“Context” in healthcare information technology resistance: A systematic review of extant literature and agenda for future research

Abstract

Resistance to Healthcare Information Technologies (HIT) continues to be a major challenge that hampers the realization of benefits. Attending to the noted significance of “context” in IT resistance, we carried out this review to understand how the “context” of healthcare in the extant HIT resistance literature has been studied. Based on a review of HIT resistance across 19 IS journals and 5 major IS conferences we organize and summarize the literature around the interaction of people, practice, and technology and provide several significant possibilities for future research.

Introduction

Healthcare Information Technology (HIT) applications such as Electronic Medical Records, Electronic Health Records, Telemedicine, and Mobile Health have tremendous potentials to overcome some of critical issues plaguing healthcare (Agarwal, Gao, DesRoches, & Jha, 2010; Chandwani & Dwivedi, 2015; Dwivedi, Shareef, Simintiras, Lal, & Weerakkody, 2016; Williams & Boren, 2008). However, despite the long-standing academic and practitioner interest in understanding and overcoming IT resistance across various contexts, user resistance is considered a critical challenge in the implementation and the successful realization of the potential benefits of these HIT applications (Ali, Zhou, Miller, & Ieromonachou, 2016; Lapointe & Rivard, 2005; Laumer & Eckhardt, 2012). We conducted this systematic review (Webster & Watson, 2002) to understand why despite the existence of several IT resistance theories, HIT resistance remains a major challenge.

Research on IT resistance suggests the pivotal role of “context”—the socio-technical settings of IT implementation (Samhan, 2018). It is argued that resistance emanates from the perceived threat to the actors regarding the changes brought by the interaction of IT with its “context” of implementation (Laumer, Maier, Eckhardt, & Weitzel, 2016; Rivard & Lapointe, 2012). Underlining the significance of context further, Romanow et al. (2012) noted that the peculiarities of the healthcare context, such as work routine and control mechanisms, make HIT resistance a distinct phenomenon compared to IT resistance in other contexts. To understand HIT resistance in the salience of “context,” we carried out this systematic review (Webster & Watson, 2002) to elucidate “how the extant HIT resistance literature has concentrated on the contextual peculiarities of the healthcare organizations?” Such an inquiry would not only reveal the reasons behind HIT resistance and prevent findings and knowledge from getting frittered but also provide several productive future research directions.

Academic literature on HIT implementation informs that success or failure of HIT is driven by the inevitable interaction of IT with people (who use IT or are affected by its use) and the practices of healthcare organizations (Goh, Gao, & Agarwal, 2011; Payton, Pare, LeRouge, & Reddy, 2011; Rivard, Lapointe, & Kappos, 2011). Therefore, we attempted to understand the context of HIT implementation in terms of people, practices, and technology and used these three dimensions and interactions among them as the guiding framework (Webster & Watson, 2002) to synthesize the extant HIT resistance literature.

Following the guideline of Webster and Watson (2002), the rest of the paper is structured as follows. We begin by presenting the conceptualization of IT resistance in Section 2. Here we discuss how it differs from IT non-acceptance. In Section 3, we discuss our review framework derived from this conceptualization of IT resistance and in Section 4 we discuss the review methodology. We then discuss our findings and observations from the review in Section 5, and in Section 6 we discuss some of the significant future research directions.