Understanding variation in subunit adoption of electronic health records: facilitating and constraining configurations of critical dependencies

Marjolein A.G. van Offenbeek, Janita F.J. Vos and Albert Boonstra

European Journal of Information Systems, 2024, vol. 33, issue 2, 221-243

Abstract: This interpretative case study demonstrates how the work system properties and roles of clinical departments are perceived to shape their adoption of an organisation-wide electronic health record. In hospitals, with their heterogeneous and powerful clinical departments, partial or non-adoption by some departments may jeopardise effective overall use. Viewing a hospital’s EHR adoption from a sociotechnical fit perspective, we unravel how clinical departments’ adoption of this organisation-wide system was primarily shaped by their critical work system dependencies rather than their role during its implementation. From the interviewees’ accounts, three orientations emerge: (1) organisation-oriented resulting in unconditional adoption; (2) department-oriented resulting in problematic or delayed adoption with high compromise costs; (3) environment-oriented resulting in at least partial non-adoption or extra design costs. Our subsequent analysis leads to the identification of four types of subunit-level characteristics influencing adoption. Their interplay informs departments in balancing between accepting compromise costs and negotiating design costs. We develop a diagnostic system model of subunit-level adoption that takes the embeddedness of the subunit into account and thereby complements individual- and organisation-level adoption theories. An accompanying heuristic may enable hospital managers to better anticipate the heterogeneity in departments’ adoption.

Date: 2024
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.1080/0960085X.2023.2225786 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:taf:tjisxx:v:33:y:2024:i:2:p:221-243

Ordering information: This journal article can be ordered from
http://www.tandfonline.com/pricing/journal/tjis20

DOI: 10.1080/0960085X.2023.2225786

Access Statistics for this article

European Journal of Information Systems is currently edited by Par Agerfalk

More articles in European Journal of Information Systems from Taylor & Francis Journals
Bibliographic data for series maintained by Chris Longhurst ().