Evaluation of organizational readiness in information systems adoption: a case study

Most ICT projects failed due to various factors including organizational issues and leaders who did not sufficiently assess organizational readiness for change. Although various perspectives and criteria have been used by researchers to measure organizational readiness, reported evidence on its measurement in information systems (IS) adoption is still limited and unclear, which calls for clarification and further studies. The purpose of the paper is to discuss the evaluation of IS adoption in organizational readiness using an extended organizational readiness framework and to identify the factors that influence organizational readiness in IS adoption. A case study was conducted on the Human Resource Management Information System (HRMIS) based on the Framework of Organizational Readiness at the Public Service Department (PSD) of Malaysia. This qualitative study involved interviews, observations and document analysis. The study found that the PSD is set to implement the HRMIS but the issues and problems identified as pertaining to the HRMIS must be addressed and dealt with immediately in order to achieve the system objectives. A number of factors influencing organizational readiness were identified in the adoption of the HRMIS: Attributes of the Change (vision clarity, change appropriateness and change efficacy), Leadership Support (top management support, presence of an effective champion, and IT support), Internal Context (organizational history of change, organizational conflicts and policies, and organizational flexibility) and Attributes of the Change Targets (collective self-efficacy and user training). Although our case study focused on a specific setting, the identified factors and proposed framework extension is potentially useful for assessing other information systems in different settings; the findings could act as a guide for assessing organizational readiness prior to the adoption of information systems

Managing change : a model for organisational readiness to adopt pharmacy information systems

Although research in organisational readiness is growing, there are still gaps in the context of adopting pharmacy information systems. Evaluating factors that affect organisational readiness to adopt pharmacy information systems might help the health sector to be more successful and avoid negative impacts or losses due to its failure. This paper discussed a proposed model for organisational readiness to adopt pharmacy information systems and factors that affect organisational readiness. A qualitative case study was conducted using interviews, document analysis and observations. This study identified four main categories of factors that influence the organisational readiness to adopt information systems, such as (1) change valence that contributes towards improving the commitment to change, (2) organisational ability that contributes to change efficacy, (3) contextual factors and (4) implementation methods that affect both, commitment to change and efficacy. The study’s findings supported and extended the theory of organisational readiness for change and expanded its use in the context of adopting pharmacy information systems. This study also provides the basis for evaluating organisational readiness on a wider domain such as adopting information systems

The development and implementation of e-health services for the Libyan NHS: case studies of hospitals and clinics in both urban and rural areas

This thesis provides an assessment of the readiness levels within both urban and rural hospitals and clinics in Libya for the implementation of E-health systems. This then enabled the construction of a framework for E-health implementation in the Libyan National Health Service (LNHS). The E-health readiness study assessed how medications were prescribed, how patients were referred, how information communication technology (ICT) was utilised in recording patient records, how healthcare staff were trained to use ICT, and how the ways in which consultations were carried out by healthcare staff. The research was done in five rural clinics and five urban medical centres and focused on the E-health readiness levels of the technology, social attitudes, engagement levels and any other needs that were apparent. Collection of the data was carried out using a mixed methods approach with qualitative interviews and quantitative questionnaires. The study indicated that any IT equipment present was not being utilised for clinical purposes and there was no evidence of any E-health technologies being employed. This implies that the maturity level of the healthcare institutions studied was at level zero in the E-health maturity model used in this thesis. In order for the LNHS to raise its maturity levels for the implementation of E-health systems, it needs to persuade LNHS staff and patients to adopt E-health systems. This can be carried out at a local level throughout the LNHS, though this will need to be coordinated at a national level through training, education and programmes to encourage compliance and providing incentives. In order to move E-health technology usage in the participating Libyan healthcare institutions from Level 0 to Level 2 in the E-health Maturity Model levels, an E-health framework was created that is based on the findings of this research study. The primary aim of the LNHS E-Health Framework is the integration of E-health services for improving the delivery of healthcare within the LNHS. To construct the framework and ensure that it was creditable and applicable, work on it was informed directly by the findings from document analysis, literature review, and expert feedback, in conjunction with the primary research findings presented in Chapter Five. When the LNHS E-Health Framework was compiled there were several things taken into consideration, such as: the abilities of healthcare staff, the needs of healthcare institutions and the existing ICT infrastructure that had been recorded in the E-readiness assessment which was carried out in the healthcare institutions (Chapter 5). The framework also provides proposals for E-health systems based on the infrastructure network that will be developed. The processes addressed are electronic health records, E-consultations, E-prescriptions, E-referrals and E-training. The researcher has received very positive, even enthusiastic, feedback from the LNHS and other officals, and that expect the framework to be further developed and implemented by the LNHS in the near future

