Challenges to implementing the national programme for information technology (NPfIT): a qualitative study

Hendy, Jane; Reeves, Barnaby C; Fulop, Naomi; Hutchings, Andrew; Masseria, Cristina

doi:10.1136/bmj.331.7512.331

Cited by 159 publications

(140 citation statements)

References 12 publications

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“…As a large-scale IT programme, the NPfIT is consistently missing the original performance targets (Hendy et al, 2005;NAO, 2006). While this is not unusual for IT-enabled projects, the NPfIT is not simply about installing new (NAO, 2006).…”

Section: Discussionmentioning

confidence: 99%

Conflicting Institutional Logics: A National Programme for IT in the Organisational Field of Healthcare

Currie

Guah

2007

Journal of Information Technology

236

220

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This paper reports the findings from a 4-year study on the UK National Health Service on the introduction of a national programme for information technology. 1 This is the largest civil IT programme worldwide at an estimated technical cost of d6.2 billion over a 10-year period. An institutional analysis of our historical and empirical data from six NHS organisations identifies growing fragmentation in the organisational field of healthcare, as past and present institutional logics both fuel and inhibit changes in the governance systems and working practices of healthcare practitioners. This is further complicated by new institutional logics that place the citizen at centre stage of the NPfIT, in a move to promote patient choice and public value.

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Section: Discussionmentioning

confidence: 99%

Conflicting Institutional Logics: A National Programme for IT in the Organisational Field of Healthcare

Currie

Guah

2007

Journal of Information Technology

236

220

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“…The degree to which a "one size fits all" solution can cause local resistance in organisations and individuals who have been used to "locally grown" systems which have high degrees of customization and localization was also highlighted by Hendy et al (42) and Gillies and Patel (43). They found this factor was a significant driver in the development of resistance to new systems by clinicians.…”

Section: Criticism Of Model Applicationmentioning

confidence: 97%

The application of technology acceptance and diffusion of innovation models in healthcare informatics

Ward

2013

Health Policy and Technology

105

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“…To achieve ''buy-in'' from potential IT users, coordination among providers, a formal process to provide technical support for individual users, programs to integrate IT into workflow, and the ability to document system problems and obtain prompt administrator feedback are essential. [59][60][61] Strategies that are related to the people, process, and program dimensions of IT management are further elaborated in Table 4. 2 When interorganizational exchange occurs, IT management needs to focus on secure and affordable information exchange, which requires the adoption of appropriate technology and personnel training.…”

Section: Management and Implementation Strategiesmentioning

confidence: 99%

“…They also need to consider other factors, such as the usability, usefulness, and flexibility of IT tools and individualized training that will influence uptake. [59][60][61] On a system level, a supportive culture, visibility of positive results from IT use, and a realistic timeline will enhance implementation. [59][60][61] Developing and installing feedback and monitoring mechanisms, as IT is being adopted, implemented, and maintained provides opportunities for continual improvement.…”

Section: Management and Implementation Strategiesmentioning

confidence: 99%

“…[59][60][61] On a system level, a supportive culture, visibility of positive results from IT use, and a realistic timeline will enhance implementation. [59][60][61] Developing and installing feedback and monitoring mechanisms, as IT is being adopted, implemented, and maintained provides opportunities for continual improvement. 66 As tools for rapid application development are refined, they will increasingly allow IT infrastructures to be responsive and concentrate on process alignment and incorporation of evidence into practice.…”

Section: Management and Implementation Strategiesmentioning

confidence: 99%

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Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice

2006

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The U.S. health care system is one of the world's most advanced systems. Yet, the health care system suffers from unexplained practice variations, major gaps between evidence and practice, and suboptimal quality. Although information processing, communication, and management are key to health care delivery and considerable evidence links information/communication technology (IT) to improvements in patient safety and quality of care, the health care system has a longstanding gap in its investment. In the Crossing the Quality Chasm and Building a Better Delivery System reports, The Institute of Medicine and National Academy of Engineering identified IT integration as critical to improving health care delivery systems. This paper reviews the state of IT use in the U.S. health care system, its role in facilitating evidence-based practices, and identifies key attributes of an ideal IT infrastructure and issues surrounding IT implementation. We also examine structural, financial, policy-related, cultural, and organizational barriers to IT implementation for evidence-based practice and strategies to overcome them. T he U.S. health care system is a $1.6-trillion industry that is undergoing rapid changes, facing increasing market pressure and competition for scarce resources. 1 The industry involves multiple private and public stakeholders, including provider associations, health care delivery organizations, insurers, consumers, community networks, and local, state, and federal agencies. It is an information intensive industry, 2 and yet it has lagged behind other industries in its investments and use of communication and information technology (IT). [3][4][5] The acquisition and implementation of IT have great implications for the operations of health care organizations because of: (1) rapidly rising health care costs; (2) escalating concerns surrounding issues of patient safety and medical errors; (3) call for improving the provision of evidence-based care; and (4) increasing regulatory requirements. 2,6 In particular, the Institute of Medicine (IOM) and the National Academy of Engineering have identified IT as crucial for building an improved health care delivery system that achieves the 6 health system 21st century attributes of being safe, effective, patientcentered, timely, efficient, and equitable. 3 Industry groups outside of health care, such as the Leapfrog Group, as well as the U.S. government, have encouraged IT investments as a solution to reduce medication errors and patient safety problems. 7-9 IT use has been shown to yield significant improvements in quality, cost containment, and patient safety in several empirical studies. [10][11][12] However, relatively little research has focused on identifying effective approaches for IT implementation and applications in evidence-based practices (EBPs). Evidence-based practice is the process of using current best evidence from well-designed research conscientiously and judiciously, in conjunction with patient values and clinical expertise, to guide health care dec...

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Challenges to implementing the national programme for information technology (NPfIT): a qualitative study

Cited by 159 publications

References 12 publications

Conflicting Institutional Logics: A National Programme for IT in the Organisational Field of Healthcare

Conflicting Institutional Logics: A National Programme for IT in the Organisational Field of Healthcare

The application of technology acceptance and diffusion of innovation models in healthcare informatics

Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice

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