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In Ghana, as with other developing countries, there are several health information technology (HIT) initiatives as interventions to improve healthcare delivery. HIT implementation undoubtedly results in change. However, most studies relating to HIT implementation readiness have constantly neglected the role of change in successfully implementing HIT. This study intends to identify factors affecting successful change management as part of preparation towards successfully implementing HIT in public hospital in Ghana. To carry out this study, we conducted in-depth interviews with a matrix of HIT senior managers and thematically analyzed the data. The data was transcribed and uploaded into a Nvivo 11 software for analysis using thematic analysis techniques. Five (5) themes were discovered. They are: 1) Stakeholder participation; 2) Proof of experience in similar project; 3) Availability of committed change agents/all-levels-change representatives; 4) Clearly articulated change implementation strategy; and 5) Training and improvement mechanism (post-implementation). A fresh call is made for more attention to be paid to change as part of preparatory measures towards the adoption of HIT in Ghana using the five cardinal approaches identified as a guide.

Although resilience is heavily studied in both the healthcare and organizational change literatures, it has received less attention in healthcare information technology (HIT) implementation research. Healthcare organizations are consistently in the process of implementing and updating several complex technologies. Implementations and updates are challenged because healthcare workers often struggle to perceive the benefits of HITs and experience deficiencies in system design, yet bear the brunt of the blame for implementation failures. This combination implores healthcare workers to exercise HIT resilience; however, how they talk about this construct has been left unexplored. Subsequently, this study explores healthcare workers' communicative constitution of HIT resilience.

Twenty-three physicians (N = 23), specializing in oncology, pediatrics or anesthesiology, were recruited from one healthcare organization to participate in comprehensive interviews during and after the implementation of an updated HIT system DIPS.

Thematic analysis findings reveal physicians communicatively constituted HIT resilience as their (1) convictions in the continued, positive developments of newer HIT iterations, which marked their current adaptive HIT behaviors as temporary, and (2) contributions to inter-organizational HIT brainstorming projects in which HIT designers, IT staff and clinicians jointly problem-solved current HIT inadequacies and created new HIT features.

Offering both practical for healthcare leaders and managers and theoretical implications for HIT and resilience scholars, this study's results suggest that (1) healthcare leaders must work diligently to create a culture of collaborative HIT design in their organization to help facilitate the success of new HIT use, and (2) information technology scholars reevaluate the theoretical meaningfulness a technology's spirit and reconsider the causal nature of a technology's embedded structures.

The purpose of this paper is to further adaptive structuration theory (AST) by associating technological appropriations with health information technology workarounds. The author argues that appropriating electronic health record (EHR) technology ironically – in a way other than it is designed to be used – and divergently across an organization results in enhanced perceptions of EHR technology and its implementation.

Data were collected from 345 healthcare employees in a single healthcare organization that was switching to EHRs from paper records. Two major constructs of AST – unfaithfulness and dissension in appropriation – were operationalized and analyzed using multivariate regressions to test the relationship between the type of appropriation and perceptions of EHR technology’s relative advantage and implementation success.

Results reveal that both ironic (unfaithful) technological appropriation and dissension in technological appropriation across the organization predicted employees’ perceptions of EHR’s relative advantage and perceptions of EHR implementation success. Furthermore, physicians are the least likely to perceive EHR’s relative advantage or EHR implementation success. These results exemplify that EHR workarounds are taking place and reaffirm AST’s principle that employees evolve technology to better suit their working environments and preferences.

The survey and scales used in this study further demonstrate that there are meaningful statistical measures to accompany the qualitative methods frequently used in the AST literature. In addition, this paper expands AST research by exploring the positive outcomes that follow ironic and divergent technology appropriations.

Existing research on the organizational implications of the introduction of new information technology (IT) has neglected to focus on the anticipation of organizational change. In this paper, the author examines the extended pre-implementation phase prior to the introduction of the largest-ever health IT (HIT) implementation in Denmark. The purpose of this paper is to expand the conceptualization of organizational change to include the neglected pre-implementation phase preceding large-scale organizational change projects.

The research is based on qualitative data consisting of interviews, documents and observations gathered during a three-year research project in the Danish health sector. An important source of methodical inspiration has been grounded theory, which has allowed the pertinent interview themes to evolve and allowed for the gradual development of a theoretical framework.

