Creating Health Care ICT Networks for All : Some Key Lessons for the UK National Program for Information Technology

The development and use of information and communication technologies (ICTs) in health care institutions has proved to be a course traversed with unexpected risks and challenges. The international experience has more failure stories to tell than stories of successful adoption, and usually the more inclusive the technology and/or the wider the span of the implementation, the more difficult the task becomes. Evidently, an inadequate technological design and/or poor performance will reduce the chances of a given ICT being successfully adopted. Yet even in cases where the technology is state-of-the-art, successful adoption is ultimately not a mere technical matter. Organizational issues are perhaps more important as technical difficulties can be the result of poorly managed development processes. Such issues as insufficient user involvement in the design process, inadequate understanding and integration of the users’ existing working routines into the new processes being introduced through IT, as well as indifference to diverse and competing political agendas may lead to failure. These and other related issues have been consistently reported in empirical studies in the field of health care ICT and illustrate the deep interrelation of technical and social aspects in systems development and use; the functionalities of a given ICT shapes and is shaped by the needs and working patterns of different stakeholder groups within participant organizations. In the end, then, the question whether an ICT project is successful or not, becomes the question of success for whom? This paper explores this question in the context of the UK's National Program for IT, while making a number of practical recommendations as to how the program could be restructured with implications for its future success