Health Information System Implementation in a Complex Acute Care Environment: A Sociotechnical Analysis

With the increase of information systems in health care, there is a growing need to better understand factors that contribute to the implementation and use of such technology. This secondary analysis explored the implementation of a health information system in a large acute care hospital from the perspective of hospital leadership and the health information system developers. The purpose of this study was to: (a) explore a group of interprofessional leaders’ perceptions of social and technical factors which impacted an HIS implementation within an acute care hospital organization; and, (b) uncover how the various social and technical forces contributed to, or prevented, successful implementation of the HIS in relation to nursing practice and education. A directed content analysis approach was used to obtain an understanding of participants’ perceptions regarding health information system implementation and use. Sittig and Singh’s (2010) sociotechnical framework was chosen as a theoretical framework to guide the analysis of focus group (n=17, in 3 separate groups) and interview data (n=10) from a longitudinal study at an acute care hospital in Ontario, Canada. Several benefits of the health information system implementation were realized including increased organizational transparency regarding patient flow and improved communication among managers and directors. Findings also indicated that implementation was compromised by problems with inaccurate data stemming from poor interoperability with other health information systems, insufficient training, and turnover of leadership during the implementation process. This type of research is important to support future implementation of information and communication technologies and contribute to a growing body of knowledge regarding the implementation of health information systems in complex healthcare environments. The consolidated evidence generated from this content analysis also has implications for the nursing profession and development of clinical practice. Further evaluation measures must be undertaken to more fully understand the role of nurses in health information systems implementation and optimize the use of these technologies in supporting nursing practice and improving patient care

Understanding IS Adoption and Success: Integration of IS Success and Technology Adoption Research

Despite continued research on technology adoption and IS success; there continue to be significant organizational challenges with IT. One reason for this may be the lack of consistent understanding resulting from the fact that there are two dominant research streams in this area – technology adoption research (TAR) and IS Success research (ISSR) – which have insufficient dialogue between them. TAR and ISSR offer complementary perspectives of IS– adoption does not necessarily mean success, and measurement of system success does not necessarily explain why the system was successful. We examine the relationship between these two research streams using the theory of planned behavior (TPB) from TAR and the IS Success model from ISSR. This paper proposes an integrated model that seeks to improve understanding of IT adoption and success. Our integrated model provides the theoretical strength of the TPB as well as the actionability of IS Success