IT, change and evaluation: an overview of the role of evaluation in healthservices

Effective evaluation is important for appropriate deployment and use of inf ormation technology, especially in the current environment of changing heal th services. However, the broad range of roles and environments in which te chnology is used challenges traditional evaluation approaches. As technolog y has progressed, these roles have developed to the extent that information technology is now often playing a very complex role in health service orga nisations. In such cases there are many uncertainties in decisionmaking tha t are difficult to address with traditional formal evaluation techniques. T here is a need to recognise and work with more complex, socially constructe d decisionmaking process relying substantially on a variety of human judgem ents. The need for this recognition is demonstrated by exploring the differ ence in our ability to analyse a range of different systems, considering th e role of complexity, uncertainty, theory, change and control. There is the need, then, for evaluation processes to complement these social decisionma king processes, rather than to replace them. The nature of these processes needs to be effectively understood to enable the most appropriate types of evaluations to be undertaken. A number of different scenarios are explored to demonstrate the types of roles that evaluation may need to take. (C) 199 9 Elsevier Science Ireland Ltd. All rights reserved.