Beyond IT and productivity : effects of digitized information flows in health care PDF
Preview Beyond IT and productivity : effects of digitized information flows in health care
Linköping Studies in Science and Technology Thesis No. 1328 LiU-TEK-LIC-2007:37 Beyond IT and Productivity - Effects of Digitized Information Flows in Health Care By Pontus Fryk Submitted to Linköping University in partial fulfillment of the requirements for the degree of Licentiate of Economics Linköping 2007 Department of Management and Engineering Linköping University, SE-581 83 Linköping © Pontus Fryk, 2007 “Beyond IT and Productivity – Effects of Digitized Information Flows in Health Care” Linköping Studies in Science and Technology, Thesis No. 1328 ISBN: 978-91-85831-08-1 ISSN: 0280-7971 LIU-TEK-LIC-2007:37 Printed by: LiU-Tryck, Linköping Distributed by: Linköping University Department of Management and Engineering SE-581 83 Linköping, Sweden Tel: +46 13 281000, fax: +46 13 281873 Beyond IT and Productivity - Effects of Digitized Information Flows in Health Care By Pontus Fryk ABSTRACT This thesis examines how investments in IT, and the digitization of information flows, have affected health care productivity. Through empirical investigations of health care processes – along with discussions based on notions derived from theories related to e.g. economics, the Productivity Paradox, General Purpose Technologies, and medical informatics – effects from digitization are detected and analyzed. An important point of departure is the so called Productivity Paradox, which raises the question why previous comprehensive investments in IT seemingly have not generated the anticipated productivity growth. Researchers have debated this dilemma for many years now but no sufficient explanations have been put forth. This is so due to a prior focus on snapshot descriptions, founded on macroeconomic statistics and aggregated data, which has resulted in ambiguous conclusions about IT and economic development. Thus, in order to really describe the effects from digitization, the process investigations mainly are carried out at the organization or department level, and from a qualitative and historical perspective. Furthermore, in the current research, it is believed that too narrow definitions of IT and productivity have contributed to the overlooking of benefits from digitization. Therefore the term IT is extended to include technology for collecting, storing, processing, retrieving, and communicating data, text, images and speech. Moreover, this definition includes both administrative and embedded IT. Also, the traditional definitions of productivity are questioned, and the concept is given a broader meaning in order to capture all possible benefits and/or disadvantages from IT investments. The results and analysis presented in this thesis show that productivity within health care has increased immensely thanks to investments in IT. In general, the treatment processes have been speeded up, health care quality has improved, and the cost effectiveness has been significantly enhanced. In other words, by introducing new thoughts regarding the Productivity Paradox, more effects from digitization are detected and analyzed. However, there are some problems connected to the implementation, adoption and diffusion of IT within health care, and they are also given proper attention throughout the current work. This work has been supported by the foundations of Jan Wallander, Tom Hedelius, and Tore Browaldh Linköping 2007 Department of Management and Engineering Linköping University, SE-581 83 Linköping SAMMANFATTNING Denna avhandling undersöker hur investeringar i IT, och digitaliseringen av informationsflöden, har påverkat produktiviteten inom sjukvården. Genom empiriska undersökningar av avgränsade sjukvårdsprocesser – samt diskussioner baserade på idéer och teorier relaterade till ekonomi, ”produktivitetsparadoxen”, så kallade General Purpose Technologies (GPTs), och medicinsk informatik – detekteras och analyseras effekter av digitaliseringen. Produktivitetsparadoxen – vilken ställer frågan varför tidigare omfattande investeringar i IT till synes inte har genererat de förväntade produktivitetsökningarna – är en viktig utgångspunkt i föreliggande studie. Forskare har dryftat detta dilemma i många år men hittills har inga fullständigt tillfredsställande förklaringar lagts fram. Detta beror till stor del på att tidigare forskning huvudsakligen har inriktat sig på makroekonomisk statistik och aggregerade data, vilket har resulterat i otydliga eller ofullständiga slutsatser angående IT och ekonomisk tillväxt. För att verkligen beskriva effekterna av digitaliseringen är denna forskning istället baserad på undersökningar på mikronivå (organisations- eller avdelningsnivå) ur ett historiskt och kvalitativt perspektiv. En annan viktig tanke som genomsyrar denna avhandling är att för snäva definitioner av IT och produktivitet har bidragit till förbiseende av många nyttor till följd av digitalisering. Därför utvidgas termen IT