Barriers to the adoption of health information technology

Information Technology (IT) is successfully applied in a diverse range of fields. Though, the field of Medical Informatics is more than three decades old, it shows a very slow progress compared to many other fields in which the application of IT is growing rapidly. The spending on IT in health care is shooting up but the road to successful use of IT in health care has not been easy. This paper discusses about the barriers to the successful adoption of information technology in clinical environments and outlines the different approaches used by various countries and organisations to tackle the issues successfully. Investing financial and other resources to overcome the barriers for successful adoption of HIT is highly important to realise the dream of a future healthcare system with each customer having secure, private Electronic Health Record (EHR) that is available whenever and wherever needed, enabling the highest degree of coordinated medical care based on the latest medical knowledge and evidence. Arguably, the paper reviews barriers to HIT from organisations’ alignment in respect to the leadership; with their stated values when accepting or willingness to consider the HIT as a determinant factor on their decision-making processes. However, the review concludes that there are many aspects of the organisational accountability and readiness to agree to the technology implementation.

Health informatics domain knowledge analysis : an information technology perspective

Health Informatics is an intersection of information technology, several disciplines of medicine and health care. It sits at the common frontiers of health care services including patient centric, processes driven and procedural centric care. From the information technology perspective it can be viewed as computer application in medical and/or health processes for delivering better health care solutions. In spite of the exaggerated hype, this field is having a major impact in health care solutions, in particular health care deliveries, decision making, medical devices and allied health care industries. It also affords enormous research opportunities for new methodological development. Despite the obvious connections between Medical Informatics, Nursing Informatics and Health Informatics, most of the methodologies and approaches used in Health Informatics have so far originated from health system management, care aspects and medical diagnostic. This paper explores reasoning for domain knowledge analysis that would establish Health Informatics as a domain and recognised as an intellectual discipline in its own right.

On managing information technology capabilities

Information technology (IT) plays a critical role of enabler of activities that improve the performance of business processes. This enabling role of IT resources means continuous investment in IT is a strategic necessity. It is established that organizations’ IT-related capabilities leverage the enabling potential of IT resources. Today’s turbulent and challenging business environment requires organizations to do more from their existing and newly acquired IT resources. To achieve this, organizations need to discover ways or establish environments to nourish their existing IT-related capabilities, and develop new IT-related capabilities. We suggest one such environment, a dynamic IT-learning environment that could contribute to nourishing existing IT-related capabilities, and developing new IT-related capabilities. This environment is a product of coordination of four organizational factors that relate to the ways in which IT-related knowledge is applied to business processes, the accompanying reward structures, and ways in which the IT-related learning and knowledge is shared within the organization. Using 216 field survey responses, this paper shows that two IT-related capabilities of top management commitment to IT initiatives, and shared organizational knowledge between the IT and business unit managers has a stronger positive influence on business process performance in the presence of this dynamic IT-learning environment. The study also shows that a marginal IT-related capability, technical IT skills, has a positive and significant influence on business process performance in the presence of this environment. These outcomes imply that organizations’ internal environments could contribute to the management of their IT-related capabilities.

Information technology investment governance: What is it and does it matter?

While the growth in the number of IT investments remains strong, research in the IT investment field is limited, resulting in suboptimal practical guidance on effectively governing IT investments. Based on resource-based theory, this paper reports the initial work involved in developing a construct names IT investment governance (ITIG), because it can be used to measure organizations' capability to govern their IT investments. This paper then empirically examines the association of ITIG and corporate performance. The preliminary result is a four-factor, 16-item instrument for assessing the ITIG construct. This method's factors are IT investment value governance, IT investment value monitoring, IT investment appraisals and IT investment project management. The impact of ITIG on corporate performance was demonstrated with a significant and positive relationship found to exist between the ITIG construct and corporate performance, thus supporting the effectiveness of the ITIG construct. Corporations with higher levels of ITIG capability are more likely to maximize the contribution of their IT investments to firm value.

