Why Health Care Information Systems Succeed or Fail

Information Systems for Public Sector Management Working Paper no. 9

27 Pages Posted: 16 Mar 2020

See all articles by Richard Heeks

Richard Heeks

University of Manchester

David Mundy

affiliation not provided to SSRN

Angel Salazar

Manchester Metropolitan University

Date Written: February 18, 1999

Abstract

Some health care information systems (HCIS) do succeed, but the majority are likely to fail in some way. To explain why this happens, and how failure rates may be reduced, this paper describes the ‘ITPOSMO’ model of conception — reality gaps. This argues that the greater the change gap between current realities and the design conceptions (i.e. requirements and assumptions) of a new health care information system, the greater the risk of failure.

Three archetypal large design — reality gaps affect the HCIS domain and are associated with an increased risk of failure:

• Rationality — reality gaps: that arise from the formal, rational way in which many HCIS are conceived, which mismatches the behavioural realities of some health care organisations.
• Private — public sector gaps: that arise from application in public sector contexts of HCIS developed for the private sector.
• Country gaps: that arise from application in one country of HCIS developed in a different country.

Some generic conclusions can be drawn about successful approaches to HCIS development. Examples include the need for more reality-oriented techniques and applications, and greater use of participative approaches to HCIS. More specifically, techniques can be identified for each of the seven ITPOSMO dimensions that will help close the gap between conception and reality. This can include the freezing of one or more dimensions of change. Such techniques will help improve the contribution that information systems can make in health care organisations.

Overall, then, this paper will provide readers with an understanding and model of why health care information systems succeed or fail, and with general guidance on how to avoid HCIS failure.

Suggested Citation

Heeks, Richard and Mundy, David and Salazar, Angel, Why Health Care Information Systems Succeed or Fail (February 18, 1999). Information Systems for Public Sector Management Working Paper no. 9, Available at SSRN: https://ssrn.com/abstract=3540062 or http://dx.doi.org/10.2139/ssrn.3540062

Richard Heeks (Contact Author)

University of Manchester ( email )

Oxford Road
Manchester, M13 9PL
United Kingdom

David Mundy

affiliation not provided to SSRN

Angel Salazar

Manchester Metropolitan University ( email )

All Saints
Manchester, M15 6BH
United Kingdom

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