An Examination of Resilience in Healthcare Information Systems in the Context of Natural Disasters

Contemporary healthcare information systems (HIS) rely heavily on IT/IS infrastructures to manage primary and essential services. Given that hospitals and HIS have been facing various disruptions from disasters, it is essential to take an integrative approach to help prepare effective coping strategies in disaster situations. To date, little is known about how HIS resilience is achieved. While Information Systems Assurance, IT Capability and Effective HIS use are important, the high degrees of HIS complexity and Interdependence of health information systems also have an impact on resilience. This study integrates a socio-technical perspective and theorizes the effect of disaster experience and influential factors for HIS resilience. HIS resilience will enable healthcare organizations to sustain the continuity of effective performance in terms of critical medical services in a disaster situation. Park et al. Information systems resilience in disaster context Proceedings of the 13th Pre-ICIS Workshop on Information Security and Privacy, San Francisco, December 13, 2018. 2 INTRODUCTION Healthcare information systems (HIS 1 ) play an important role in preventing mistakes and protecting patients from associated safety risks (Smith et al. 2014). Health care organizations are also constantly confronted with stress, shocks, crises and change of environment (Maresso et al. 2013) and this can lead employees to fail to provide good care. Under such situations, resilience of HIS can be important to deal with adversities. Hospital employees rely on resilient systems to continue providing healthcare services during unexpected events (Park et al. 2015). Resilience is important for healthcare systems (Cook 2007) since HIS systems need to convey needed information in the face of changes and challenges. In fact, in an article “Identifying Issues for the Bright ICT Initiative” (Lee and Fedorowicz 2018), the authors identify business continuity and disaster recovery as #5 and #6 of IT leaders’ most important/ worrisome concerns. Clearly, resilience is an antidote to such concerns. Yet, the concept of information systems resilience has remained relatively unexplored in the IS literature, and even more so, in the context of healthcare (Smith et al. 2014). Especially, there has been little research regarding whether employees’ effective HIS use can contribute to resilient HIS and further, can be achieved through effective HIS use under boundary conditions (HIT complexity and HIT interdependence) in disaster situations. To summarize, the purpose of this study is to: (a) examine the relationship between effective HIS usage, HIS infrastructure and HIS resilience and further (b) investigate the effect of boundary conditions (i.e., HIT complexity and HIT interdependence) on the relationship between effective HIS use and HIS resilience by comparing HIS in two situations – hospitals that have been through disaster experience vs those that have not. 1 We refer to Health Information Systems (HIS) and Health Information Technology (HIT) interchangeably to avoid monotony. Park et al. Information systems resilience in disaster context Proceedings of the 13th Pre-ICIS Workshop on Information Security and Privacy, San Francisco, December 13, 2018. 3 THEORY In this section, we develop hypotheses with key constructs of this paper. The hypotheses posited in this section are summarized in Figure 1. Perceived information Systems Resilience Employee’s perceptions of health information system resilience is defined as the belief that the HIS is characterized by the ability to bounce back from negative experiences and by flexible adaptation to certain contexts. This definition is based on individuals’ belief regarding the capacity of their organization’s information systems to maintain and renew themselves, particularly in the presence of stressors, or to absorb or cushion themselves against damage or loss (Rose 2004). Resilience has been widely recognized as a factor that effectively preserves operational continuity and delivery of care by motivating employees to perform better, increasing employee job satisfaction and commitment, and improving group and organizational effectiveness (See Avey et al. 2010; Luthans et al. 2007; Peterson et al. 2011). Resilient systems have the ability to “maintain positive adjustment under challenging conditions” (Sutcliffe and HIT Capability Information Assurance HIT Interdependence Effective HIS Use HIS Resilience HIT Complexity