Organizational Design and Engineering in Healthcare IT

AMCIS 2011 Healthcare Mini-Track Call for Papers

Two recent reviews of the electronic health record (EHR) literature show that all is not well especially with respect to the alignment of organizational design and the engineered artifact. Niazkhani et al (2009, p. 546) concluded "When put in practice, the formal, predefined, stepwise, and role-based models of workflow underlying CPOE systems may show a fragile compatibility with the contingent, pragmatic, and co-constructive nature of workflow.” Two of the findings of Greenhalgh et al (2009, p. 767) were “while secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work is often made less efficient” and “the EPR may support, but will not drive, changes in the social order of the workplace”. In addition, Fontaine et al (2010) concluded from a systematic literature review in primary care that “The potential for HIE to reduce costs and improve the quality of health care in ambulatory primary care practices is well recognized but needs further empiric substantiation “.

Just as in enterprise resource planning (ERP) adoption, healthcare organizations (HCOs) expect Healthcare Information Technology (HCIT) to shape their organization design through the embedded workflow engineered most often from a mechanistic worldview. Oftentimes the contingencies and exceptions aren’t accounted for leaving the blame to fall upon the usual reasons for HCIT failure (e.g., poor implementation, lack of training, resistance). Organizational Design and Engineering (ODE) takes the position that the “either-or” mindset must be replaced with a more holistic view of designing the organization and artifact. The complex interplay between organization and engineering, oftentimes intangible, requires a multi-disciplinary approach to solve the challenge of the social and technological world of healthcare being inextricably linked to healthcare policy.

The mini-track seeks contributions from the spectrum of disciplines that are involved in HCIT whose paper focus has both the elements of organizational design and an engineered artifact regardless of research or discipline orientation. These might address theoretical, empirical and design-based studies on medical-technical infrastructures, tools and applications, health information behavior, cost/benefits as well as social implications. HCIT’s are broadly defined to include technologies in clinical informatics, E-health, M-Health, consumer health, public health, and health policy.

Best papers will be fast-tracked to a special issue on HCIT with The International Journal of Organisational Design and Engineering (IJODE) due out in second half 2011. Contact the co-chairs if you have questions about submission and fit of your contribution with IJODE.

Mini-track Chairs: Nelson King and Ronald Batenburg

References:

Fontaine, P. Ross, S.E., Zink, T. Schilling, L.M. 2010. "Systematic Review of Health Information Exchange in Primary Care Practices", J Am Board Fam Med (23), pp. 655– 670

Greenhalgh, T., Potts, H.W.W., Wong, G., Bark, P., and Swinglehurst, D. 2009. "Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method," Milbank Quarterly (87:4), pp. 729-788.

Niazkhani, Z., Pirnejad, H., Berg, M., and Aarts, J. 2009. "The Impact of Computerized Provider Order Entry Systems on Inpatient Clinical Workflow: A Literature Review," Journal of the American Medical Informatics Association (16:4), pp. 539-549.