Impact of IT on Health Care Professionals: Changes in Work and the Productivity Paradox

Abstract

Health care organizations are under increasing pressure to become more efficient while at the same time maintaining or improving the quality of care. Information technology (IT), with its potential to increase efficiency, accuracy and accessibility of information, has been expected to play an important role in supporting these changes. We report the impact of patient care information systems on health care professionals in five community hospitals. The study framework incorporated both quality of care in Donabedian's elements of structure-process-outcome and Grusec's three levels of IT impact: direct substitution, proceduralization and new capabilities. The study results suggest that, for specific tasks, IT increased efficiency and productivity--a single employee was able to complete more tasks. However, this produced other consequences not predicted. Participants noted this change did not 'free up time' to spend with patients, but meant there were potentially more opportunities to provide services and more tasks to complete. Other effects included: reduced job satisfaction as more time was spent on the computer; less frequent interactions with patients and for shorter duration; and an increasingly 'visible' accountability as performance was easily monitored. There were also changes in roles and responsibilities as the computer enabled tasks to be carried out from a number of locations and by a variety of personnel. When innovations are introduced into organizations there are both expected and unexpected consequences. Increased awareness of the interactive relationship between computer users and the technology helps organizations better understand why results do, or do not, occur. One must look beyond just simply increasing productivity by replacing manual tasks with automated ones, to examining how the changes influence the nature of work and relationships within the organization.

Mapping innovation dynamics in hospitals

“…They include the nature of innovation (with a particular distinction being made between hybrid medical technologies and the NICTs that make remote diagnosis and treatment possible) and the diffusion of IT and its impact on the quality of healthcare and on well-being, job quality, skills and productivity (Stanback, 1987 ;Herbst et al, 1989 ;Fuchs, 1990 ;Anderson et Aydin, 1997 ;Hebert, 1998 ;Lau et al, 1998 ;Rigby, 1999 ;Dixon, 1999 ;Burke and Menachemi, 2004).…”

The effect of information technology on hospital performance

“…Since that time, much progress has been made in our understanding of how HIT affects productivity. Research suggests that health care professionals are able to accomplish more tasks, yet unintended consequences, such as decreased time in patient care services and patient satisfaction, were found [29]. Thus, keeping up with the pace of HIT is not advantageous if links to quality of care are not established.…”

Mobile Support for Community Healthcare

“…Some examples given of technology performing in such a paradoxical manner include car brakes which are designed to slow cars down, and yet the more effectively brakes perform, the faster people drive their cars; antibiotics used to kill pathogens and reduce disease actually result in pathogens evolving into stronger stains resistant to antibiotics; heroin was recommended as a cure for morphine addiction but turned out to generate an even bigger addiction problem. (Arnold 2003, p234) The concept of a technology paradox within the health service has been previously identified by Hebert (1998) while investigating healthcare provision in 5 community hospitals. As Hebert noted "results suggest that, for specific tasks, IT increased efficiency and productivity -a single employee was able to complete more tasks.…”