Achieving change in primary care—causes of the evidence to practice gap : systematic reviews of reviews

Acknowledgements The Evidence to Practice Project (SPCR FR4 project number: 122) is funded by the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR). KD is part-funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Research and Care West Midlands and by a Knowledge Mobilisation Research Fellowship (KMRF-2014-03-002) from the NIHR. This paper presents independent research funded by the National Institute of Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Funding This study is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR).Peer reviewedPublisher PD

Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia

There is worldwide demand for the implementation of electronic health systems and a transformation to electronic transactions in healthcare organisations. This move to e-health transformation stems from the perceived positive impact that e-health systems have in improving the quality of healthcare and, in turn, reducing expenses. Despite this, more than half of previous Electronic Health Record System (EHRS) implementation projects have failed due to several barriers and challenges. There has been no previous research that has explored the implementation of an EHRS in Primary Healthcare Centres (PHCs). In addition, barriers and facilitators to the implementation of large-scale EHRS in PHCs are not well defined and there is little known about the impact of Financial Resources (FR) and Centralised Management (CM) on such implementation. Thus, this thesis aims to explore the large-scale implementation of EHRS in PHCs in Saudi Arabia (SA). To achieve this aim, a mixed-methods approach comprising both quantitative and qualitative methods was adopted. Data were collected via questionnaire-based studies and semi-structured interviews. Three different populations were targeted: project team members, PHC staff, and EHRS end-users. Descriptive and inferential statistics were applied to the quantitative data, and thematic analysis was used to analyse the qualitative data. The findings revealed high PHCs readiness at the organisational and individual level when compared with the technological level. Both FR and CM were documented to have a positive impact on the implementation of a large scale EHRS. Several facilitators to the implementation of the EHRS were identified, including: strong leadership and appropriate management, PHC specifications, system usability, perceived usefulness and efficiency. The scale of the project, shortage in Health Informatics (HI) expertise, lack of training and support, geographic challenges, software selection and end-user involvement were identified as the main barriers to implementing a large-scale EHRS in the PHCs. No relationships were detected between individual demographic differences, such as age and gender, and level of readiness or satisfaction. Based on the Saudi experience, there may be some important transferable lesson for similar projects elsewhere. Large-scale EHRS projects need to adopt CM. In addition, due to shortage in HI expertise, policymakers may need to carry out some consultations to formulate good implementation plane. Large-scale projects also need to be implemented by more than one vendor and include training and technical support to increase end-user satisfaction. Inadequate infrastructure, lack of interoperability, changing executives and lack of technical support were the main possible causes to the failure of large-scale EHRS projects. Implementation needs to ensure sufficient budget and time have been allocated to mitigate the challenges identified

Electronic Health Record Implementation Strategies for Decreasing Healthcare Costs

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training logs, activity records, and cost information. Methodological triangulation was used to validate the creditability and interpretation of the data in transcribing themes. Three themes emerged from the analysis of study data: implementation of EHRs, costs of implementing EHRs, and perceived usefulness of EHRs. Participants indicated that the implementation of EHRs depended on motivation, financial cost, and the usefulness of EHRs relating to training that reflected user-friendliness. The implications of this study for social change include the potential to lower the cost and improve the efficiency of healthcare for patients. The use of EHR systems could enhance the quality of care delivered to patients through improved accessibility, elimination of duplicative tests, and retrieval of accurate patient information. The use of EHRs can lead to a comprehensive preventative healthcare system resulting in a healthier environment

An empirical study of the technological, organisational and environmental factors influencing South African medical enterprises' propensity to adopt electronic health technologies

Information and communication technologies can be used to deliver healthcare services and improve the healthcare system. Any electronic healthcare system whose usage results in the efficient and enhanced quality of healthcare is an eHealth system and can be beneficial for medical enterprises. Despite the advantages that eHealth systems offer, medical enterprises are often reluctant to abandon their paper-based systems and embrace eHealth solutions. Through a review of existing eHealth literature, this study identified generic technologies used within South African medical enterprises. Fourteen (14) technologies, that represent a basket of eHealth systems for supporting the business management, professional clinical informatics, patient information storage and consumer health informatics functional areas, were identified. The study then aimed to determine the state of adoption of these technologies as well as the factors influencing adoption. The technological, organisational and environmental (TOE) factors that contributed to the current state of adoption were identified through a review of existing TOE literature. A model that explores the effects of these pre-determined TOE factors on the propensity to adopt eHealth was developed and tested. A cross-sectional, quantitative study was carried out and survey data was collected from a sample of 130 medical enterprises in South Africa. Data was collected using a structured questionnaire. Correlation analysis was used to test the model’s hypotheses and hierarchical regression was used to test the overall TOE model. By using the TOE framework, the study has provided a theoretical contribution and addressed a gap in the literature into the barriers and determinants of the adoption of information and communication technologies (ICTs) in healthcare. The results of the study show that South African medical enterprises use systems that range from simple electronic fund transfer systems to more complex electronic record and clinical decision support systems. Of the 14 technologies that were identified, business information systems such as medical aid claims submission systems and electronic record systems for patient and fee related information were the most adopted while a steady, but continued increase in the adoption of clinical health information systems was observed. Specifically, the study reveals that electronic fund transfer systems are the most adopted systems while ePrescription systems are the least used. Furthermore, the study shows that in addition to the enterprises’ operating period, perceived benefits, IT infrastructure, senior clinician involvement, resource commitment and external pressure are correlated with the propensity to adopt while system complexity is a barrier to technology adoption

