Exploring the impact of operating model choice on the governance of inter-organizational workflow: the U.S. e-prescribing network

Abstract

Inter-organizational networks play an increasing role in delivering computer-mediated public services such as healthcare. Many networks govern through an infomediary (i.e., electronic broker) that brings together disparate member organizations. These networks can resemble an enterprise where standards and incentives for use are imposed on its partners. This study seeks to extend an enterprise IT governance (ITG) concept to the U.S. e-prescribing network as it transitions from a paper-based network to a computer-mediated one. The operating model, proposed by Ross et al (2006), emphasizes choices in standardization and integration to align strategy with operational processes to improve enterprise performance. Missing in their work is evidence that macro-level choices embedded in the operating model directly impact network workflow. A comparative synthesis traces the changes made to the U.S. e-prescribing operating model to their impact upon the roles and relationships among network members. Some workflow mis-alignments were traceable to the operating philosophy imposed by healthcare policy-makers. The study suggests IT alignment in networks may be better achieved through governing operating models rather than the traditional ITG focus on organizational forms.

Keywords:

• healthcare information systems
• IT governance
• system design
• operating model
• inter-organizational network
• workflow

Acknowledgements

An early version of this paper, co-authored with Bijan Azad, was published in the Proceedings of the SIGPrag Workshop held at ICIS 2010 in Saint Louis. The guidance of the special issue editors was instrumental, along with the feedback of Bijan Azad and anonymous reviewers. The research was partially supported by the University Research Board of the American University of Beirut and the IBM Center for the Business of Government.

Additional information

Notes on contributors

Nelson King

About the authors

Nelson King is an associate professor at the Olayan School of Business – American University of Beirut. His research interests are in networked information systems, especially inter-organizational collaboration in healthcare. He obtained his Ph.D. in industrial and systems engineering from the University of Southern California where he also did post-doctoral research in imaging informatics. Before joining academia, he spent over 20 years as a systems engineer. Nelson's healthcare work has been published in journals such as the European Journal of Information Systems, Communications of the Association for Information Systems, E-Service Journal, and International Journal of Organizational Design and Engineering. Some of his earlier work has been published in MIS Quarterly and IEEE Transactions on Engineering Management. He serves as associate editor for Communications of the Association for Information Systems, Health Systems, Information Systems Management, and International Journal of Organisational Design and Engineering.