Implementing new ways of working: interventions and their effect on the use of an electronic medication record

ABSTRACT

Successful deployment of information technology (IT) involves implementation of new ways of working. Under-recognition of this organizational element of implementation entails considerable risk of not attaining the benefits that motivated deployment, yet knowledge of how to work systematically with organizational implementation is sparse. This study investigates a set of interventions undertaken to implement one mandated procedure associated with an electronic medication record, namely that all information about medication is recorded in the system. Medical record audits show that the interventions, which were devised and performed as part of the study, significantly lowered the number of records that violated the procedure. This positive effect was, however, not achieved until multiple interventions had been employed, and there is some indication that the effect may be wearing off after the interventions have ended. We discuss the implications of these results for efforts to work systematically with the organizational implementation of IT systems.

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INDEX TERMS

Primary Classification:
  H. Information Systems
  H.5 INFORMATION INTERFACES AND PRESENTATION (I.7)
      H.5.3 Group and Organization Interfaces
          Subjects: Computer-supported cooperative work

Additional Classification:
  H. Information Systems
  H.5 INFORMATION INTERFACES AND PRESENTATION (I.7)
      H.5.3 Group and Organization Interfaces
          Subjects: Organizational design

  K. Computing Milieux
  K.6 MANAGEMENT OF COMPUTING AND INFORMATION SYSTEMS
      K.6.4 System Management

General Terms:
Experimentation, Human Factors

Keywords:
adoption, diffusion, electronic medication record, healthcare, organizational implementation