, 35 records were incorporated into the synthesized framework, with 4 dimensions being identified: technology, organization, environment, and interorganizational relationships. The technology dimension included relative advantage, complexity, compatibility, trialability, observability, switching cost, standards uncertainty, and shared business process attributes. The organization dimension included organizational scale, organizational culture, staff resistance to change, staff training, top management support, and organizational readiness. The environment dimension included external pressure, external support, network externality, installed base, and information communication. Finally, the interorganizational relationships dimension included partner trust, partner dependence, relationship commitment, and partner power. Conclusions The synthesized framework presented in this paper extends the current understanding of the factors that influence the adoption of health information standards in health care organizations. It provides policy and decision makers with a greater awareness of factors that hinder or facilitate their adoption, enabling better judgement and development of adoption intervention strategies. Furthermore, suggestions for future research are provided.

Stagewise Overview of Issues Influencing Organizational Technology Adoption and Use

“…This will enable members to develop new skills and competencies that help these continuously learning organizations to undergo constant renewal (Tamayo-Torres et al, 2016 ). The term “knowledge management” was mentioned in the literature as a recommended practice by which a member's knowledge can evolve into team and organizational knowledge (Han et al, 2020 ). The more knowledge is built and shared, the more readily the organization will adopt new technologies and the more likely it is to survive.…”

“…Other terminologies used for this concept in the literature include centralized vs. decentralized (see Wang and Feeney, 2016 ) and formal vs. informal power structures (see Peir and Meliá, 2003 ). It is worth highlighting that the relationship between organizational size and technology adoption is not clear, since it is argued that large organizations have more resources for faster technology adoption while small organizations have less bureaucracy and structural complexity that could slow down the adoption of technology (Han et al, 2020 ). We believe that when organizations have a more organic structure during technology adoption, the employees are more engaged and communicative.…”

“…This is the time either to make up for the organization's history of past technology implementation failures or to build on a history and culture of successful technology implementations. Past experiences of failure pose a risk to new changes and create uncertainties (Han et al, 2020 ), while past successes facilitate new technology changes (Kumar et al, 2018 ). We believe that by knowing the pre-change stage very well and carefully designing the interventions, organizations can influence the human-technology interaction and lead the change process toward a desired outcome.…”

“…Globalization and rapid technology advancements have been found to impose competitive pressure on organizations for survival. Governmental pressure has also been seen as a key factor in technology adoption (Aldossari and Mokhtar, 2020 ; Han et al, 2020 ). Legal bodies and other socio-political actors also influence technology trends (Nielsen and Mengiste, 2014 ).…”

“…The extent to which an organization is able to adapt to required changes is referred to as organizational readiness. With regard to technology changes, readiness encompasses technological infrastructure, knowledge, (human) resources, and managerial commitment to change, and the extent of readiness is a precursor to successful organizational change management (Han et al, 2020 ; Maali et al, 2020 ). Therefore, each of the factors that contribute to readiness deserves attention.…”