Information technology and its changing roles to economic growth and productivity in Australia

In this paper we describe our investigation of the role of investment in information technology (IT) on economic output and productivity in Australia over a period of about four decades. The framework used in this paper is the aggregate production function, where IT capital is considered as a separate input of production along with non-IT capital and labour. The empirical results from the study indicate the evidence of robust technical progress in the Australian economy in the 1990s. IT capital had a significant impact on output, labour productivity and technical progress in the 1990s. In recent years, however, the contribution of IT capital on output and labour productivity has slowed down. Regaining the IT capital productivity therefore remains as a key challenge for Australia, especially in the context of greater IT investment in the future.

On information technology competencies for collaborative organizational structures

There is an uptake of organizations involvement in collaborative organizational structures (COS). As the nature and level of information technology (IT) investment in COS will be similar, the COS IT competencies will leverage the IT investments to create the collaborative rent generating potential of the COS, which would then improve the business value of the COS members. Consistent with the resource-centric views of the firm, we suggest that the COS members need to contribute their managed IT competencies to their COS, whose synergies would create COS IT competencies. We suggest three key IT competencies for COS; proactive top management decision synergy, collaborative and agile IT infrastructure, and cross-functional tactical management synergy. Using survey data, we find evidence of a positive association between these COS IT competencies and the collaborative rent generating potential of the COS. We also find a positive association between the collaborative rent generating potential of the COS and the business value of the COS members. The results suggest that developing COS IT competencies add value to a COS and its members. This study provides guidance for organizations looking to leverage their involvement in a COS.

Information Technology in Construction – Domain Definition and Research Issues

This article discusses the scope of research on the application of information technology in construction (ITC). A model of the information and material activities which together constitute the construction process is presented, using the IDEF0 activity modelling methodology. Information technology is defined to include all kinds of technology used for the storage, transfer and manipulation of information, thus also including devices such as copying machines, faxes and mobile phones. Using the model the domain of ITC research is defined as the use of information technology to facilitate and re-engineer the information process component of construction. Developments during the last decades in IT use in construction is discussed against a background of a simplified model of generic information processing tasks. The scope of ITC is compared with the scopes of research in related areas such as design methodology, construction management and facilities management. Health care is proposed as an interesting alternative (to the often used car manufacturing industry), as an IT application domain to compare with. Some of the key areas of ITC research in recent years; expert systems, company IT strategies, and product modelling are shortly discussed. The article finishes with a short discussion of the problems of applying standard scientific methodology in ITC research, in particular in product model research.

The Electronic Journal of Information Technology in Construction (ITcon): An Open Access Journal Using an Un-paid, Volunteer-Based Organization

Introduction This case study is based on the experiences with the Electronic Journal of Information Technology in Construction (ITcon), founded in 1995. Development This journal is an example of a particular category of open access journals, which use neither author charges nor subscriptions to finance their operations, but rely largely on unpaid voluntary work in the spirit of the open source movement. The journal has, after some initial struggle, survived its first decade and is now established as one of half-a-dozen peer reviewed journals in its field. Operations The journal publishes articles as they become ready, but creates virtual issues through alerting messages to “subscribers”. It has also started to publish special issues, since this helps in attracting submissions, and also helps in sharing the work-load of review management. From the start the journal adopted a rather traditional layout of the articles. After the first few years the HTML version was dropped and papers are only published in PDF format. Performance The journal has recently been benchmarked against the competing journals in its field. Its acceptance rate of 53% is slightly higher and its average turnaround time of seven months almost a year faster compared to those journals in the sample for which data could be obtained. The server log files for the past three years have also been studied. Conclusions Our overall experience demonstrates that it is possible to publish this type of OA journal, with a yearly publishing volume equal to a quarterly journal and involving the processing of some fifty submissions a year, using a networked volunteer-based organization.

