Managing Technological Change: Organizational Aspects of Health Informatics PDF
Preview Managing Technological Change: Organizational Aspects of Health Informatics
Health Informatics (formerly Computers in Health Care) Kathryn 1. Hannah Marion 1. Ball Series Editors Health Informatics Series (formerly Computers in Health Care) Series Editors Kathryn J. Hannah Marion J. Ball Dental Informatics Integrating Technology into the Dental Environment L.M. Abbey and J. Zimmerman Ethics and Information Technology A Case-Based Approach to a Health Gare System in Transition J .G. Anderson and K. W. Goodman Aspects ofthe Computer-Based Patient Record MJ. Bail and M.F. Collen Performance Improvement Through Information Management Health Gare' s Bridge to Success M.J. Ball and J.V. Douglas Strategies and Technologies for Healthcare Information Theory into Practice MJ. Ball, J.V. Douglas, and D.E. Garets Nursing Informatics Where Garing and Technology Meet, Third Edition M.J. Ball, K.J. Hannah, S.K. Newbold, and J.V. Douglas Healthcare Information Management Systems A Practical Guide, Second Edition MJ. Bail, D.W. Simborg, J.W. Albright, and J.V. Douglas Healthcare Information Management Systems Cases, Strategies, and SoluJions, Third Edition M.J. Ball, C.A. Weaver, and J.M. Kiel Clinical Decision Support Systems Theory and Practice E.S. Berner Strategy and Architecture of Health Care Information Systems M.K. Bourke Information Networks for Community Health P.F. Brennan, S.J. Schneider, and E. Tornquist Informatics for the Clinical Laboratory A Practical Guide D.F. Cowan (continued after index) N aney M. Lorenzi Robert T. Riley Managing Technological Change Organizational Aspects of Health Informatics Second Edition With 29 Figures ~ Springer Nancy M. Lorenzi, PhD Robert T. Riley, PhD Informatics Center Eskind Biomedical Library Vanderbilt University Medical Center 2209 Garland Avenue Nashville, TN 37232-8340 USA [email protected] Series Editors: Kathryn 1. Hannah, PhD, RN Marion 1. BaU, EdD President, HECS, Inc. Vice President and Clinical Information Strategies Professor (ADJ) Healthlink Incorporated Department of Community Baltimore, MD Health Sciences and Faculty of Medicine Adjunct Professor The University of Calgary Johns Hopkins University Calgary, Alberta School of Nursing Canada Baltimore, MD USA Cover illustration: © 2003 Nikolai Punin/images.com Library of Congress Cataloging-in-Publication Data Lorenzi, Nancy M. Managing technological change / Nancy M. Lorenzi, Robert T. Riley. p. cm.-(Health informatics) Includes bibliographical references and index. ISBN 978-1-4419-3133-7 ISBN 978-1-4757-4116-2 (eBook) DOI 10.1007/978-1-4757-4116-2 1. Medical informatics. 2. Health services administration. 3. Technological innovations. 1. Riley, Robert T. Il. Title. III. Series. R858.L668 2004 651.5'04261-dc22 2003063339 ISBN 978-1-4419-3133-7 Printed on acid-free paper. © 2004 Springer Science+Business Media New York Original1y published by Springer-Verlag New York, Tnc. in 2004 Softcover reprint of the hardcover 2nd edition 2004 Ali rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher Springer Science+Business Media, LLC. except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adap tation, computer software, or by similar or dissimilar methodology now know or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks and similar terms, even if the are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. 9 8 7 6 5 432 1 SPIN 10680585 springeronline.com Robert T. Riley Ph.D., June 26, 1937-January 18, 2003 This book is dedicated to Bob Riley. Bob was the co-author of the first edition of this book. He was the author who added all the comments that will make you smile with his way of express ing camp lex topics with a touch of mischief For example, I was explaining the sociological theories of team development and he just listened and then took all of the theory and explained it (quite accurately, I must say) as the sled-dog model of team development. (Pages 144-145) Bob was a tenured faculty member in the University of Cincinnati, College of Business Administration until he founded Riley Associates, a successful international consulting and training firm. He was nationally and interna tionally acclaimed for his presentations, his management development semi nars, and his consulting skills. He authored several books and numerous articles on management or managing technological change. He was known for his humor, his canstant quest for new knowledge, his ability to under stand and solve problems, his ability to make friends, and his ability to teach others. Bob was also my husband of many years, my co-author, my business partner, my "how to give a presentation coach", and my best friend. Tragically on January 18, 2003 he lost his two year battle with cancer and I miss him so very much. To all those who have learned the hard way that hardware and software are not enough Series Preface This series is directed to healthcare professionals who are leading the trans formation of health care by using information and knowledge. Launched in 1988 as Computers in Health Care, the series offers a broad range of titles: some addressed to specific professions such as nursing, medicine, and health administration; others to special areas of practice such as trauma and radiology. Still other books in the series focus on interdisciplinary issues, such as the computer-based patient record, electronic health re cords, and networked healthcare systems. Renamed Health Informatics in 1998 to refiect the rapid evolution in the discipline now known as health informatics, the series will continue to add titles that contribute to the evolution of the field. In the series, eminent experts, serving as editors or authors, offer their accounts of innovations in health informatics. Increasingly, these accounts go beyond hardware and software to address the role of information in infiuencing the transforma tion of healthcare delivery systems around the world. The series also will increasingly focus on "peopleware" and organizational, behavioral, and societal changes that accompany the diffusion of information technology in health services environments. These changes will shape health services in the next millennium. By making full and creative use of the technology to tarne data and to trans form information, health informatics will foster the development of the