Increasing affordance potency through process improvement: case study of a healthcare system

ABSTRACT

While the adoption of electronic health records (EHR) has greatly increased in recent years, the ability of healthcare organizations to leverage their EHRs to improve clinical outcomes has not been clearly evidenced. One reason is that most healthcare organizations implement commercial information systems that are designed to support a pre-defined set of clinical work processes. These systems rarely support every clinical work process in the most effective way and must therefore be modified post-implementation to improve operational alignment in order to better meet the needs of the healthcare organization. This paper investigates that process in the context of a clinical process improvement project. We found that EHR adaptations are most effectively enabled when the goals of the organization and the affordances of system features are known to those using the system. This is because the actualization of the affordances, which result in process improvement, arises from the potency of affordances of the system’s features. In this paper we present the case of a healthcare organization that has successfully modified and leveraged its EHR to improve the clinical process that supports the entire spectrum of care for the identification and treatment of alcohol withdrawal patients. We use the post-implementation adaptation of EHRs to extend the theoretical concept of affordance potency for process improvement from a temporal perspective.

Additional information

Notes on contributors

Chad Anderson

Chad Anderson is an Assistant Professor of Information Systems in the Farmer School of Business at Miami University. He received his Ph.D. in Computer Information Systems from Georgia State University and holds an MBA from Eastern Kentucky University and Bachelor of Science degrees in Occupational Therapy and Psychology from Eastern Kentucky University and Business Administration from North Dakota State University. His research interests include the role of technology in the delivery of health care, information security and privacy, and the materiality of information technology. His work has been published in Information and Organization, Journal of the Association for Information Systems, Journal of Management Information Systems, MIS Quarterly, International Journal of Medical Informatics and other journals.

Mala Kaul

Mala Kaul is an assistant professor of information systems in the College of Business at the University of Nevada, Reno. She received her Ph.D. from the Robinson College of Business at Georgia State University. Her research focuses on information systems design, cyber security and privacy, and health information technology. She has extensive industry experience as an information systems professional. Her work has been published in MIS Quarterly, Journal of Management Information Systems, Harvard Business Review, Journal of Database Management, and other journals.

Dana Edberg

Dana Edberg has been on the faculty of the University of Nevada, Reno since 1983. She has served in a variety of administrative roles including Department Chair and Interim Dean of the College of Business. She has taught a wide variety of classes in information systems including database design, information visualization, programming and systems design/development. Her research explores the types of interpersonal and learning relationships developed in organizations to best support the effective implementation and use of technology. Her work has been published in journals such as Journal of Management Information Systems, Communications of the Association of Information Systems, Journal of Information Systems Applied Research, Health Systems and Information Systems Management. Her technology-related professional work experience includes software engineering project management, database design, and the purchase and implementation of large-scale systems in government and industry. She is currently researching health information systems and worked with a team from the university to evaluate the implementation of a state-wide health information exchange.