The IT productivity paradox in health: a stakeholder's perspective

While information technology (IT) investments in healthcare are higher than ever, there are contradictions in the literature regarding their ability to improve productivity, quality of care and/or healthcare system efficiency. Using theories that can help make sense of these contradictions, we propose a new framework to assess the actual impacts of health information technology (HIT) implementation.

Following an exhaustive literature review, we build upon the 'productivity paradox' and 'stakeholder' theories to improve the evaluation of IT impacts in healthcare. Interview data from three case studies of HIT implementation in different hospitals were used to develop our proposed framework.

The empirical data analysis suggests that it is important: (1) to identify, account for and accurately measure the appropriate impacts (beneficial/adverse, expected/unforeseen effects); (2) to consider the context of implementation; (3) to adopt a multi-level perspective (individual, group and organization); and (4) to take into account the various stakeholders' perspectives (managers, health professionals and patients).

An assessment framework was developed to provide general guidance on how to assess HIT impacts. The proposed framework will be useful for researchers and practitioners as it takes into account the underlying reasons for the HIT productivity paradox and identifies the salient outcomes of interest linked to HIT implementation.