Guah, Matthew W. (2005) Institutionalization and de-institutionalization processes in the UK healthcare system : the role of emerging technologies. PhD thesis, University of Warwick.

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Abstract

This thesis is a result of a research project that examines the Information Systems
strategy of the National Health Service (NHS). The researcher followed the process
of implementing a Primary Service Provision (PSP). PSP is an initiative by the NHS
Information Authority (NHSIA) to develop and establish a National Programme for
Information Technology (NPfIT)—a means of providing a useable electronic health
record nationally to the UK.
Five case studies are presented in the thesis, containing:
1. Two primary care facilities;
2. Three secondary care facilities;
These cases were developed as a result of studying the internal processes, decision
and support paths applied individually in the NHS.
The research approach adopts qualitative and interpretative analysis that includes
longitudinal case studies. This multiple case study approach has an embedded design
incorporating the components of work business processes as subunits to enhance
insight. Data was collected predominantly from interviews supported by archive
material, documents, and direct observation. Overlapping cross case, and within case
analysis was undertaken, using Activity Records, Strategic Choice Analysis, and
concepts supported by various researchers in the past (Avgerou & Cornford, 1993;
Davenport, 1993; Eisenhardt, 1989; Galliers, 1991). While it might be possible for
similar processes to result in different solution when adopted in another research
context, in these seven cases quite different approaches were taken. The Thesis concludes that while the core processes were the same across the cases, the following
issues combined together to lead to quite different approaches in each case:
1. The detail of the IS strategic processes;
2. The variation in the contexts;
3. The logic of the decision process as they evolved; and
4. The view of the actors involved.
The researcher is of a strong belief that as time progresses and experience is gained
and the situation with NPfIT evolves, the various actors would change their views
towards IS strategy. This could result in changes in the overall NHS IS business
model and healthcare delivery process support. This assumption, however, could be
affected by the appearance of very little transfer of knowledge—across different parts
of the NHS—regarding past experience with IS implementation.
The author argues that NPfIT mainly serves to diffuse information and
communication technologies in the NHS. As a result the NPfIT is changing the way
by which the NHS competes and meets the needs of it patients, the business model
and the value-creating processes. New opportunities are also taking place introducing
new healthcare delivery processes and modifying the existing processes.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > R Medicine (General) T Technology > T Technology (General)
Library of Congress Subject Headings (LCSH):	Great Britain. National Health Service, Information storage and retrieval systems -- Medical care, Medical care -- Great Britain -- Case studies, Medical care -- Information technology
Official Date:	2005
Dates:	Date Event 2005 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Business School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Currie, Wendy, 1960- ; Kotlarsky, Julia
Sponsors:	Great Britain
Description:	This is an abridged version for electronic use; please see the official URL for details on how to access the full version.
Extent:	xiii, 386 leaves
Language:	eng
URI:	http://wrap.warwick.ac.uk/id/eprint/4024

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