Information Technology in Complex Health Services
Organizational Impediments to Successful Technology Transfer and Diffusion
- Affiliations of the authors: Consultant in Health Management Research and Analysis, Caringbah, New South Wales, Australia (FCGs); Fujitsu Centre, University of New South Wales (CS); Department of Computing, Macquarie University, New South Wales (CNGD)
- Correspondence and reprints: F.C. Gray Southon, MSc, PhD, MComm, 15 Parthenia Street, Caringbah, New South Wales 2229, Australia. E-mail: gsouthon{at}ozemail.com.au
- Received 24 September 1996
- Accepted 14 November 1996
Abstract
Objective To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services.
Design A case analysis of the failure of an implementation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This application had been proven in the United States environment.
Measurements Interviews involving over 60 staff at all levels of the service were undertaken by a team of three. The interviews were recorded and analyzed for key themes, and the results were shared and compared to enable a continuing critical assessment.
Results Two components of the transfer of the system were considered: the transfer from a different environment, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framework. In relation to the first, it was found that there was a lack of fit in the business environments and strategies, organizational structures and strategy-structure pairing as well as the management process-roles pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships.
Conclusion The large-scale developments of integrated health services present great challenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There is a need to take a more sophisticated approach to understanding the complexities of organizational factors than has traditionally been the case.
