Abstract
BackgroundUnderstanding how health organizations decide on information technology (IT) investments is imperative to ensure successful implementation and adoption. There is a high rate of failure and a tendency to downplay the complexity of implementation progression. Alberta Health Services introduced a patient portal called MyChart. Although MyChart allows patients to view appointments and selected laboratory results and to communicate with their providers, its uptake varies.ObjectiveThe study aimed to examine the institutional decision-making processes that shaped the development and implementation of MyChart.MethodsA historical study was conducted based on the 7-step framework, where one engages in a rigorous archival critical analysis (including internal and external criticism) of documents and analysis of interviews. We reviewed and analyzed 423 primary and secondary sources and interviewed 10 key decision makers.ResultsSupportive leadership, project management, focused scope, appropriate technology and vendor selection, and quick decision making were some of the facilitators that allowed for the growth of proof of concept. The planning and implementation stages did not depend much on the technology itself but on the various actors who influenced the implementation by exerting power. The main barriers were lack of awareness about the technology, proper training, buy-in from diverse system leaders, and centralized government decision making.ConclusionsOrganizational priorities and decision-making tactics influence IT investments, implementation, adoption, and outcomes. Future research could focus on improving the applicability of needs assessments and funding decisions to health care scenarios.
Highlights
BackgoundAging populations, increased prevalence of chronic conditions, and consequent rising costs significantly challenge health care systems worldwide
The following sections describe the events based on the An overview of the Alberta Health and Alberta Health Services (AHS) timelines is shown extracted data from these sources
The proof of concept (PoC) leadership team agreed that the “technology was the easiest part,” as they focused on foundational features with very minimal customization (AHS information technology (IT) senior level participant 5)
Summary
BackgoundAging populations, increased prevalence of chronic conditions, and consequent rising costs significantly challenge health care systems worldwide. Understanding how health organizations decide on IT investments is imperative to ensure successful implementation and adoption. The literature shows that the majority of health IT investments are struggling to achieve the hoped-for improvements in quality of care and economic benefits [2,3,4,5] These technologies tend to run over budget because of inadequate preparation for the complexities of implementation [6,7]. Understanding the events and actors involved in each stage of the cycle provides for better future planning for the successful implementation of IT investments such as patient portals [8]. Understanding how health organizations decide on information technology (IT) investments is imperative to ensure successful implementation and adoption. Future research could focus on improving the applicability of needs assessments and funding decisions to health care scenarios
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