Health IT Implementation and the Impact of the COVID-19 Pandemic on Clinician-IT Dynamics: Qualitative Study
Authors: Bamgboje-Ayodele Adeola , Boscolo Adrian , Burger Mitchell , Hutchings Owen , Shaw Miranda , Shaw Tim , Tariq Amina , Naicker Sundresan , McPhail Steven , Baysari Melissa 
Published: November 2024

Background
The COVID-19 pandemic necessitated the rapid development and implementation of health ITs to support health care delivery. Health IT implementation is difficult at the best of times, due to complex sociotechnical challenges that vary across contexts and settings; however, it is currently unclear how the pandemic impacted health IT implementation processes. The aim of this study was to explore the impact of the pandemic on health IT implementation processes, including pre- and postimplementation phases, and identify the sociotechnical factors that shaped health IT implementation during an unprecedented circumstance.

Objective
This study aimed to explore the impact of the pandemic on HIT implementation processes, including pre- and postimplementation phases, and identify the socio-technical factors that shaped health IT implementation during an unprecedented circumstance.

Methods
Participants were from one of two teams: (1) health care staff members (doctors, nurses, nurse unit managers, and support staff members) from a virtual hospital in Australia; and (2) IT professionals within the broader health care organization assigned to the hospital. Participants took part in an interview or focus group from July to November 2022. Participants were asked to describe the process used for rapid health IT design and implementation during the COVID-19 pandemic. Qualitative data were analyzed thematically.

Results
A total of 15 participants took part in the study. Both internal and external team structures, and the communication pathways that underpinned these, were reported to influence the health IT lifecycle, which in turn impacted outcomes, particularly when perceived normal ways of working were challenged during the pandemic. Across the pre-post lifecycle, preimplementation processes were viewed to be most impacted by the COVID-19 pandemic. Participants reported that their roles and responsibilities changed during health IT implementations in the pandemic, impacting co-design processes and highlighting the need for health IT implementation processes to cater for new work and the redistribution of existing work.

Conclusions
Our study uncovered the negative impact of the COVID-19 pandemic on team structures, communication pathways, and health IT preimplementation processes (project management and co-design). While health care organizations are keen to transition beyond the ways of working during the pandemic, it is imperative to learn from the health IT implementation successes and failures that occurred in the pandemic via process evaluations. Our evaluation offers learnings for research (an adapted interdisciplinary team communication framework), practice (the need for health care organizations to review their communication structures, IT staff skills, and proposed processes), and education (the need for better education and training of IT professionals working in clinical settings on health concepts) on health IT implementations as the world transitions to the “new norm.”