The alignment of information systems with organizational objectives and strategies in health care

Abstract

Purpose

The alignment of information systems with organizational objectives and strategies is a key, contemporary challenge to organizations in general and the health care industry in particular. Researchers and managers alike believe that the selection of new information systems to support objectives and strategies focuses the organization on accomplishing its objectives and realizing the value of the investments in the systems. The purpose of this study was to help understand alignment in health care so that health care information systems planners can better achieve it.

Methods

Structured interviews with 15 top information systems managers in health care organizations of various sizes and types inquired about organizational objectives and strategies, the process for choosing new information systems to support those objectives and strategies, and the concomitant facilitating and hindering managerial actions and organizational characteristics.

Results

In addition to identifying and elucidating specific objectives, strategies, processes for choosing new systems, and facilitating and hindering actions and characteristics, the study used the data to characterize a generalized process of alignment in health care organizations.

Conclusions

The study contributes by confirming that alignment is a significant issue in health care organizations, and that such organizations make deliberate efforts to achieve it. The study further contributes by providing tables of actions and characteristics that managers might use as checklists in current and future alignment efforts as well as in generally cultivating broad support for alignment. Finally, it contributes by suggesting future study of alignment's predictors and effects in health care organizations.

Introduction

Information technology is playing an increasingly central role in the U.S. health care industry [31]. This is because information systems investments can contribute greatly to improved service quality, operational efficiency, patient satisfaction, and patient care [11], [12], [26]. Even greater adoption and use of such systems in health care could save an additional $162 billion a year [29].

Despite the evidence that IS investments can deliver value to firms in the industry, organizations face a problem successfully deriving value from those investments. Although some health care information systems succeed, many fail in some way [3], [17]. For example, electronic medical record systems frequently do not meet expectations [28]. One major reason for this disappointing outcome is the difficulty health care organizations have in choosing information systems that will actually support their organizational objectives and strategies [41].

The alignment of information systems in support of such objectives and strategies has been the top, or among the top, IT concerns of management in organizations in general for over two decades [6], [25]. The even longer-standing presumption behind alignment is that when any area of an organization takes actions to support the overall strategy, those actions help achieve the objectives top management views as critical to the organization's success [10], [37]. The results of the actions thus contribute more to the organization's performance [39]. In particular, when a specific area of the organization implements an information system to support the overall organizational strategy, the system provides a means to help top management realize its objectives and thereby enhance performance.

On the other hand, an organization's failure to align the information system with its strategies can result in lost opportunities, wasted resources, and consequent unfavorable performance [7], [22], [18]. The organization fails to acquire the information system that would enable it to support a strategy, achieve an objective, and contribute to performance (i.e., it loses opportunities), or it spends time and money acquiring an information system that does not support strategy, does not achieve an objective, and does not contribute to performance (i.e., it wastes resources). At the extreme, the decision makers’ knee-jerk urge to imitate competitors, excessive fascination with new technology, and internal organizational politics with vocal users and intimidated managers can foil an organization's attempts to invest in information systems that actually support strategy. Clever software vendors with hints at impossible benefits can do likewise.

The alignment of information systems in health care is especially critical because such systems can contribute to the success of so many health care organizations [16], [19]. The decision to implement an information system in a health care organization is difficult [14]. However, insufficient research has investigated how organizations in the industry overcome the challenges of deciding to invest in systems that will actually support their objectives and strategies. This study attempts to help understand alignment in health care by answering the following questions so that health care information systems planners can better achieve alignment:

• How do health care organizations attempt to choose new information systems that support objectives and strategies?

• What managerial actions and organizational characteristics enable them to do so?¹

• What managerial actions and organizational characteristics hinder them in doing so?

The meaning of strategic alignment is discussed next. Then, the research methods for collecting data are explained. The data analysis and findings follow. The paper concludes with a discussion of the findings as well as implications for health care industry managers and researchers.