The Relationship Between Innovation Capabilities, Information Management, and HIT Quality in Healthcare Organizations: Development of a Sociotechnical Model
Creators: name: Esdar, Moritz
Publisher: name: Universität Osnabrück
Year: 2023
Subjects: subject: hospital information systems
subject: diffusion of innovation
subject: organizational culture
subject: health information management
subject: organizational innovation
subject: organizational change management
subject: 610 - Medizin, Gesundheit

description: Background: Healthcare organizations are critical for translating health information technology (HIT) based innovation into clinical care support. Despite their importance, very few reliable accounts exist about organizational facilitators, not only for the adoption of HIT systems but also for the systems’ quality (i.e., HIT quality). However, it can be assumed that an organizational climate that embraces innovation and reflects the ability to innovate, i.e., organizational innovation capabilities, together with professional information management practices, may act as essential facilitators of HIT quality. Yet, there is no coherent conceptualization and corresponding measurement frameworks of both organizational innovation capabilities as well as of professional information management and no evidence on how they affect HIT quality. Addressing this issue also requires taking external influences, such as the legal-financial environment, into account, as prior research has pointed to their integral role in promoting the uptake of HIT in healthcare organizations. Objective: The primary aim of this thesis is twofold: First, to find out what constitutes both innovation capabilities and professional information management and to develop corresponding measurement models. Second, to research the relationship between innovation capabilities, the professionalism of information management, and indicators of HIT quality – specifically the HIT workflow support and its perceived quality – in light of different legal-financial environments. Methods: Quantitative data from representatives of hospitals (CIOs and clinical directors) in Austria, Germany, and Switzerland were collected across four separate surveys and used to develop a sociotechnical model that interlinks all relevant constructs. The model development spans five publications. Throughout these publications, the central constructs were developed iteratively using factor analytic techniques and their interrelationships tested using various regression techniques. The final model was established by applying partial least squares structural equation modeling. Results: Various insights on the constituents of organizational innovation capabilities and information management as well as on their association to HIT quality were yielded across the publications, culminating in the proposal of the so-called IQHIT model in the last publication. Most importantly, the results confirmed a strong link between the innovation capabilities on different organizational levels and HIT quality. Specifically, the top management team’s and the IT department’s innovation capabilities positively influenced the degree of HIT workflow support and the perceived HIT quality. This effect was entirely mediated by the professionalism of information management. Moreover, the legal-financial environment showed to affect both the organizations’ innovation capabilities as well as several measures of HIT quality across publications. Conclusions: The results should encourage executives and decision-makers to realize the significant impact their organizations can exert on the level of HIT quality and thus to take agency in shaping the digital transformation in healthcare. They may do so by aiming to facilitate an organizational climate that encourages innovation and by establishing professional information management activities. Nevertheless, further studies to validate and extend the findings are warranted and the IQHIT model provides various access points to do so.