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Journal Article

Implementing Electronic Health Information Systems in Local Community Settings: examining Individual and Organisational change experiences in the Philippines  pp187-198

Shainur Premji, Ann Casebeer, Richard E Scott

© Jan 2012 Volume 15 Issue 2, Editor: Shaun Pather, pp149 - 229

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Abstract

In this paper, we examine the implementation of an electronic health information system called the Community Health Information Tracking System (CHITS) in health centres in the Philippines. CHITS was created in 2005 to respond to a gap in population health decision‑making that developed when the Philippines government underwent health sector reforms in the 1990s, shifting resources and decision‑making authority from the national Department of Health to local governmental units at the municipal, provincial and regional levels. Two models ‑ Prochaska and Velicers Transtheoretical Model for Health Behaviour Change and Greenwood and Hinings Organisational Change Management Model ‑ were used to examine the transition from a paper to electronic environment and to assess processes and outcomes at the individual and organisational levels. Final results show both models adequately described the change management processes that occurred for health centre workers and health centres during implementation. However, neither model was developed to focus well on system and government level action and inaction. Our use of these frameworks was therefore unable to fully encapsulate the multiple organisational and political layers of change required in a highly decentralised environment; the health centre as an organisational entity was, and remains, highly dependent on decisions made by local governmental units … decision and policy‑makers at this level must undergo their own change management processes in order for the adoption of CHITS to proceed. We therefore see a series of processes required to proceed both concurrently and sequentially in order for change to occur and be sustained individually, organisationally and systemically. In particular, the role and power of government policy and decision‑making requires more deliberate attention when building our models and conducting our empirical enquiries.

 

Keywords: health information systems, evaluation, individual and organisational change management, e-health, decentralisation

 

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Journal Issue

Volume 15 Issue 2 / Jul 2012  pp149‑229

Editor: Shaun Pather

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Keywords: information systems, service quality, SERVQUAL, service performance, service expectations, difference scores, user satisfaction, quality evaluations, Technical and Functional Quality Model, mobile telephony industry, factor analysis, health information systems, evaluation, individual and organisational change management, e-health, decentralisation

 

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