BMC Med Inform Decis Mak - Understanding managerial behaviour during initial steps of a clinical information system adoption.

Tópicos

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Resumo

CKGROUND: While the study of the information technology (IT) implementation process and its outcomes has received considerable attention, the examination of pre-adoption and pre-implementation stages of configurable IT uptake appear largely under-investigated. This paper explores managerial behaviour during the periods prior the effective implementation of a clinical information system (CIS) by two Canadian university multi-hospital centers.METHODS: Adopting a structurationist theoretical stance and a case study research design, the processes by which CIS managers' patterns of discourse contribute to the configuration of the new technology in their respective organizational contexts were longitudinally examined over 33 months.RESULTS: Although managers seemed to be aware of the risks and organizational impact of the adoption of a new clinical information system, their decisions and actions over the periods examined appeared rather to be driven by financial constraints and power struggles between different groups involved in the process. Furthermore, they largely emphasized technological aspects of the implementation, with organizational dimensions being put aside. In view of these results, the notion of 'rhetorical ambivalence' is proposed. Results are further discussed in relation to the significance of initial decisions and actions for the subsequent implementation phases of the technology being configured.CONCLUSIONS: Theoretical and empirically grounded, the paper contributes to the underdeveloped body of literature on information system pre-implementation processes by revealing the crucial role played by managers during the initial phases of a CIS adoption.

Resumo Limpo

ckground studi inform technolog implement process outcom receiv consider attent examin preadopt preimplement stage configur uptak appear larg underinvestig paper explor manageri behaviour period prior effect implement clinic inform system cis two canadian univers multihospit centersmethod adopt structurationist theoret stanc case studi research design process cis manag pattern discours contribut configur new technolog respect organiz context longitudin examin monthsresult although manag seem awar risk organiz impact adopt new clinic inform system decis action period examin appear rather driven financi constraint power struggl differ group involv process furthermor larg emphas technolog aspect implement organiz dimens put asid view result notion rhetor ambival propos result discuss relat signific initi decis action subsequ implement phase technolog configuredconclus theoret empir ground paper contribut underdevelop bodi literatur inform system preimplement process reveal crucial role play manag initi phase cis adopt

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