This interdisciplinary PhD lies at the intersection of three domains: Human Resource (HR) Management, Information Systems (IS) and Health Informatics, also known as eHealth. It focuses specifically on Human Resource Information Systems (HRIS) designed for or used in health organizations. The studies described used both secondary and empirical research methods to synthesize the existing body of evidence, generate new evidence and advance current theoretical models in this area. Study 1: A methodologically rigorous Systematic Literature Review captured, critically appraised and synthesized the existing corpus of research pertinent to HRIS. It revealed that while some studies of HRIS implementation have differentiated between expected and realized benefits, none have compared both of these in the context of healthcare, and none have compared HRIS in different healthcare systems (Tursunbayeva et al., 2016). Study 2: The empirical studies were aimed at addressing this knowledge gap by analysing the expected and realized benefits from HRIS projects for different stakeholders within healthcare organizations in two countries. They also set out to assess to what extent identified in the systematic review sociotechnical factors of influence affected implementation and outcomes in these projects. The empirical research followed a qualitative embedded case study design, using both documentary analysis and stakeholder interviews. Two case examples were selected for analysis - a national and a regional HRIS development and implementation programmes in two different European countries. The same commercial HRIS system was procured under public tender and deployed in both settings. Data were analyzed within and across both cases in order to identify their commonalities and differences. The integrated analysis identified a wide range of expected benefits that had driven both projects for different actors. There was evidence of all the categories of expected benefit identified in previous HRIS research (Parry & Tyson, 2011), except for improving Organizational image. Uniquely the results indicate that HRIS projects can be also driven by organizations’ motivations to benchmark themselves against the sector leaders and by particular requirements of the health sector (e.g. improving patient care). The comparative analysis of the two case studies also provided clear evidence that benefits realization takes place not only during the IS implementation process, but also through its use and can be affected by a wide range of sociotechnical factors. The case studies analyzed in this thesis also demonstrate that there are strong interdependencies both across different categories of benefit and between different actors. Importantly, the analysis also revealed the variation between benefits expected at the outset of the project compared to the outcomes realised later on. Study 3: In order to better understand this gap, further analysis was undertaken of the processes of HRIS development and implementation that had influenced each outcome. This used an Institutional Theory lens to explore how different (competing) institutional pressures had shaped the development and implementation of this “IS innovation” within these organizational settings over time. The concepts of the “organizing vision” and “strategic responses” were invoked to understand how different organizational actors had interpreted the nature and goals of the innovation and how they had chosen to respond to the various institutional pressures associated with them. This analysis yielded a framework for describing the process through which social context shapes organizational IS innovations over time. This framework, and the taxonomy of expected and realized benefits from HRIS, contribute meaningfully to the development of theory in this area and can inform future HRIS research. Insights and recommendations from the studies are also valuable for managers planning, delivering or evaluating HRIS development and implementation projects, which can be complex and challenging.
Questa tesi di dottorato è interdisciplinare e interseca tre ambiti: la gestione delle risorse umane (HRM), i sistemi informativi (IS) e l'informatica medica (eHealth). Si concentra in particolare sugli IS per la gestione delle risorse umane (HRIS), progettati per e/o utilizzati nelle aziende sanitarie. Sono stati impiegati sia metodi di ricerca secondari che empirici per sintetizzare i dati disponibili ad oggi, fornirne di nuovi e migliorare gli attuali modelli teorici in questo settore. Studio 1: Una revisione sistematica della letteratura ha permesso di raccogliere, valutare criticamente e sintetizzare l’esistente corpus di dati della ricerca relativa agli HRIS. Tale analisi ha rivelato che, mentre alcuni studi di implementazione degli HRIS hanno distinto tra i benefici attesi e quelli realizzati, nessuno li ha confrontati nell'ambito sanitario, e nessuno ha comparato progetti di HRIS in diversi sistemi sanitari (Tursunbayeva et al., 2016). Studio 2: Gli studi empirici hanno avuto lo scopo di affrontare questo gap della letteratura attraverso l'analisi dei benefici attesi e realizzati di progetti HRIS per diversi stakeholder all'interno delle aziende sanitarie in due Paesi. Essi inoltre volevano valutare in che misura fattori socio-tecnici di influenza identificati nella revisione sistematica hanno interessato l’implementazione e gli esiti di questi progetti. La ricerca ha seguito un qualitative embedded case study design utilizzando sia le analisi documentarie che le interviste agli stakeholder. Due casi sono stati selezionati come esempi per l'analisi: un programma nazionale e uno regionale di sviluppo e di implementazione degli HRIS relativi rispettivamente a due aziende sanitarie di due diversi Paesi europei, dove lo stesso sistema commerciale HRIS è stato acquistato con gara pubblica e implementato. I dati sono stati analizzati sia all'interno che tra i due casi, al fine di identificare punti in comune e differenze. L'analisi integrata ha identificato una vasta gamma di benefici attesi per diversi stakeholder, benefici che avevano guidato entrambi i progetti. C’è stata evidenza di tutte le categorie di benefici attesi individuati nelle precedenti