Entangled stakeholder roles and perceptions in health information systems: a longitudinal study of the UK NHS N3 network

The combination of pervasive and complex technology and an increasingly challenging healthcare environment is the setting for this research study. As a longitudinal case study, the research tracks the development and implementation of a large private information systems network in the UK National Health Service (NHS). Using stakeholder theory, we unpack the story of a complex network of stakeholder roles and perceptions and how these change over time. Our findings show that favorable and unfavorable positions held by multiple stakeholder groups become entangled, where even the same focal group may adopt competing positions which undermine the adoption of the health network. As this situation develops, the policy and implementation of the broader health IT program becomes confused and destabilized. This study makes three contributions. It expands the literature on stakeholder theory within the IS domain; it extends the managerial focus of stakeholder approaches to include policy-making in the diverse multi-stakeholder setting of healthcare; it demonstrates how stakeholder analysis can be employed in IS research by adopting a broader, dynamic approach to identifying and including different stakeholder groups focusing on their varied roles and views during the course of a large scale health IT program.