Decision making process for clinical it investments in a public health care organization – contingency approach to support the investment decision process
Keywords:costs and cost analysis, economics, health information management, case management, signal processing, computer-assisted software
Purpose Health care organizations are lacking a clear decision-making framework in IT investment decisions. This study aims at finding a practical tool able to take the different financial and non-financial factors into account. The usefulness of one possible tool, the Contingency Theory, is evaluated.
The Contingency Theory seeks to understand which external factors in particular have an impact on the organization's operations or which internal factors must be taken into account to make the optimal investment. In the public health care context the internal variables such as organization's culture and condition of existing technology, and external variables such as legislation and politics play an important role.
Methods The Contingency Theory is applied to a complex real-world investment case a posteriori, and the variables thus obtained are compared with the actual acquisition process which took place. The relevant information has been gathered from the accounting systems, and by interviews.
Results The Contingency Theory finds a relevant set of variables to consider in the decision-making process, and the set of variables mostly coincides with the actual parameters considered in the decision-making process. The actual acquisition process placed more weight on cost factors than the Contingency Theory approach would have done.
Conclusions The application of contingency theory suggests that in this case the expected value of costs was over-emphasized. It is likely that a contingency-based approach would have given a more balanced view of the different parameters. Further research is required to establish its usefulness in different types of public health care acquisitions.