ricerche sull’HRIS (Parry & Tyson, 2011), ad eccezione del miglioramento dell'immagine organizzativa. Straordinariamente i risultati indicano che i progetti HRIS possono essere spinti anche dalla motivazione delle aziende a confrontarsi con i leader del settore e da particolari esigenze del settore sanitario (es. migliorare la cura del paziente). L'analisi comparativa ha fornito una chiara evidenza che la realizzazione dei benefici avviene non solo durante il processo di implementazione degli IS, ma anche attraverso il loro uso e può essere influenzata da diversi fattori socio-tecnici. I casi analizzati dimostrano che ci sono forti interdipendenze sia tra le categorie di benefici sia tra gli stakeholder. L'analisi ha rivelato anche la variazione tra benefici attesi e risultati realizzati. Studio 3: Un’ulteriore analisi dei processi di sviluppo e implementazione degli HRIS è stata condotta utilizzando la Institutional Theory per comprendere come essi siano stati plasmati dalle differenti pressioni istituzionali nel corso del tempo, influenzando i risultati dei progetti. I concetti di organizing vision e strategic responses sono stati invocati per capire come gli stakeholder avevano interpretato gli obiettivi dell’innovazione e il modo in cui essi avevano scelto di rispondere alle pressioni istituzionali. Questa analisi ha prodotto un framework per descrivere il processo attraverso il quale il contesto sociale modella le innovazioni organizzative degli IS nel corso del tempo. Questo framework e la tassonomia dei benefici attesi e realizzati dagli HRIS contribuiscono significativamente allo sviluppo della teoria in questo settore e possono ispirare la ricerca futura relativa agli HRIS. I risultati e le raccomandazioni che emergono da questi studi sono anche utili per manager che pianificano, eseguono o valutano progetti sugli HRIS, complessi e impegnativi.
Developing and implementing ICT innovations for efficiency, quality and effectiveness in complex organizations: a comparative analysis of human resource informations systems in health care
TURSUNBAYEVA, Aizhan
2017-07-12
Abstract
This interdisciplinary PhD lies at the intersection of three domains: Human Resource (HR) Management, Information Systems (IS) and Health Informatics, also known as eHealth. It focuses specifically on Human Resource Information Systems (HRIS) designed for or used in health organizations. The studies described used both secondary and empirical research methods to synthesize the existing body of evidence, generate new evidence and advance current theoretical models in this area. Study 1: A methodologically rigorous Systematic Literature Review captured, critically appraised and synthesized the existing corpus of research pertinent to HRIS. It revealed that while some studies of HRIS implementation have differentiated between expected and realized benefits, none have compared both of these in the context of healthcare, and none have compared HRIS in different healthcare systems (Tursunbayeva et al., 2016). Study 2: The empirical studies were aimed at addressing this knowledge gap by analysing the expected and realized benefits from HRIS projects for different stakeholders within healthcare organizations in two countries. They also set out to assess to what extent identified in the systematic review sociotechnical factors of influence affected implementation and outcomes in these projects. The empirical research followed a qualitative embedded case study design, using both documentary analysis and stakeholder interviews. Two case examples were selected for analysis - a national and a regional HRIS development and implementation programmes in two different European countries. The same commercial HRIS system was procured under public tender and deployed in both settings. Data were analyzed within and across both cases in order to identify their commonalities and differences. The integrated analysis identified a wide range of expected benefits that had driven both projects for different actors. There was evidence of all the categories of expected benefit identified in previous HRIS research (Parry & Tyson, 2011), except for improving Organizational image. Uniquely the results indicate that HRIS projects can be also driven by organizations’ motivations to benchmark themselves against the sector leaders and by particular requirements of the health sector (e.g. improving patient care). The comparative analysis of the two case studies also provided clear evidence that benefits realization takes place not only during the IS implementation process, but also through its use and can be affected by a wide range of sociotechnical factors. The case studies analyzed in this thesis also demonstrate that there are strong interdependencies both across different categories of benefit and between different actors. Importantly, the analysis also revealed the variation between benefits expected at the outset of the project compared to the outcomes realised later on. Study 3: In order to better understand this gap, further analysis was undertaken of the processes of HRIS development and implementation that had influenced each outcome. This used an Institutional Theory lens to explore how different (competing) institutional pressures had shaped the development and implementation of this “IS innovation” within these organizational settings over time. The concepts of the “organizing vision” and “strategic responses” were invoked to understand how different organizational actors had interpreted the nature and goals of the innovation and how they had chosen to respond to the various institutional pressures associated with them. This analysis yielded a framework for describing the process through which social context shapes organizational IS innovations over time. This framework, and the taxonomy of expected and realized benefits from HRIS, contribute meaningfully to the development of theory in this area and can inform future HRIS research. Insights and recommendations from the studies are also valuable for managers planning, delivering or evaluating HRIS development and implementation projects, which can be complex and challenging.| File | Dimensione | Formato | |
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