Organizational Factors: Their Role in Health Informatics Implementation

Organizational Factors: Their Role in Health Informatics Implementation

Michelle Brear (University of New South Wales, Australia)
Copyright: © 2009 |Pages: 8
DOI: 10.4018/978-1-60566-078-3.ch016
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Abstract

The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health specific research, informed by a larger body of evidence emerging from interdisciplinary organizational, psychological and sociological research, has confirmed the view that organizational factors can be the decisive factor in the success of an intervention (Lorenzi et al, 1997). However it remains rare for organizational factors to be explicitly addressed in the implementation process. As such their contribution to the success or failure of informatics applications is not properly understood. This has implications for future interventions. Applications which were not utilized or did not perform adequately in a particular setting may be dismissed, while other, less appropriate systems may be adopted because organizational factors influenced their success. Explicit study of the role of organizational factors on the implementation of health informatics interventions is necessary to develop an understanding of their influence in the healthcare context. Healthcare organizations tend to be highly task oriented, labor intensive and dependent on interdisciplinary teamwork, so the influence of organizational factors within them may differ considerably from the business settings in which they have traditionally been studied (Chau, 2001). Health organisations are also increasingly underresourced due to the global downturn in government social spending, health sector privatization and aging populations. It is these characteristics which necessitate rapid uptake of informatics applications, capable of automating aspects of healthcare provision and reducing labor intensity (Coiera, 2004). From a technical perspective, rapid and fundamental transformation of the healthcare sector through informatics is achievable. However, without a clear understanding of, and ability to manage organizational factors it is unlikely that informatics applications will realize their potential in the health sector. This short review provides an overview of the key organizational factors influencing the success of informatics interventions. It begins by positioning informatics interventions in the broader context of organizational change, before discussing the current understanding of selected factors.
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Informatics Implementation As Organizational Change

Implementing informatics applications is essentially “a politically textured process of organizational change” (Berg, 1999, p87), aimed at achieving user acceptance and utilization of informatics applications. Organizational change requires people to be aware of a need for change, identify a particular course through which the change can occur and take actions to make it happen (Lorenzi, 2004). Resistance to change occurs if users are not aware of the need for change, not convinced of the course of action set out or unable to carry out the necessary action. It is the users, not the technology that should be the centre of the change process, as the decision to utilise the system is ultimately theirs (Berg, 1999).

Even the best-designed and well-intentioned informatics interventions are likely to lead to productivity losses in the early stages and create major changes (Lorenzi, 2004). Timely and effective training of users can reduce the disruption, however is not enough to ensure success as even a correctly used system can have far reaching effects. Informaticians taking a ‘socio-technical’ approach, view the application as one component of a complex system, the health organisation, whose introduction will disrupt other components of the system (e.g. patients and clinicians). They advocate design approaches which aim to create technology which ‘fits’ within the complex system (Kaplan, 2001).

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Editorial Advisory Board
Table of Contents
Foreword
Neil Pattison
Preface
Emma Parry, David Parry
Acknowledgment
Emma Parry, David Parry
Chapter 1
Peter Stone
Improving women’s health is a vital task for the world. The consequences of obstetric and gynecological disease are serious both for the women... Sample PDF
An Introduction to Women's Health and Informatics
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Chapter 2
Premila Fade
Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are... Sample PDF
Women's Health Informatics: The Ethical and Legal Issues
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Chapter 3
David Parry
Recording information about symptoms, observations, actions, and outcomes is a key task of health informatics. Standardization of records is vital... Sample PDF
Coding and Messaging Systems for Women's Health Informatics
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Chapter 4
Gareth Parry
Women’s health in primary care is a large part of the generalist’s practice. Information technology (IT) is now an integral part of the generalist’s... Sample PDF
Women's Health Informatics in the Primary Care Setting
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Chapter 5
Emma Parry
The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is... Sample PDF
The Electronic Health Record to Support Women's Health
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Chapter 6
Graham Parry
Information technology and communication systems have made imaging in women’s health easier at many levels. There are now many commercial systems on... Sample PDF
Imaging and Communication Systems in Obstetrics and Gynecology
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Chapter 7
Emma Parry
Pregnancy is unique in medicine in providing a discrete event with a fixed end. It is well suited to data collection and statistical assessment.... Sample PDF
Statistical Measures in Maternity Care
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Chapter 8
Kiran Massey, Tara Morris, Robert M. Liston
Our ultimate goal as obstetric and neonatal care providers is to optimize care for mothers and their babies. As such, we need to identify practices... Sample PDF
Building Knowledge in Maternal and Infant Care
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Chapter 9
Malcolm Battin, David Knight, Carl Kuschel
Neonatal care is an extremely data-intensive activity. Physiological monitoring equipment is used extensively along with web-based information tools... Sample PDF
Informatics Applications in Neonatology
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Chapter 10
Jenny Westgate
During pregnancy the fetus requires an adequate supply of oxygen and clearance of carbon dioxide which is a waste product of metabolism. In fetal... Sample PDF
Computerizing the Cardiotocogram (CTG)
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Chapter 11
Liron Pantanowitz
Automation and emerging information technologies are being adopted by cytology laboratories around the world to augment Pap test screening and... Sample PDF
Computer Assisted Cervical Cytology
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Chapter 12
Laurie Elit, Susan Bondy, Michael Fung-Kee-Fung, Prafull Ghatage, Tien Le, Barry Rosen, Bohdan Sadovy
Ovarian cancer affects 2,400 women annually in Canada with a case fatality ratio of 0.70. There are several practice guidelines that indicate women... Sample PDF
Informatics and Ovarian Cancer Care
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Chapter 13
Jamila Abuidhail
Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare... Sample PDF
Women's Health and Health Informatics: Perinatal Care Health Education
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Chapter 14
Shona Kirtley
In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health... Sample PDF
Electronic Information Sources for Women's Health Knowledge for Professionals
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Chapter 15
David Parry
Decision analysis techniques attempt to utilize mathematical data about outcomes and preferences to help people make optimal decisions. The... Sample PDF
Computerised Decision Support for Women's Health Informatics
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Chapter 16
Michelle Brear
The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health... Sample PDF
Organizational Factors: Their Role in Health Informatics Implementation
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Chapter 17
Josipa Kern
When things go well then often it is because they conform to standards (ISO, 2005). According to the Oxford Dictionary of Modern English, there is a... Sample PDF
Standardization in Health and Medical Informatics
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Chapter 18
Elske Ammenwerth, Stefan Gräber, Thomas Bürkle, Carola Iller
This chapter summarizes the problems and challenges which occur when health information systems are evaluated. The main problem areas presented are... Sample PDF
Evaluation of Health Information Systems: Challenges and Approaches
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Chapter 19
Pirkko Nykänen
eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health... Sample PDF
eHealth Systems, Their Use and Visions for the Future
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Chapter 20
Nilmini Wickramasinghe, Santosh Misra, Arnold Jenkins, Douglas R. Vogel
Superior access, quality and value of healthcare services has become a national priority for healthcare to combat the exponentially increasing costs... Sample PDF
The Competitive Forces Facing E-Health
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About the Contributors