Lessons from a failed information systems initiative: issues for complex organisations☆

Southon, Gray; Sauer, Chris; Dampney, Kit

doi:10.1016/s1386-5056(99)00018-0

Cited by 129 publications

(66 citation statements)

References 10 publications

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“…First, although numerous studies have reported that CIS use translates into benefits (e.g., fewer medication errors, [26][27][28][29] increased financial gain, 30 better quality of care, 31,32 improved practitioners' performance, 33-35 enhancement of diagnostic accuracy 36 and increased safety 3,37 ), computer systems that satisfy users and that actually contribute to the quality and safety of patient care are rare. [4][5][6][38][39][40][41][42] By depicting the dynamics of the implementation process, our study helps to explain why this is so. Second, previous research has shown that, although a system's technical factors (e.g., it "fits the workflow," augments physicians' judgment rather than replaces it, 43 is user friendly, is flexible 38,44,45 and has an innovative design 45,46 ) may be crucial in determining the success or failure of a CIS implementation, organizational factors (e.g., supportive leadership and championship, 38,43,44,46,47 clinician involvement 47 and physician empowerment 38 ) are paramount.…”

Section: Discussionmentioning

confidence: 99%

Getting physicians to accept new information technology: insights from case studies

Lapointe

Rivard²

2006

Canadian Medical Association Journal

162

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ResearchT he potential contribution of a clinical information system (CIS) to the quality of health care 1-3 is generally acknowledged, and numerous hospitals have been engaged in their implementation. [4][5][6] Investment in information technology (IT) in the health care sector is higher than ever. Physicians play a critical role in the success of CIS implementation, 10-13 but many are reluctant to use IT tools. 14,15Rather than viewing resistance as a barrier to be removed, 16or taking for granted that resistance will be dysfunctional and even destructive, 17 we considered that it can also be useful in preventing the implementation of systems that are flawed 18 or that would have negative organizational impacts. 17 We analyzed cases of CIS implementation in 3 hospitals to understand better the dynamics of physicians' resistance to CIS implementation. We also sought to determine whether resistance was an a priori reaction or whether it developed only later, during the implementation. MethodsFor our analytical framework, we drew from a model that suggests that, when a CIS is introduced, resistance behaviours occur if users perceive threats from the interaction of initial conditions and system features.12 During implementation, triggers may change the nature of the initial conditions or change the object of resistance, and resistance behaviours may vary in intensity, from apathy to aggressive actions (Appendix 1). 12For our study, we selected 3 hospitals in which CIS had been or was being implemented. The cases were selected with enough similarities and differences so as to maximize variation and allow for comparison (Table 1). 19,20For data collection, we used direct observation, documentation and interviews, with interviews being the principal source of data. The initial people interviewed were the project manager, the nursing director and the medical director at each hospital. A snowball sampling strategy 21,22 was then used, whereby those interviewed identified additional people whom they thought held critical information about the project, had exhibited extreme behaviours of acceptance or resistance, or portrayed the typical behaviours of their professional group. Data collection ended when information obtained from additional respondents could not be justified in terms of effort and resources.23 We used open-ended questions and asked respondents to describe the implementation, from project initiation to termination. Following an interview protocol, additional questions were prompted to ensure data completeness Getting physicians to accept new information technology: insights from case studies Background: : The success or failure of a computer information system (CIS) depends on whether physicians accept or resist its implementation. Using case studies, we analyzed the implementation of such systems in 3 hospitals to understand better the dynamics of physicians' resistance to CIS implementation.Methods: : We selected cases to maximize variation while allowing comparison of CIS implementations. Data were coll...

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Section: Discussionmentioning

confidence: 99%

Getting physicians to accept new information technology: insights from case studies

Lapointe

Rivard²

2006

Canadian Medical Association Journal

162

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“…Maximising the potential of next-generation healthcare requires the involvement of a wider constituency of disciplinary experts, including social scientists, management (in addition to product design, healthcare and computing) (Pagliari, 2007). Empirical research has shown that the health sector has been particularly prone to product development problems including unanticipated technical, human or organisational issues (Southon et al, 1999). Moreover, design flaws that affect the ease of use and reliability of systems and may even be dangerous, creating ill-feeling and reducing clinicians' willingness to use emerging systems, software and hardware in practice (Dumay and Feriks, 2004).…”

Section: Opportunities For Changementioning

confidence: 99%

Towards sustainable business models from healthcare technology research

Mulvenna

Wallace

et al. 2010

IJCIH

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As demographic ageing impacts across the world, health and welfare organisations are seeking new paradigms of care that address people's needs as well as being inherently more scalable than the incumbent processes and services. The aim of this paper is to describe the current situation in Europe with information on service provision, before signposting some possible new ways to develop sustainable business models that support care models. The paper uses a case study approach to examine the issues in the introduction of such business models, from a perspective of the translation of research proof of 22 M. Mulvenna et al.concepts into business services and from the perspective of developing innovations from research that address unmet or poorly considered needs of user. The paper shows how several innovative European projects are anticipating the need for service change and are designing their research outcomes to match the needs of service commissioners more fully. The conclusion discusses several different approaches before drawing together strands of the work and providing tentative recommendations on the way forward to develop new inclusive technology-enhanced services in health and social care.Keywords: inclusion; information and communications technology; ICT; health and welfare services; business models.Reference to this paper should be made as follows: Mulvenna, M., Wallace, J., Moore, G., Martin, S., Galbraith, B., Haaker, T., Moelaert, F., Jansson, M., Bergvall-Kåreborn, B., Castellot, R., Melander-Wikman, A., Bengtsson, J.E., Isaksson, L. and Nugent, C. (2010) Chris Nugent is a Professor of Biomedical Engineering at the University of Ulster. His research addresses the themes of technologies to support independent living, medical decision support systems specifically in the domain of computerised electrocardiology and the development of internet-based healthcare models. He has published extensively in these areas with the work spanning theoretical, clinical and biomedical engineering domains.

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“…Decision makers often believe technology will bring benefits to the organization as a whole and to the patients, in particular, and that it should be fully embraced. However, in some cases the implementations does fail (Southon et al, 1999;Vishwanath and Scamurra, 2007). In some other cases, the same systems implemented in two different settings resulted in two different outcomes, where in one setting it was widely accepted and in another setting it was rejected by the users (Travers and M.Downs, 2000;Gremy et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Understanding and Addressing the ‘Fit’ Between User, Technology and Organization in Evaluating User Acceptance of Healthcare Technology

Mohamadali

Garibaldi

2012

Proceedings of the International Conference on Health Informatics

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Abstract:In this paper, we discuss the importance of addressing the 'fit' between user, technology and organization in evaluating user acceptance of healthcare technology. We give an overview of evaluation dimensions and explore two models that are related to 'fit'. We demonstrate how users' acceptance factors in previous studies could be better explained through the perspective of 'fit' between user, technology and organization. We believe that the importance of 'fit' needs to be understood in greater detail among the evaluation research community. The 'fit' between user, technology, and organization needs to be addressed together with the factors that influence user acceptance. This paper attempts to gain empirical support for the inclusion of 'fit' between user, technology and organization when evaluating user acceptance of the healthcare technology.

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Lessons from a failed information systems initiative: issues for complex organisations☆

Cited by 129 publications

References 10 publications

Getting physicians to accept new information technology: insights from case studies

Getting physicians to accept new information technology: insights from case studies

Towards sustainable business models from healthcare technology research

Understanding and Addressing the ‘Fit’ Between User, Technology and Organization in Evaluating User Acceptance of Healthcare Technology

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