Examining the PoC System Implementation and Adoption: A FVM Perspective

HIS implementation is complex and involves people issues as well as technological issues. The effect of sociotechnical issues such as macro level or external factors including political, social, economic, environmental infrastructure and technology, laws and regulations; meso level or organizational factors such as leadership, management style, policies, structure; and micro level or tactical factors such as information sharing, training and learning, technical staff or user behaviour, have been less widely studied. Yet, it is precisely these issues that separately or in combination derail numerous HIS implementations. To examine this dilemma, we proffer a unique application of the fit viability model (FVM) to facilitate a better understanding of key issues pertaining the implementation and adoption of a Point of Care (PoC) System at one of the not for profit private hospitals in Australia. This will help the decision makers in hospital to understand how the new system fits within the different departments and also is it a viable option to install such a new system. This study focuses on just two departments of the hospital; namely, food services and environment services. An exploratory single case qualitative study methodology is adopted. From such an analysis, it is possible to identify optimal aspects with the PoC solution and opportunities to add value

Factors that affect the use of electronic personal health records among patients: A systematic review

Background: Electronic personal health records (ePHRs) are web-based tools that enable patients to access parts of their medical records and other services. In spite of the potential benefits of using ePHRs, their adoption rates remain very low. The lack of use of ePHRs among patients leads to implementation failures of these systems. Many studies have been conducted to examine the factors that influence patients’ use of ePHRs, and they need to be synthesised in a meaningful way.ObjectiveThe current study aimed to systematically review the evidence regarding factors that influence patients’ use of ePHRs. Methods: The search included: 42 bibliographic databases (e.g. Medline, Embase, CINHAL, and PsycINFO), hand searching, checking reference lists of the included studies and relevant reviews, contacting experts, and searching two general web engines. Study selection, data extraction, and study quality assessment were carried out by two reviewers independently. The quality of studies was appraised using the Mixed Methods Appraisal Tool. The extracted data were synthesised narratively according to the outcome: intention to use, subjective measures of use, and objective measures of use. The identified factors were categorised into groups based on Or and Karsh’s conceptual framework. Results: Of 5225 citations retrieved, 97 studies were relevant to this review. These studies examined more than 150 different factors: 59 related to intention to use, 52 regarding subjectively-measured use, and 105 related to objectively-measured use. The current review was able to draw definitive conclusions regarding the effect of only 18 factors. Of these, only three factors have been investigated in connection with every outcome, which are: perceived usefulness, privacy and security concerns, and internet access. Conclusion: Of the numerous factors examined by the included studies, this review concluded the effect of 18 factors: 13 personal factors (e.g. gender, ethnicity, and income), four human-technology factors (e.g. perceived usefulness and ease of use), and one organisational factor (facilitating conditions). These factors should be taken into account by stakeholders for the successful implementation of these systems. For example, patients should be assured that the system is secure and no one can access their records without their permission in order to decrease their concerns about the privacy and security. Further, advertising campaigns should be carried out to increase patients’ awareness of the system. More studies are needed to conclude the effect of other factors. In addition, researchers should conduct more theory-based longitudinal studies for assessing factors affecting initial use and continuing use of ePHRs among patients

Inside the “Black Box”: Investigating the Link between Organizational Readiness and IT Implementation Success

The complexity of today’s organizational IT-driven transformations, such as implementing ERPs and CRMs, urges companies to conduct upfront preparations to ensure implementation success. Organizational readiness is therefore regarded as a critical precondition that increases the chances of IT implementation success. To deepen the theoretical understanding of the link between organizational readiness and IT implementation success, we present preliminary results of a qualitative survey among a group of seasoned IT project/change management experts and derive a theoretical framework explaining the link between the two constructs