knowledge age in health care. As co editors, we pledge to support our pro fessional colleagues and the series readers as they share advances in the emerging and exciting field of health informatics. Kathryn J Hannah Marion J Ball IX Preface Employees can be easily overwhelmed by changes instituted in large organ izations if they feel they have little or no say in or control over the changesY In addition, computers interact in complex ways with the organ ization and can significantly affect people's attitudes. Other important factors are the relationship between the technology and normal informa tion processes within an organizationY In particular, there are important differences between vertical and horizontal communications. The vertical communication relates mainly to the management control and accounta bility processes, and was typically what managers sought first.5,6 However, performance gains have been most notable when systems perform hori zontal communications at the process level: linking activities together, sup porting front-line decision makers, and enabling the business to flow more efficiently. The types of systems and the types of information handled by these two dimensions are typically very different, and inappropriate use of technol ogy can be destructive.7,8 The role of information technology creates a very complex picture.9 Its impact is often immense and has an extensive impact on the way that organizations are operated and managed.10 The key is understanding where information technology will be successful, and what problems might be anticipated.ll,12 For this edition we have revised the chapters into five major sections: (1) Setting the Stage, (2) Establishing Strategie Direction, (3) Preparing for Change, (4) Implementating the Change, and (5) Managing the Postimple mentation Stage. We believe that new arrangement makes it easier to follow the scope of this book, which focuses on organizational informatics in its day-to-day form. Acknowledgments As Bob and I wrote the first edition of this book, we thought several times about the need to acknowledge the assistance we received from so many xi Xll Preface people. When the "gallows humor" effect inevitably took over at times during the process, we laughed about the type of comments we might make, ranging from thanking every relative whose name we could remember to thanking those-especially, the guilty-who figured in many of the "war stories" scattered throughout the book. However, as the writing process drew to a dose, we ended up appreciat ing all those who supported out writing effort. We hoped the first edition of this book would aid in creating more successful health informatics imple mentations over the coming decade, and we also hoped that we could help reduce the "pains" and "scars" that we and others have suffered in the past in this area. Thus, our acknowledgments were truly from the heart. Dur first acknowledgment was to Dr. Marion 1. Ball, who has an uncanny sense of timing as to when issues are right for further exploration and when people need to be nurtured and encouraged into making a contribution. Dur relationship with Marion began in the 1970s when she and Nancy served on the National Library of Medicine's Biomedical Library Review Committee. For many years, the relationship continued only through an annual Christmas message. However, when most needed, Marion became reconnected more intensely with our lives, and there have been many positive outcomes of this reconnection. Another critical supporter was Dr. Donald C. Harrison, the then Senior Vice President and Provost of the University of Cincinnati Medical Center and Nancy's boss! Don supported Nancy's expansion into new areas and responsibilities, both at the Univer sity and for moving into writing the original version of this book. Special thanks to Michelle Schmitt of Springer Verlag who kept her "finger on the pulse" and waited until it was time to bring this edition to publication. Thank you for your continued support. Many thanks also to Timothy Taylor also of Springer, who probably learned more about man agement than he thought as he edited the manuscript. At my new home-Vanderbilt University-I wish to thank my many col leagues for their support through the last four years. Finally, in the first edition we grudgingly recognize the "assistance" of all those organizational problem children we encountered who needed to remain anonymous-though the temptation was alm ost overwhelming to name ·names. It is their behaviors and attitudes that either cause or aggravate many of the problems discussed in this book. So to all those people that provided some of our greatest frustrations over the years-thank you. Without your behaviors, our efforts may never have become so focused. References 1. Bailey JRS. Managing People and Technological Change. London: Pitman, 1993. 2. Baltzer JA. People and Process: Managing the Human Side of Information Technology Application. Boulder, CO: CAUSE, 1991. Preface xiii 3. Davenport TH. Saving IT's soul, human-centered information management. Harvard Business Review 1994;72(March-April):119-133. 4. Schultheiss EE. Optimizing the Organization: How to Link People and Tech nology. Cambridge: Ballinger, 1988. 5. Gardner Ep, Young P, Ruth SR. Evolution of attitudes toward computers: a retrospective view. Behav Inform Technol 1989;8(2):89-98. 6. Pancer S, George M, Gebotys RJ. Understanding and predicting attitudes towards computers. Comput Hum Behav 1992;8:211-222. 7. Bartlett CA, Ghoshal S. Changing the role of top management: beyond systems to people. Harvard Business Review 1995;73(May-June):132-142. 8. Earl MJ, Feeny DE Is your CIO adding value? Sloan Manag Rev 1994; Spring:11-20. 9. Saville J, Sowerbutts T. Information Management: People, Organizations, and Technology. South Melbourne: Macmillan Company of Australia, 1990. 10. Blackler F, Brown C. Evaluation and the impact of information technologies on people in organizations. Hum Relat 1985;38(3):213-231. 11. Davenport TH. Information politics. Sloan Manag Rev 1992;Fall:53-65. 12. Mankin D, Tora K, Barbara A. Factors in successful implementation of computer-based office information systems: a review of the literature with sug gestions for OBM research. Special Issue: Computers, People and Productivity. J Organizational Behav Manag 1984;6(Fall-Winter):1-20.
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