Improving the ‘manager-clinician’ collaboration for effective healthcare ICT and telemedicine adoption processes – a cohered emergent perspective

ABSTRACT

Existing research shows that the adoption of information and communication technologies (ICTs) for healthcare development in developing countries is largely dominated by donor and international agencies, but the actual organizational-level decisions are often driven by corporate healthcare managers. The consequences of the strategic-driven healthcare ICT adoption practices are that they fail to match clinician users’ requirements and cause them to disuse ICTs for clinical practices and healthcare development. Prior attempts to bring local and globally-distributed actors together to implement ICTs innovatively for healthcare development have emphasized less on synthesizing the diverse information system approaches that inform our understanding of how to narrow the ‘manager-clinician’ tensions in ICT adoption for development in emergent situations. To fill this gap, this article explains the process of shifting healthcare ICT adoption from top-down planning to collective user involvement to enhance clinicians’ acceptance of ICTs for clinical practices and development in a Ghanaian teaching hospital, using the cohered emergent transformation model. Action research was used to engage the hospital’s corporate managers, clinician managers and clinicians, and elicit their views and experiences of the hospital’s ICT adoption for healthcare delivery improvement. Together with observations and document analysis, the data was analyzed to understand the hospital’s information and communication technologies for development (ICT4D) adoption issues and identify ways of managing them. The outcomes provide alternative theoretical and practical ways of adopting healthcare technology systems that shift the excessive use of managers’ powers in ICT adoption towards clinicians’ involvement, to enable technology acceptance for clinical practices and healthcare development.

KEYWORDS:

• Healthcare ICT4D adoption
• emergence
• rationalist
• cohered emergent transformation
• collaboration
• Ghana

Acknowledgements

I am grateful to the developmental feedback I received from Professor Sajda Qureshi, Dr. Francis Kofi Andoh-Baidoo and the anonymous reviewers that enabled me to shape this paper to its intellectual form. I also acknowledge the earlier feedback from Professor Nandish Patel, Professor Peter Kawalek and Dr. Roberta Bernardi. Finally, I am thankful to all participants of the study and to the Committee on Human Research and Publication Ethics, Kumasi, Ghana for approving the progress of the study.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Frank Nyame-Asiamah is PhD Supervisor/Director of Study at London School of Commerce, the Associate College of Cardiff Metropolitan University, and Sessional Lecturer/Tutor on Postgraduate Diploma in Education (Business Studies) at Canterbury Christ Church University. Frank also serves as an ambassador for the CMS Community Connect@AOM group. Previously, he was Curriculum Manager in Business Studies at Hackney Community College/New City College in London. Frank’s research expertise covers organizational learning, healthcare information systems, corporate social responsibility, diaspora entrepreneurship, and critical research approaches. His current projects involve healthcare learning design and evaluation processes, corporate environmental management and commercial fire risk communication assessment. Frank has been called upon to act as a referee for paper submissions for academic journals and conferences.