Successful Public Health Information System Database Integration Projects: A Qualitative Study

Abstract

ObjectiveTo explore the most important public health information system database integration project success factors to include: technological, organizational, project-specific, or external.MethodsThis study involved a cross-case design. Cases were identified through literal replication logic and screened through a survey and review of available literature. Study participants were interviewed through hour-long sessions steered by a semi-structured guide. Survey responses, interview transcripts and available documents were coded and analyzed deductively, and matrices were developed to illustrate relationships.ResultsLeadership among the project’s participants is the most important integration project success factor. This leadership factor manifests in the following ways. Executive sponsors champion the initiative. Informaticians facilitate communication and system requirement collection. Program directors contribute substantive energy to the project and remove obstacles. Some other factors also contribute to project success. For example, strong Financial Management and Support promotes project initiation. Technological aspects impact the final product’s quality. Utilizing formal project management techniques, particularly the Agile software development methodology, contributes to successful project resolution by ensuring daily operational effectiveness.DiscussionThe principal finding illustrates important contributions by project leaders, transcending those of the executive sponsor. Other participants, notably informaticians and program directors, substantially contribute to the project’s success. Additionally, the Agile software development methodology is emerging as a successful approach to project management for these and related projects.ConclusionInvesting in the leadership and project management skills of database integration project participants could improve the success of future projects. State health department staff considering these projects should carefully select project participants and train them accordingly.

Are we doing it right? We need to evaluate the current approaches for implementation of digital health systems

“…[48][49][50] Agile approaches, which are more flexible than Traditional approaches, have been suggested for implementing HIT for large digital health programs. [51][52][53] Unlike Traditional approaches, Agile approaches value continuous adaptation to changing requirements, regular delivery of functioning software, frequent in-person communication between project teams and customers as well as within project teams, collaboration between project team and customers, and autonomous teams. 33 In an educational paper, Kitzmiller et al suggest Agile approaches for several components of project management (e.g.…”

“…53 Hybrid approaches that combine aspects of the Agile and Traditional project management approaches have been recommended by others as a way of speeding up project execution and delivering better solutions for customers; 38,52,53 however, suggestions for Agile and Hybrid approaches are not supported by objective evidence of their effectiveness for implementing HIT projects. Although some project teams have been reported to perceive Agile or hybrid approaches as more suitable for managing HIT projects, 51 objective evidence is needed to prove that Agile and hybrid approaches are indeed more effective at enabling HIT projects to meet budget, time and scope goals. But there is a stark absence of studies in mainstream academic and grey literature that systematically evaluate the comparative effectiveness of project management approaches for large HIT implementation projects.…”

“…27,[54][55][56] They also lack empirical evidence to support their guiding principles and often only cite unvalidated 'lessons learnt' or respondents' opinions from single-location implementations. [51][52][53] Health care is an evidence-based discipline, and this should apply to implementation of HIT projects. Hospitals are complex, adaptive systems; therefore, as we evolve from simple bespoke digital systems built to detailed clinical requirements for a limited set of clinicians to the more modern implementation of commercial, off-the-shelf, integrated systems spanning hospitals, we also need to mature and evolve our approach to evidence-based change and implementation methods.…”

Co-design of a Smartphone App for People Living With Dementia by Applying Agile, Iterative Co-design Principles: Development and Usability Study

“…Agile software development focuses on collaboration with users and rapid software deployment [ 27 ]. Scaling tests to a mobile device requires regular input and development iterations from end users, with an understanding that direct translation between devices may be unsuitable.…”