JMIR Publications

ABSTRACT

Background:

Large health organizations often struggle to build complex health information technology (HIT) solutions of high quality and are faced with ever growing pressure to continuously innovate their information systems. While achieving high quality HIT implementations requires change and, therefore, an innovative organization, innovation and change can also be regarded as a threat to a running system. Rather limited research has been conducted in this context that explores the relationship between the organization’s innovative capabilities and HIT quality in the sense of achieving high quality support of patient care.

Objective:

To explain how the different facets of organizational innovation capabilities are linked to HIT quality in order to eventually achieve better information provision in health care organizations.

Methods:

We designed a survey assessing various domains of HIT quality as well as the organization’s capacity for innovation and administered it to hospitals across Austria, Germany, and Switzerland. The results from 232 hospitals were used to fit a model that was specified to predict HIT quality domains as a function of multiple interrelationships among the facilitating constructs using partial least squares structural equation modeling (PLS-SEM).

Results:

The results from PLS-SEM indicated satisfactory values of the model parameters, including the convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and of innovation capabilities. Pursuant to this model, HIT quality was expressed as the path from a “professional information management” explaining “HIT support of patient care” (R² = .55) to explaining “perceived goodness of information provision” (R² = .53) via “perceived HIT support”. “Innovation capabilities of the top management team” were strongly associated with the ones of the “IT department” and of the “organization at large”. These capabilities mainly acted on the “professionalism of information management” (R² = .73), particularly through the innovative attitude of the top management team and of the IT department as well as on the perceived HIT quality through an organization-wide culture of innovation. Based on these findings, we propose this model as the innovation and quality model of health information technology, the IQHIT model, which measures and explains the internal modes of action for HIT quality and for innovation capabilities as well as their interaction.

Conclusions:

The IQHIT model combines individual associations that are well-known from the literature with the empirical evidence of the complex interplay of HIT quality and innovation. It highlights the key of the professionalism of information management to the quality with which patient care processes are supported by HIT and how innovation capabilities shape information management. The IQHIT model may serve to stimulate further scientific work also in the field of HIT adoption and diffusion as well as to provide practical advice on how to achieve good patient care with the help of health IT.