Investigating the roots of successful IT adoption processes - an empirical study exploring the shared awareness-knowledge of Directors of Nursing and Chief Information Officers

Abstract

BackgroundThe majority of health IT adoption research focuses on the later stages of the IT adoption process: namely on the implementation phase. The first stage, however, which is defined as the knowledge-stage, remains widely unobserved. Following Rogers’ Diffusion of Innovation Theory (DOI) this paper presents a research framework to examine the possible lack of shared IT awareness-knowledge, i.e. an information gradient, of two crucial stakeholders, the Chief Information Officer (CIO) and the Director of Nursing (DoN). This study shall answer the following research questions: (1.) Does this gradient exist? (2.) Which direction does it have? (3.) Are certain health IT (HIT) attributes associated with a potential gradient? (4.) Which determinants of diffusion go along with this gradient?MethodResults of two surveys that focused on the topic “IT support of clinical workflows” from the viewpoint of CIOs and DoNs with corresponding datasets from 75 hospitals were used in a secondary data analysis. The gradient was operationalised by measuring the disagreement of CIOs and DoNs on the availability and implementation status of 29 IT functions. HIT attributes tested were relevance and market penetration of the IT functions, determinants of diffusion were inter-professional leadership and IT service density.ResultsThe analysis revealed a significant disagreement on the availability of 9 out of 29 HIT functions. In 23 HIT functions, the CIOs reported a higher implementation status than the DoNs, which pointed to a trend for a unidirectional gradient. The disagreement was significantly lower when the relevance of the IT function was high. Both determinants of diffusion correlated significantly negative with the degree of disagreement.ConclusionThis is the first study to empirically examine shared awareness-knowledge of two IT-stakeholders that are crucial for triggering IT adoption on the frontline level in hospitals. It could be shown that a gradient and thus a lack of shared awareness-knowledge existed and was associated with certain factors. In conclusion, hospitals should implement improved cooperation between IT staff and clinicians and IT service density when establishing the prerequisites for successful IT adoption processes.

Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

“…Interpersonal connections are also critical for creating the necessary trust in innovation [50]. Yet, the health and social care system in England has been characterised as one that is rich in isolated clusters in need of connectivity [51].…”

Leadership in Digital Health Services: Protocol for a Concept Analysis

“…Nurses and physician leaders working in middle management also play an important role in implementing HIT [ 14 ], and senior nurses and physician managers seem to be responsible for making decisions about obtaining new HIT [ 30 , 53 ]. Collaborations between nurse leaders and chief information officers have also been scrutinized [ 50 , 54 ]. Overall, leadership in digital health services seems to require interprofessional and intersectoral collaboration involving working together with other health care leaders, chief information managers, health care professionals, research and educational centers, and HIT vendors [ 14 , 50 , 54 , 55 ].…”

“…Collaborations between nurse leaders and chief information officers have also been scrutinized [ 50 , 54 ]. Overall, leadership in digital health services seems to require interprofessional and intersectoral collaboration involving working together with other health care leaders, chief information managers, health care professionals, research and educational centers, and HIT vendors [ 14 , 50 , 54 , 55 ].…”

Leadership in Digital Health Services: Protocol for a Concept Analysis (Preprint)

“…Nurses and physician leaders working in middle management also play an important role in implementing HIT [14], and senior nurses and physician managers seem to be responsible for making decisions about obtaining new HIT [30,53]. Collaborations between nurse leaders and chief information officers have also been scrutinized [50,54]. Overall, leadership in digital health services seems to require interprofessional and intersectoral collaboration involving working together with other health care leaders, chief information managers, health care professionals, research and educational centers, and HIT vendors [14,50,54,55].…”

“…Collaborations between nurse leaders and chief information officers have also been scrutinized [50,54]. Overall, leadership in digital health services seems to require interprofessional and intersectoral collaboration involving working together with other health care leaders, chief information managers, health care professionals, research and educational centers, and HIT vendors [14,50,54,55].…”