Mind the Gap: Assessing Alignment between Hospital Quality and its Information Systems

ABSTRACT

We present a method to assess how aligned hospital information systems (HIS) are with quality standards adopted by the organization. Canonical action research is our mode of inquiry, in a district hospital implementing multiple certification standards. We build on the “ground-truth” provided by healthcare professionals to identify risks and opportunities for HIS developments while contributing to their awareness of its implications. We address different categories of design-reality gaps, namely the organizational, service, process, and individual. The findings suggest that HIS compliance should address five interrelated dimensions of context, people, processes, IT, and information/data. The proposed method allows self-evaluation through gap analysis and a comprehensive assessment of hospital quality, integrating HIS and healthcare processes. Moreover, it supports multiple quality models in hospitals and the development of heterogeneous HIS solutions in different maturity stages. HIS developments should be a priority for hospital quality worldwide; especially in the emerging economies that require methods accessible to their resources, standards compliance, and demographic demands for healthcare.

KEYWORDS:

• healthcare
• information systems
• HIS
• IS quality
• design-reality gaps
• compliance

Acknowledgements

The authors are indebted to Anabela Serra, Alexandra Ângelo, Sofia Barata, and Sérgio Bugalho for their contributions. The authors acknowledge the valuable comments and suggestions of the reviewers and participants of the ISD 2015 conference at Harbin, China, that allowed us to extend and improve this research project.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributors

João Barata is a researcher at CISUC, University of Coimbra and the manager of CTCV – Microsoft Innovation Center, at RECET – Network of Technological Centers of Portugal. He has 18 years experience in the joint development of quality management systems and information systems (IS). As a consultant, he has worked with over 200 public and private organizations in Europe, America, and Africa, including multinationals such as KPMG, BP, Exide, Ericson, Daimler, and Renault. He is Adjunct Professor in the fields of IS Quality and IS Planning at ISMT – Miguel Torga Institute, Coimbra, since 2005. Prior to this he was a lecturer at the Catholic University of Portugal, from 2002 to 2005. In 2016, he was invited to join the Polytechnic Institute of Coimbra as Assistant Professor of Information Systems. João is an Industrial Engineer, holds an M.Sc. in Informatics Engineering, and a Ph.D. in Information Systems from the University of Coimbra. His main research interests are information systems and quality management systems synergies, enterprise modelling, business process management, agile development, and industry 4.0.

Paulo Rupino da Cunha is assistant professor of information systems at the Faculty of Science and Technology of the University of Coimbra, Portugal. Paulo is Director of Informatics and Systems Lab of Instituto Pedro Nunes (IPN), a non-profit association for Innovation and Technology Transfer. Paulo holds a Ph.D. in Informatics Engineering from the University of Coimbra. He has been Adjunct Associate Teaching Professor in the School of Computer Science at Carnegie Mellon, USA, from May 2009 to Dec 2012, and Visiting Associate at Brunel University, UK, from 2008 to 2010. He has been the Vice-President of the Board of Instituto Pedro Nunes and of IPN-Incubadora, a Business Incubator. For a period of three years, he was the elected Coordinator of the Informatics Engineering Chapter for the centre region of Portugal of the Portuguese Engineering Association, and for a two-year term he was a member of the Executive Committee of the Department of Informatics Engineering of the University of Coimbra. He has been involved in the organization of mini-tracks in several conferences, including AMCIS and HICSS. Paulo serves in editorial boards or program committees of several outlets and has reviewed for MISQ, EJIS, ICIS, ECIS, AMCIS, HICSS, among others.

Ana Paula Melo Santos is the Coordinator of the Health Quality and Risk Office at HDFF, District Hospital of Figueira da Foz, Portugal. She holds a holds a Pharmacy degree from the University of Coimbra and a Master in public health from the Faculty of Medicine of the University of Coimbra. Ana Paula has over 35 years of experience in the health sector and participated in several research projects in the field of hospital quality. She has been working in hospital certification and accreditation programs according to multiple regulations including Joint Commission International and, more recently, ISO 9001 and ACSA.

ORCID

João Barata http://orcid.org/0000-0002-7456-594X

Paulo Rupino da Cunha http://orcid.org/0000-0003-2701-5248