INFORMATION TECHNOLOGY IN COMPLEX HEALTH-SERVICES - ORGANIZATIONAL IMPEDIMENTS TO SUCCESSFUL TECHNOLOGY-TRANSFER AND DIFFUSION

Objective: To identify impediments to the successful transfer and impl ementation of packaged information systems through large, divisionaliz ed health services. Design: A case analysis of the failure of an imple mentation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This applicatio n had been proven in the United States environment. Measurements: Inte rviews involving over 60 staff at all levels of the service were under taken by a team of three. The interviews were recorded and analyzed fo r key themes, and the results were shared and compared to enable a con tinuing critical assessment. Results: Two components of the transfer o f the system were considered: the transfer from a different environmen t, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framewo rk. In relation to the first, it was found that there was a lack of fi t in the business environments and strategies, organizational structur es and strategy-structure pairing as well as the management process-ro les pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships. Conclusion: The large-scale developments of integrated health services present great c hallenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There i s a need to take a more sophisticated approach to understanding the co mplexities of organizational factors than has traditionally been the c ase.