Health information systems: failure, success and improvisation

Area of Science:

• Medical Informatics
• Health Information Systems Research

Background:

• Widespread health information systems (HIS) failures are increasingly reported in medical informatics.
• Existing assumptions about HIS success are challenged by evidence of frequent HIS failures.

Purpose of the Study:

• To develop a robust conceptual foundation for understanding health information systems (HIS) failure and success.
• To provide practical guidance for mitigating HIS failures and enhancing project outcomes.

Main Methods:

• Comprehensive literature review and case analysis.
• Development and pilot testing of a novel conceptual model for HIS failure analysis.

Main Results:

• The "design-reality gap" conceptual model effectively explains diverse HIS success and failure cases.
• The model demonstrates utility as a risk assessment and mitigation tool for HIS projects.
• Evidence suggests traditional development methodologies may be insufficient, highlighting the need for emergent change and improvisation in HIS.

Conclusions:

• The "design-reality gap" model serves as a valuable tool for both post hoc evaluation and pre hoc risk management of HIS.
• The model validates essential methods, roles, and competencies for supporting dynamic improvisation in successful HIS implementation.