Technological Change at Work: The Impact of Employee Involvement on the Effectiveness of Health Information Technology

Abstract

This paper uses data from a large, integrated, healthcare provider to assess the moderating role that employee involvement (EI) plays in the effectiveness of a patient scheduling module that is part of an electronic health record (EHR) system. While the module facilitated the appointment-making process, its effects were greater in those clinics that sought input from frontline workers and made use of worker peers trained as system “super-users.” The findings offer two explanations for the received literature’s inability to pin down an EI-performance link. First, some of the gains attendant to EI likely flow through the implementation and use of new technologies. Second, those studies that do consider EI in the context of technological change may be focusing exclusively on workplace-level features of the employment relationship, ignoring variation in functional- and strategic-level aspects of employment relations. The study also presents the first empirical evidence of EI’s potential to enhance the effectiveness of health IT, in particular, findings that should inform policymakers and sectoral actors as they allocate substantial resources toward the healthcare industry’s transition from paper-based to electronic recordkeeping.

Keywords: employee involvment (EI), information technology (IT), health information technology (IT), electronic health records (EHRs)