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A Socio-Technical Analysis of Barriers to Implementing a Clinical Information System in a Nursing Home
Abstract
In this chapter, the authors aim to identify key barriers affecting the implementation of a clinical information system (CIS) in a nursing home from a socio-technical perspective. The data collected through field observations and semi-structured individual interviews were analyzed using the immersion/crystallization approach based on the Sittig-Singh healthcare socio-technical framework (HSTF). Three categories of implementation factors encompassing the eight HSTF dimensions were identified: infrastructure-based factors, process-based factors, and outcome-based factors. The authors extended the HSTF by proposing two additional dimensions: advocacy, promoting the articulation and influence of changes in the system and subsequent outcomes by CIS stakeholders, and adaptability, ensuring the ability of the system to adjust to emerging needs. This chapter expanded prior research and identified barriers related to why the nursing home CIS was abandoned. A knowledge base and recommendations are offered herein as a guide for future implementation strategies and policies in CIS initiatives.
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