Information Technology Development Needs in Community Pharmacies : A Strategic Approach

In the context of health care, information technology (IT) has an important role in the operational infrastructure, ranging from business management to patient care. An essential part of the system is medication management in inpatient and outpatient care. Community pharmacists strategy has been to extend practice responsibilities beyond dispensing towards patient care services. Few studies have evaluated the strategic development of IT systems to support this vision. The objectives of this study were to assess and compare independent Finnish community pharmacy owners and staff pharmacists priorities concerning the content and structure of the next generation of community pharmacy IT systems, to explore international experts visions and strategic views on IT development needs in relation to services provided in community pharmacies, to identify IT innovations facilitating patient care services and to evaluate their development and implementation processes, and to assess community pharmacists readiness to adopt innovations. This study applied both qualitative and quantitative methods. A qualitative personal interview of 14 experts in community pharmacy services and related IT from eight countries and a national survey of Finnish community pharmacy owners (mail survey, response rate 53%, n=308), and of a representative sample of staff pharmacists (online survey, response rate 22%, n=373) were conducted. Finnish independent community pharmacy owners gave priority to logistical functions but also to those related to medication information and patient care. The managers and staff pharmacists have different views of the importance of IT features, reflecting their different professional duties in the community pharmacy. This indicates the need for involving different occupation groups in planning the new IT systems for community pharmacies. A majority of the international experts shared the vision of community pharmacy adopting a patient care orientation; supported by IT-based documentation, new technological solutions, access to information, and shared patient data. Community pharmacy IT innovations were rare, which is paradoxical because owners and staff pharmacists perception of their innovativeness was seen as being high. Community pharmacy IT systems development processes usually had not undergone systematic needs assessment research beforehand or evaluation after the implementation and were most often coordinated by national governments without subsequent commercialization. Specifically, community pharmacy IT developments lack research, organization, leadership and user involvement in the process. Those responsible for IT development in the community pharmacy sector should create long-term IT development strategies that are in line with community pharmacy service development strategies. This could provide systematic guidance for future projects to ensure that potential innovations are based on a sufficient understanding of pharmacy practice problems that they are intended to solve, and to encourage strong leadership in research, development of innovations so that community pharmacists potential innovativeness is used, and that professional needs and strategic priorities will be considered even if the development process is led by those outside the profession.

Technology management - Structuring the strategic dialogue

Successful innovation requires effective communication within and between technical and nontechnical communities, which can be challenging due to different educational backgrounds, experience, perceptions, and attitudes. Roadmapping has emerged as a method that can enable effective dialogue between these groups, and the way in which information is structured is a key feature that enables this communication. This is an area that has not received much attention in the literature, and this article seeks to address this gap by describing in detail the structures that have been successfully applied in roadmapping workshops and processes, from which key learning points and future research directions are identified.

Building the single market with information technology - lessons from a transnational IT implementation

The subject company operates in a vigorously growing sector of the packaging market, with plants in most European countries. But could this disparate business function as a single company in a single (European) market? This article sets out some lessons learned from a pilot transnational implementation of a strategic management information system, designed to counter entrenched national business thinking in one European company and its subsidiaries.

Making sense of health information technology implementation: A qualitative study protocol.

BACKGROUND: Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff members observe and make sense of unexpected disruptions in care. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning, and effective problem solving -- strategies that studies have linked to successful change. Project teamwork is a change strategy increasingly used by hospitals that facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. METHODS: In this longitudinal case study, we aim to examine project teams' sensemaking and action as the team prepares to implement new information technology in a tiertiary care hospital. Based on management and healthcare literature on HIT implementation and project teamwork, we chose sensemaking as an alternative to traditional models for understanding organizational change and teamwork. Our methods choices are derived from this conceptual framework. Data on project team interactions will be prospectively collected through direct observation and organizational document review. Through qualitative methods, we will identify sensemaking patterns and explore variation in sensemaking across teams. Participant demographics will be used to explore variation in sensemaking patterns. DISCUSSION: Outcomes of this research will be new knowledge about sensemaking patterns of project teams, such as: the antecedents and consequences of the ongoing, evolutionary, social process of implementing HIT; the internal and external factors that influence the project team, including team composition, team member interaction, and interaction between the project team and the larger organization; the ways in which internal and external factors influence project team processes; and the ways in which project team processes facilitate team task accomplishment. These findings will lead to new methods of implementing HIT in hospitals.