JMIR Publications

ABSTRACT

Background:

Understanding 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 the implementation progression. Alberta Health Services introduced a patient portal called MyChart®. Although MyChart® allows patients to view appointments, selected lab results, and communicate with their providers, its uptake has varied.

Objective:

To examine the institutional decision-making processes that shaped the development and implementation of MyChart®.

Methods:

A historical study was conducted based on the 7-step framework developed by Mason et al, where one engages in a rigorous archival critical analysis (including internal and external criticism) of documents and analysis of interviews. We reviewed and analyzed over 423 primary and secondary sources and interviewed ten key decision makers.

Results:

Supportive 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 the 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 central decision-making.

Conclusions:

Organizational priorities and decision-making tactics influence IT investments, implementation, adoption and outcomes. Future research may focus on improving the applicability of needs assessments and funding decisions to health care scenarios.