The main finding of this paper is that the anticipatory pre-implementation phase is not simply passive waiting time for organizational members. Evidence from a three-year research project demonstrates how organizational members engage in recurring patterns of sensemaking, positioning and scripting of possible futures in preparation for the organizational changes that next generation HIT imposes. The study argues that resistance to organizational change may be better understood as resistance to having to give up institutionalized rights and responsibilities.

The paper offers a conceptual model—the anticipation cycle—that enables the systematic analysis of the relational mechanisms at work when organizational members are preparing for pending organizational change. Early analysis based on the anticipation cycle enables organizations and scholars to bring previously black-boxed anticipatory patterns into the equation of organizational change.

This paper aims to validate an initially developed e-Health readiness assessment model.

The authors thematically analysed an initial qualitative data collected and used the outcome to develop survey instruments for this study. To collect the quantitative data, the authors used the drop and collect survey approach given the research setting. The quantitative data was analysed using factor and regression analyses of SPSS 23 in which hypotheses formulated were tested.

The results suggest that the model [R² = 0.971; F (5, 214) = 1414.303], which is made up of readiness assessment factors (constructs) and measuring tools explain about 97% of the variance of the overall health information technology/e-Health adoption readiness at Komfo Anokye Teaching Hospital. The measuring tools were reliable for assessing the composite variables (constructs): technology readiness; operational resource readiness; organizational and cultural readiness; regulatory and policy readiness; and core readiness, which have significant influence on eHealth adoption readiness assessment..

This study has successfully validated empirically developed eHealth readiness assessment model with complete reliable indicators given that existing eHealth readiness assessment models have not been effective due to a general lack of standard indicators for measuring assessment factors. The study also contributes to the growing research on the adoption of information technology/systems in health-care environment using the Technology–Organization–Environment framework.

This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective “physician e-leadership” (PeL) and implementation of e-health.

The analyzed studies were retrieved with explicit keywords and criteria, including snowball sampling. They were synthesized with existing theoretical models on VT research, healthcare team competencies and medical leadership.

Six domains for further PeL inquiry are delineated: resources, task processes, socio-emotional processes, leadership in VTs, virtual physician-patient relationship and change management. We show that, to date, PeL studies on socio-technical dynamics and their consequences on e-health are found underrepresented in the health literature; i.e. no single empirical, theoretic or conceptual study with a focus on PeL in virtual healthcare work was identified.

E-health practices could benefit from organization-behavioral type of research for discerning effective physicians’ roles and inter-professional relations and their (so far) seemingly modest but potent impact on e-health developments.

Although best practices in e-health care have already been identified, this paper shows that physicians’ roles in e-health initiatives have not yet received any in-depth study. This raises questions such as are physicians not yet sufficiently involved in e-health? If so, what (dis)advantages may this have for current e-health investments and how can they best become involved in (leading) e-health applications’ design and implementation in the field?

If effective medical leadership is being deployed, e-health effectiveness may be enhanced; this new proposition needs urgent empirical scrutiny.

The health-care industry has multiple stakeholders, with knowledge dispersed among clinicians, experts and patients and their families. As the adoption of health-care information technologies (HITs) depends on multiple factors, this study aims to uncover the motivators for adopting them.

The study considers 391 respondents, representing the health-care sector, to evaluate the motivators for adopting HITs for better-dispersed knowledge management. The authors analyze the responses using exploratory factor analysis (EFA) to identify the actual structure of the factors, followed by confirmatory factor analysis (CFA).

EFA categorized the factors into four classes: quality management; information sharing; strategic governance; and available technological infrastructure. CFA revealed that the strategic governance factor is most predictive of successfully adopting HITs that model the normative pressure of Institutional theory in health-care organizations. These results indicate that, along with considerations of finances, care quality and infrastructure, effective government involvement and policy-making are important for successful HIT adoption.

Results reveal that stakeholders’ motivating factors for HIT adoption in a developed economy like the United Arab Emirates are based on considering HITs as a knowledge management mechanism. These factors may help other nations in HIT implementation and drive valuable innovations in the health-care sector. This research presents the implications for health-care professionals and stakeholders in relation to adopting HITs and their role in knowledge flow for efficient care.

HITs offer an affordable and convenient platform for collaboration among diverse teams in the health-care sector. Apart from this, it helps in facilitating an interactive platform for knowledge creation and transfer for the benefit of users and providers.

The purpose of this paper is to investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use.

An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients.

A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users’ expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions.

Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas.

The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population.

Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013).

Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it.

Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses.

ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population.

Using new empirical data, this study increases understanding of the extent of ACOs’ current and developing HIT capabilities to support ongoing care management.