Implementing information systems in health care organizations: myths and challenges

Int J Med Inform. 2001 Dec;64(2-3):143-56. doi: 10.1016/s1386-5056(01)00200-3.


Successfully implementing patient care information systems (PCIS) in health care organizations appears to be a difficult task. After critically examining the very notions of 'success' and 'failure', and after discussing the problematic nature of lists of 'critical success- or failure factors', this paper discusses three myths that often hamper implementation processes. Alternative insights are presented, and illustrated with concrete examples. First of all, the implementation of a PCIS is a process of mutual transformation; the organization and the technology transform each other during the implementation process. When this is foreseen, PCIS implementations can be intended strategically to help transform the organization. Second, such a process can only get off the ground when properly supported by both central management and future users. A top down framework for the implementation is crucial to turn user-input into a coherent steering force, creating a solid basis for organizational transformation. Finally, the management of IS implementation processes is a careful balancing act between initiating organizational change, and drawing upon IS as a change agent, without attempting to pre-specify and control this process. Accepting, and even drawing upon, this inevitable uncertainty might be the hardest lesson to learn.

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Diffusion of Innovation
  • Humans
  • Medical Records Systems, Computerized*
  • Organizational Culture
  • Organizational Objectives