Despite the possible benefits of implementing healthcare information technologies, successful implementation of effective healthcare information technology is constrained by cultural and regulatory concerns and technical obstacles encountered when establishing or upgrading an organisation's enterprise infrastructure. In this paper, we advance Ross' four-stage model of enterprise architecture maturity as a valuable IT resource for helping healthcare organisations sustain a competitive advantage. We use partial least squares (PLS) structural equation modelling to analyse survey data from 164 US hospitals at different stages of EA maturity. Our results provide evidence that enterprise architecture maturity directly influences the effectiveness of hospitals' IT resources for achieving strategic goals. Further, enterprise architecture maturity indirectly influences the effectiveness of IT resources when IT alignment is incorporated as a mediating variable. We discuss the implications of our findings for research and practice and suggest opportunities for future research.

Intense pressure to control costs and improve patient care quality is driving hospitals to increasingly look to information technology (IT) for solutions. As IT investment and IT capability have grown in hospitals, the need to manage IT resources aggressively has also increased. The rise in complexity and sophistication of the IT capability in hospitals has also increased the importance of IT governance in these organizations. Yet, there is limited empirical data about the antecedents and consequences of IT governance. We draw upon extant literature related to power and politics and capability management to propose, operationalize, and empirically examine a nomological model that explains and predicts IT governance and its ensuing impact on risk management and IT contribution to hospital performance. We empirically tests our hypotheses based on survey data gathered from 164 CIOs of US hospitals. The results have implications for hospitals’ readiness and predisposition for IT governance, as their structural and relational mechanisms can affect IT governance and, indirectly, IT value creation. A contribution of this study is that it is one of the first to empirically examine antecedents to IT governance and its impact on IT performance in a high-velocity environment that is riddled with technological turbulence.

This study employs a multiple respondent research technique to assess the efficacy of a framework intended to improve the quality of healthcare provided to patients. We use survey data from 78 matched respondents to answer the question to what extent does IT capability intentions affect a hospital's ability to detect and reduce clinical errors. We investigate empirically the impact of IT capability intentions and IT infrastructure integration on elements of IT-enabled quality of care. Our findings position IT capability intentions as an antecedent to IT infrastructure integration and suggest IT infrastructure integration is the key component in overcoming a highly fragmented delivery system. The degree of IT infrastructure integration has significant effects on quality of care, in terms of both patient-centric responsiveness and error detection and reduction.

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