Managing Health Information Delivery Processes for Better Medical Decision Making

Hospitals often retain inadequate systems because they are concerned about the organisational and financial cost of IT investments that do not clearly lead to increased revenue. Previous work has not carefully examined the health care, organisational and business process issues caused by widespread under-investment in Health Information Systems, leading to compromised decision making. Methods: This paper describes the processes involved in a common data management problem in hospitals by investigating the use of a legacy semi-integrated system. It combines a number of methods in a novel way interviews, surveys and a simulation to show how data loss affects the length of service time for patients. Findings: The paper finds that data delay or loss inclines medical consultants to make decisions about patient care without full access to all requested data, leading to repeat patient scanning, risks to patients and costs to the system. Contribution: It examines how the processes leading to unreliable data delivery influence the decisionmaking behaviour of actors in a system. It shows how problematic processes lead to doctors making decisions even if data is absent and illustrates how inertia in adopting integrated health IS, providing improved decision support, can have an impact on patient care.