Health Information System Promoting Action Design Research to create value in healthcare through IT

Recently there has been varying proof showing that health IT reduces costs while improving the standard of care offered. The same factors that had caused delays in reaping benefits from IT investment made in other sectors (i.e. time consuming procedural change) are also very common within the healthcare sector. Due to the current transitive nature of the Healthcare sector, new IT investment is likely not going to provide maximum value unless this new investment is backed up with a total reform of healthcare delivery. The overall ability of healthcare IT value researchers to add value to practice will be severely limited as a result of the traditional ex-post approach to measuring IT and the fact that government spurs significant investment. It may be risky to generalize or compare results from traditional IT value research with those from healthcare due to the difference between them. It is broadly accepted that the key to improved healthcare quality and reduced cost is Healthcare Information Technology (HIT) (Sherer, 2014). The idea of Knowledge Management (KM) as a probable solution to most of the problems confronting the U.S. And international healthcare systems has emerged. Safety concerns and quality of patient care, serious ineffectiveness, contrasting information principles technologies, rapidly growing costs and clinical information overload are some of these problems (Wills et al. 2010). Although still in its infancy and quite far from providing meaningful use, the potential of IT in healthcare is increasing. Subsequently, healthcare stakeholders like hospitals, medical practitioners, physicians, and consumers are faced with a myriad of concerns associated with IT use in healthcare. Thus, its enactment is a constant challenge for the healthcare sector (Palvia et al. 2012). I propose an action design research that uses existing theories as a base, but is adapted to fit the specific characteristics of the healthcare industry. By actively partaking in the design and appraisal of these new socio-technical systems, IT value researchers can generate sound theories to explain value creation in healthcare so that practice can be influenced (Sherer, 2014).

Introduction

The results reported by various industries such as banking and finance indicate that digitally automated client transaction and processing decades ago are very similar to those being reported today in healthcare. Several years were spent by IT researchers to determine how, why, and when value is generated from investments made in IT. This allowed IT researchers not to only have a firm grasp on how to properly study IT value, but to also have a solid body of knowledge about the dynamics that generate it (Kohli & Grover, 2008), especially the time-intensive process changes that are required. This extensive body of knowledge can therefore be of significance to IT value researchers who are well situated to use it to clarify how IT can be of value to the healthcare industry. However, there is a possibility that industry differences will influence how IT value is taken in the healthcare, this is because industry is a significant differentiator in IT research. Furthermore, the relevance of research approaches that focus on post-hoc analysis of former IT investments can neither be timely nor be able to influence healthcare now, when extensive investment incentives are stimulating adoption and industry change. Using traditional IT as a base, strategically positioned IT researchers studying the generation of value in healthcare can adapt it as necessary to account for the dissimilarities it has with the health industry. I argue that IT researchers must actively be involved in the design and assessment of the innovation that is currently underway in IT and multi-organizations. In order to proffer answers to the questions of how and what IT interventions can do to increase value to healthcare, it is necessary for researchers to adopt action design research approaches. (Sherer, 2014).

Statement and Analysis

Traditional IT Value Research and the Healthcare Industry

Under certain circumstances, research on IT value has shown that IT creates value, and firms do not appropriate all the generated value. This value manifests in various ways and at several organizational levels. A multiplicity of balancing organizational investments influence IT value. In Healthcare, there are a number of distinct differences that can influence conditions to drive value, the complementing elements, the mechanisms, which allow the value to be added, and the methods used to measure the value. Healthcare characterizes a remarkably different socio-technical context when compared with several industries where IT research is being conducted, and IS theories developed (e.g. transportation, manufacturing, financial services). Healthcare benefits through societal values like; improved living standard, public health, and lack of disease. In addition, traditional benefits like costs, choice, customer satisfaction, profitability still exist....

Although the outcome sought after by healthcare's numerous and diverse stakeholders are different, traditional IT value research has concentrated on its economic impact). As an illustration, nurses and physicians will emphasize on healthcare quality, while directors and managers are more concerned about efficiency. Social, economic, environmental and behavioral factors influence the value of healthcare among stakeholders who belong to identical groups. Some values are personal, thus cannot be expressed by numbers and formulas i.e. quality of life. Regular IT business value research does not usually distinguish performance and its possibly different values to each individual interpretation of dissimilar stakeholders. Healthcare IT's most prominent issue is to improve societal value. This is a more complex variable, as it may have diverse meanings to various stakeholders. Whereas, Regular IT value research is concerned with multiplying firm value. Traditional IT value research is yet to thoroughly explain the casual relationship that exists between IT investment and value. The mechanism via which value is generated is believed to be influenced by multifaceted interactions and dependences of all healthcare participant's goals. The heterogeneity among healthcare providers, patients, and the functionality of their applications (e.g. electronic healthcare records) is becoming increasingly challenging to control. The role of IT in increasing value to healthcare through regular mechanisms like system and work process standardization is brought about by a realignment of business processes and organizational change, this is complicated by the complexity of each patient's unique circumstance.
The distinct requirements of various healthcare stakeholders and settings makes it hard to control the interdependence between applications like basic electronic healthcare records and decision support components that leverage these records (Sherer, 2014). The interactions and complementarities between IT assets and their complex social relations are yet to be addressed by traditional IT value research. The success of IT implementation is directly linked to the workflow of existing professionals who are a powerful force in healthcare (Goh, Gao, & Agarwal, 2011). Also, additional factors impact the value of healthcare. These factors such as risk to life, quality, and privacy concerns of the patient. Similarly, for healthcare delivery to become more integrated (i.e. medical conditions oriented) rather than organized around separate specialists, delivery of quality care has to be the joint responsibility of several providers and a single organization can no longer control various processes. Therefore, complementary changes within an organization alone are not enough to effect value realization, rather a wave of change across several organizations is required.

Healthcare is not a self-contained institute, rather a complicated combination of diverse organizational forms that is subject to several market and regulatory structures. Unlike other sectors where partners join forces to produce a service, the mechanism via which care value can be achieved is different from other industries. This is evident in interactions where participants like insurers, influence prices but do not partake in care delivery.

A possible drawback lies in costly and negative effect on care quality brought about by workarounds which may result from the implemented changes which are actually supposed to encourage value realization via information sharing. As an example, insurers and providers share data to improve care quality for certain patients, healthcare patient data security was unintentionally compromised by members sharing spreadsheets and databases in order to bypass difficult-to-use enterprise information systems (Sherer, 2014). Initial research in healthcare did not specify which complementary elements are important to the creation of value in this sector, neither did it specify the mechanisms by which these elements influence value realization. It is expected that the difference between healthcare and other industries will impact value and its mode of creation, there is an opening to contextualize assumptions which reflect the institutional environment and material resources of the industry and consider how they affect value and its creation in healthcare. Although we can use traditional IT theories as foundations, the results cannot be applied so simply; rather, special attention has to be paid to the social context whereby existing theories will be verified (Sherer, 2014).

Position

Action Design Research for Healthcare IT Value

Econometric, empirical, variance theories, the ex-post perspective, firm-level perspective, and complementary effect of lag and contextual elements have been dominant in Traditional IT business value research (Schryen, 2013). Industry dissimilarities that impedes application of traditional IT value research results, combined with time struggles to effect change, has influenced me to promote for an action design research approach to study IT value. Most traditional IT…