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Changing Healthcare Institutions with Large Information Technology Projects

Changing Healthcare Institutions with Large Information Technology Projects
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Author(s): Matthew Waritay Guah (Erasmus University Rotterdam, The Netherlands)
Copyright: 2007
Pages: 5
Source title: Managing Worldwide Operations and Communications with Information Technology
Source Editor(s): Mehdi Khosrow-Pour, D.B.A. (Information Resources Management Association, USA)
DOI: 10.4018/978-1-59904-929-8.ch193
ISBN13: 9781599049298
EISBN13: 9781466665378

Abstract

This paper reviews the development of institutional theory in direct relations to historical changes within the UK’s National Health Service (NHS) with an eye to contributing to the theoretical specification of social information processes. This is done partly by extending certain paradigms (see Powell & DiMaggio, 1991; Meyer & Rowan, 1977; Tolbert & Zucker, 1994) through a proposed model of causes and consequences of variations in levels of institutionalisation in the healthcare sector. It reports findings from a three-year study on the NHS implementation of the largest civil information systems worldwide at an estimated cost of $10 billion over a ten-year period. The theoretical basis for analysis is developed, using concepts drawn from “IT conversion effectiveness”, “productivity increases”, realization of business value”, and “organisational performance improvements”, as well as mixed empirical results about the lack of IT investments value in the NHS. The findings suggest that large-scale IT change imposed upon a highly institutionalised healthcare is fraught with difficulty mainly because culturally embedded norms, values and behavioural patterns serve to impede centrally imposed initiatives to automate clinical working practices. It concludes with discussion about the nature of evaluation procedures in relation to the process of institutionalizing IS in healthcare.

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