Hospital Information Systems Replacement and Healthcare Quality

Hospital Information Systems Replacement and Healthcare Quality

Anargyros Chryssanthou (Hellenic Data Protection Authority, Greece), Iraklis Varlamis (Harokopio University of Athens, Greece), John Constantine Sarivougioukas (Social Insurance Institute IKA, Greece) and Ioannis Apostolakis (National School of Public Health, Greece)
Copyright: © 2012 |Pages: 12
DOI: 10.4018/ijrqeh.2012070101
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The aim of this paper is to develop a methodology for deciding when a Hospital Information System (HIS) must be replaced and in addition to discuss how the decision for system replacement affects the quality of healthcare services. In the hypothesis, the Hospital IS has been in operation for a period of time and the Hospital managers have to choose between the replacement with a new Information System (IS) and the continuation of its use. Leaving aside the economic factors concerning the return of a possible investment, the decision is still difficult and will be based on scientific and technological factors. The proposed methodology employs confidential information from the Hospital, which relates to the system operation and usability, the satisfaction of doctors and patients, etc. It also examines the entire working environment and common factors that affect the choice of Hospital managers (e.g., financial constraints).
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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).

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