här till att inkludera teknologi för att samla, lagra, bearbeta, återfå och kommunicera data, text, bilder och tal. Dessutom omfattar denna definition både administrativ och inbäddad IT. Vidare ifrågasätts de traditionella definitionerna av produktivitet, och begreppet ges en bredare betydelse för att fånga upp alla möjliga nyttor och/eller nackdelar som kan härledas till IT investeringar. Resultaten och analysen som presenteras i denna studie visar att produktiviteten inom sjukvården har ökat enormt tack vare IT-investeringar. Generellt sett så har sjukvårdsprocesserna snabbats upp avsevärt, sjukvårdskvaliteten har förbättrats, och kostnadseffektiviteten har ökat. Med andra ord, genom att introducera nya tankar gällande produktivitetsparadoxen, har fler effekter kunnat detekteras och analyseras. Det finns emellertid också många problem förknippade med implementering, användande och spridning av IT, vilka ges tillbörlig uppmärksamhet i denna undersökning. I förlängningen bidrar analysen av digitaliseringseffekterna till en ökad förståelse för hur ”IT-fieringen” av modern sjukvård påverkar dess produktivitet i form av exempelvis bättre (och även helt nya) behandlingsmetoder, förkortad konvalescens och snabbare patientflöden. Vidare ges förslag på hur implementeringsförfaranden kan skötas smidigare än tidigare, vilka problem relaterade till digitalisering som bör beaktas och lösas, samt vilka möjliga framtida nyttor som skulle kunna realiseras och hur. Detta torde vara av intresse för yrkesverksamma inom sjukvården, patienter, politiker som skall besluta om sjukvård, och även samhället i stort. Det övergripande målet med avhandlingen är således att underlätta utvecklingen mot en alltmer digitaliserad – och förhoppningsvis därav förbättrad – sjukvård genom att fördjupa förståelsen för relationen mellan IT och produktivitet. Preface The division of Economic Information Systems engages in research and education in the borderland between management and IT. More specifically, the subject area relates to the transmission of information from, between and to people. Of special interest is the role of strategies and information systems when people work together in different kinds of organizations (companies, public authorities and associations), but also when they interact with customers and citizens. Our research is concentrated in the following areas: * IT and productivity * Strategic use of IT, with a focus on organization for the use of IT * Strategy and management control * Financial accounting, auditing and economic crime Most doctoral candidates in the division of Economic Information Systems are enrolled in either the Swedish Research School of Management and Information Technology (MIT) or the Research Programme for Auditors and Consultants (RAC). MIT is a joint endeavour involving some ten colleges and universities. Within the structure of this network, a doctoral programme is offered with a focus on issues arising in the borderland between management and IT. The RAC is a graduate education programme focused on accounting and auditing, with an emphasis on the processing of information. It combines internships at auditing firms with graduate courses and work toward a licentiate degree. This thesis, Beyond IT and Productivity: Effects of Digitized Information Flows in Health Care, is presented by Pontus Fryk for the degree of Licentiate of Economics – in the subject area of Economic Information systems – at the Department of Management and Engineering, Linköping University. Fryk is currently enrolled in the MIT Research School and holds a Master of Science in Engineering. Linköping, August 2007 Fredrik Nilsson Professor Economic Information System FOREWORD The current research is conducted within the ITOP Research Program (Impact of IT On Productivity). The program uses the so called Productivity Paradox as a major starting- point. This term is derived from the notion that there is no clear connection between IT investments and productivity growth. In other words, until recently, studies based on aggregate data have failed to prove that digitization contributes to economic growth. Today, however, positive effects of IT investments on productivity have been reported, but the overall value of IT is still under debate. Previous research has focused largely on IT capital spending and not how the technology is actually used. The ITOP program, in contrast, has adopted a micro-level approach based on empirical investigations of generic processes in order to study both administrative and embedded IT. The research strives to detect effects from digitization by looking at limited processes before and after the introduction of IT. In addition to effects on productivity as traditionally measured, numerous other benefits of IT, some of them not even measurable, are identified. This research would not have been possible without the great financial support from the foundations of Jan Wallander, Tom Hedelius, and Tore Browaldh, which is deeply appreciated.
The list of books you might like
