Hospital Information Systems Replacement and Healthcare Quality

Background

Research in Information Systems Replacement appears with many different terms in the literature such as software evolution, software maintenance, information system replacement etc. When talking about IS replacement, software is the first factor that comes into mind (Ng et al., 2002). Deprecated operating systems, software programs with inflexible user interfaces and legacy drivers that do not support new hardware and communication protocols, are some of the issues that a IS replacement analysis must examine and solve.

Apart from software, information systems also include people, procedures, data and hardware that gather and process digital information (Jessup & Valacich, 2008). As a consequence, a complete study on IS replacement must also focus on inflexible procedures, legacy hardware, data formats and communication protocols, which are not in use any more, and people who cannot further support the IS operation and need further training (Gupta & Raghunathan, 1988). The critical question that every replacement model tries to answer is: ‘Maintain or Replace?’ According to Gupta and Raghunathan (1988), system software maintenance includes defects’ correction, design enhancements and modifications to the system's behavior. These maintenance actions affect the overall operation of the information system and propagate to all the other participants of the IS (hardware, people, data and procedures). The analysis of the maintenance cost (Lucas, 1975) and the justification of a replacement decision according to financial criteria (maintenance costs compared to the cost of investment in replacement and the expected return) is a difficult and complicated operation, which takes into account several factors (Bacon, 1992; Renkema, & Berghout, 1997).