“Doctors Do Too Little Technology”: A Longitudinal Field Study of an Electronic Healthcare System Implementation

Abstract

W ith the strong ongoing push toward investment in and deployment of electronic healthcare (e-healthcare) systems, understanding the factors that drive the use of such systems and the consequences of using such systems is of scientific and practical significance. Elaborate training in new e-healthcare systems is not a luxury that is typically available to healthcare professionals-i.e., doctors, paraprofessionals (e.g., nurses) and administrative personnel-because of the 24 × 7 nature and criticality of operations of healthcare organizations, especially hospitals, thus making peer interactions and support a key driver of or barrier to such e-healthcare system use. Against this backdrop, using social networks as a theoretical lens, this paper presents a nomological network related to e-healthcare system use. A longitudinal study of an e-healthcare system implementation, with data gathered from doctors, paraprofessionals, administrative personnel, patients, and usage logs lent support to the hypotheses that: (1) ingroup and outgroup ties to doctors negatively affect use in all user groups; (2) ingroup and outgroup ties to paraprofessionals and administrative personnel positively affect use in both those groups, but have no effect on doctors' use; and (3) use contributes positively to patient satisfaction mediated by healthcare quality variables-i.e., technical quality, communication, interpersonal interactions, and time spent. This work contributes to the theory and practice related to the success of e-healthcare system use in particular, and information systems in general.

Contextual Factors Influencing Health Information Systems Implementation in Public Sector – Investigating the Explanatory Power of Critical Success Factors

“…A similar discussion about the importance of the context in HIS implementation is emphasized by Yusof et al [32], who suggest an evaluation model for HIS that focus alignment between human, organization and technology. Important conditions for and barriers to the adoption of healthcare technology is also investigated and discussed [10], [28]. Despite Heeks' [13] call for studies of failures, we take a successful case as our point of departure in this paper, as we aim to compare this case and the reasons we find to explain the success with existing knowledge on CSFs.…”

Gestão do Conhecimento no Âmbito da Administração Hospitalar: Proposta de Modelo Conceitual Integrativo para Gestão do Corpo Clínico

“…Os médicos, especificamente, apresentando grande conhecimento tácito, apresentam também grande resistência à implantação de sistemas de suporte à decisão clínica (Venkatesh, Zhang & Sykes, 2011).…”

Health Care Information Systems: Architectural Models and Governance

“…The professional-driven and hierarchical nature of health care organizations: one of the barriers to the full exploitation of all the potential associated with health information systems is that powerful actors in care delivery often resist technology (IHCO, 2011;Kane & Labianca, 2011). Given the hierarchical nature of health care (Fichman et al, 2011), aversion to technology by an influential physician is likely to irremediably affect other caregivers' behaviours (Venkatesh et al, 2011;IHCO, 2010). 5.…”

“…Empirical evidence (IHCO, 2008;2009e; as well as literature Venkatesh et al, 2011) emphasize that the low levels of formalization of the governance models of the HISs are greatly affecting the development of the HISs themselves. Low financial support-often pointed out as the main problem by health care CIOs -is mainly a reflection of the low commitment by the majority of the strategic board, which often neither has a clear idea about how ICT can have an impact that goes beyond mere efficiency, nor fosters the pursuit of a clear ICT strategy (Callen et al, 2007).…”