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The Large-Scale Implementation of a Health Information System in Brazilian University Hospitals: Process and Outcomes

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Listed:
  • Clarissa Carneiro Mussi

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

  • Ricardo Luz

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

  • Dioni da Rosa Damázio

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

  • Ernani Marques dos Santos

    (Postgraduate Center in Administration, Federal University of Bahia, Salvador 40110-903, Brazil)

  • Violeta Sun

    (School of Arts, Sciences, and Humanities, University of São Paulo, São Paulo 03828-000, Brazil)

  • Beatriz Silvana da Silveira Porto

    (Center for Health Sciences, Federal University of Santa Maria, Santa Maria 97105-900, Brazil)

  • Gabriel Oscar Cremona Parma

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

  • Luiz Alberto Cordioli

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

  • Robert Samuel Birch

    (School of Engineering, University of Liverpool, Liverpool L69 3GH, UK)

  • José Baltazar Salgueirinho Osório de Andrade Guerra

    (Postgraduate Program in Administration, University of Southern Santa Catarina, Palhoça 88137-270, Brazil)

Abstract

Governments around the globe are paving the way for healthcare services that can have a profound impact on the overall well-being and development of their nations. However, government programs to implement health information technologies on a large-scale are challenging, especially in developing countries. In this article, the process and outcomes of the large-scale implementation of a hospital information system for the management of Brazilian university hospitals are analyzed. Based on a qualitative approach, this research involved 21 hospitals and comprised a documentary search, interviews with 24 hospital managers and two system user focus groups, and a questionnaire of 736 respondents. Generally, we observed that aspects relating to the wider context of system implementation (macro level), the managerial structure, cultural nuances, and political dynamics within each hospital (meso level), as well as the technology, work activities, and individuals themselves (micro level) acted as facilitators and/or obstacles to the implementation process. The dynamics and complex interactions established between these aspects had repercussions on the process, including the extended time necessary to implement the national program and the somewhat mixed outcomes obtained by hospitals in the national network. Mostly positive, these outcomes were linked to the eight emerging dimensions of practices and work processes; planning, control, and decision making; transparency and accountability; optimization in the use of resources; productivity of professionals; patient information security; safety and quality of care; and improvement in teaching and research. We argued here that to maximize the potential of information technology in healthcare on a large-scale, an integrative and cooperative vision is required, along with a high capacity for change management, considering the different regional, local, and institutional contexts.

Suggested Citation

  • Clarissa Carneiro Mussi & Ricardo Luz & Dioni da Rosa Damázio & Ernani Marques dos Santos & Violeta Sun & Beatriz Silvana da Silveira Porto & Gabriel Oscar Cremona Parma & Luiz Alberto Cordioli & Robe, 2023. "The Large-Scale Implementation of a Health Information System in Brazilian University Hospitals: Process and Outcomes," IJERPH, MDPI, vol. 20(21), pages 1-25, October.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:21:p:6971-:d:1266966
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    References listed on IDEAS

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    1. Andrew M. Pettigrew, 1987. "Context And Action In The Transformation Of The Firm," Journal of Management Studies, Wiley Blackwell, vol. 24(6), pages 649-670, November.
    2. Catalin Popescu & Hani EL-Chaarani & Zouhour EL-Abiad & Iza Gigauri, 2022. "Implementation of Health Information Systems to Improve Patient Identification," IJERPH, MDPI, vol. 19(22), pages 1-20, November.
    3. Clarissa Carneiro Mussi & Christine Duarte do Valle Pereira & Rogério Tadeu de Oliveira Lacerda & Ernani Marques dos Santos, 2018. "Pre-Implementation evaluation of a nationwide information system for university hospitals: lessons learned from a study in Brazil," Behaviour and Information Technology, Taylor & Francis Journals, vol. 37(3), pages 217-231, March.
    4. Rodrigo Fernandes Malaquias & Fernanda Francielle de Oliveira Malaquias & Yujong Hwang, 2017. "The role of information and communication technology for development in Brazil," Information Technology for Development, Taylor & Francis Journals, vol. 23(1), pages 179-193, January.
    5. Ricardo Luz & Clarissa Carneiro Mussi & Ademar Dutra & Leonardo Correa Chaves, 2021. "Implementation of large-scale health information systems," Revista de Gestão, Emerald Group Publishing Limited, vol. 28(2), pages 106-132, May.
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