Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Cultural orientations and information systems success in public and private hospitals: preliminary evidences from Italy

Authors: Luigi Lepore, Concetta Metallo, Francesco Schiavone, Loris Landriani

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

Abstract

Background

The effective adoption and use of digital and computerized systems and records in hospitals are crucial for increasing the overall quality, safety and outcomes of any national health community. Prior research found that hospitals’ dominant cultural orientation affects the adoption of new technology. However, the organizational culture of hospitals can greatly vary between public and private hospitals. Thus, the ownership type of the hospital is likely to affect, to some extent, the aforementioned relationship between culture and information system success. The present article focuses in detail on this issue and attempts to answer the following research question: which cultural orientations are promoting information system success in public and private hospitals?

Methods

The authors develop and test two hypotheses about this relationship via two regression approaches (single-level and multi-level). The authors collected data from 172 respondents—clinicians and non-clinicians—working in two (one public and one private) hospitals in Campania, one of the largest regions in Italy.

Results

The findings of this study show clear differences between private and public hospitals. First, a dominant cultural orientation that emphasizes flexibility values (clan and adhocracy cultures) positively influences information systems success in terms of individual impact. Second, the influence of a clan orientation on individual impact is stronger in the public hospital. Third, the influence of an adhocracy orientation is stronger in the private hospital. Overall, the type of ownership—either public or private—of these healthcare organizations affects the link between cultural orientations and IS success.

Conclusion

Managers of private hospitals should offer to their employees the opportunity to adopt and implement new information systems processes driven by openness towards the external environment in order to benchmark and learn from what was done previously in other organizations. Managers of public hospitals should set up human resource management practices, knowledge creation mechanisms, and internal communication capable of generating a friendly learning environment for their employees when adopting new technology.
Literature
1.
Hoffman N, Klepper R. Assimilating new technologies: the role of organizational culture. Inf Syst Manag. 2000;17(3):36–42.CrossRef
2.
Van Der Meijden MJ, Tange HJ, Troost J, Hasman A. Determinants of success of inpatient clinical information systems: a literature review. J Am Med Inform Assoc. 2003;10(3):235–43.CrossRefPubMedPubMedCentral
3.
Bradley RV, Pridmore JL, Byrd TA. Information systems success in the context of different corporate cultural types: an empirical investigation. J Manag Inf Syst. 2006;23(2):267–94.CrossRef
4.
Leidner DE, Kayworth T. A review of culture in information systems research: toward a theory of information technology culture conflict. MIS Q. 2006;30(2):357–99.CrossRef
5.
Aarts J, Koppel R. Implementation of computerized physician order entry in seven countries. Health Aff. 2009;28(2):404–14.CrossRef
6.
Middleton B, Bloomrosen M, Dente MA, Hashmat B, Koppel R, Overhage JM, et al. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J Am Med Inform Assoc. 2013;20(e1):e2–8.CrossRefPubMedPubMedCentral
7.
Harrison MI, Ross K, Bar-Lev S. Unintended consequences of information technologies in health care—an interactive sociotechnical analysis. J Am Med Inform Assoc. 2007;14(5):542–9.CrossRefPubMedPubMedCentral
8.
Kim YG, Jung K, Park YT, Shin D, Cho SY, Yoon D, Park RW. Rate of electronic health record adoption in South Korea: a nation-wide survey. Int J Med Inform. 2017;101:100–7.CrossRefPubMed
9.
DeLone WH, McLean ER. Information systems success: the quest for the dependent variable. Inf Syst Res. 1992;3(1):60–95.CrossRef
10.
DeLone WH, McLean ER. The DeLone and McLean model of information systems success: a ten-year update. J Manag Inf Syst. 2003;19(4):9–30.CrossRef
11.
Park J, Chae YM, Lee YT, Cho K, Kim J, Lee BH. Evaluation of CDSS for drug prescriptions based on success measures. J Kor Soc Med Inform. 2009;15(3):293–301.CrossRef
12.
Kivinen T, Lammintakanen J. The success of a management information system in health care–a case study from Finland. Int J Med Inform. 2013;82(2):90–7.CrossRefPubMed
13.
Cho KW, Bae SK, Ryu JH, Kim KN, An CH, Chae YM. Performance evaluation of public hospital information systems by the information system success model. Healthcare Inform Res. 2015;21(1):43–8.CrossRef
14.
Agourram H. Defining information system success in Germany. Int J Inf Manag. 2009;29(2):129–37.CrossRef
15.
Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inform. 2001;64(2–3):143–56.CrossRefPubMed
16.
Koppel R. Great promises of healthcare information technology deliverless. In: Healthcare information management systems. Cham: Springer; 2016. p. 101–25.CrossRef
17.
Hogan SJ, Coote LV. Organizational culture, innovation, and performance: a test of Schein's model. J Bus Res. 2014;67(8):1609–21.CrossRef
18.
Ginter PM, Duncan JW, Swayne LE. Strategic management of health care organizations: Jossey-Bass; 2013.
19.
Stock GN, McFadden KL, Gowen CR. Organizational culture, critical success factors, and the reduction of hospital errors. Int J Prod Econ. 2007;106(2):368–92.CrossRef
20.
Brazil K, Wakefield DB, Cloutier MM, Tennen H, Hall CB. Organizational culture predicts job satisfaction and perceived clinical effectiveness in pediatric primary care practices. Health Care Manag Rev. 2010;35(4):365–71.CrossRef
21.
Cameron KS, Quinn RE. Diagnosing and changing organisational culture. Reading: Addison-Wesley; 1999.
22.
23.
Quinn RE, Rohrbaugh J. A competing values approach to organizational effectiveness. Public Prod Rev. 1981:122–40.
24.
Prenestini A, Calciolari S, Lega F, Grilli R. The relationship between senior management team culture and clinical governance: empirical investigation and managerial implications. Health Care Manag Rev. 2015;40(4):313–23.CrossRef
25.
Singer SJ, Falwell A, Gaba DM, Meterko M, Rosen A, Hartmann CW, Baker L. Identifying organizational cultures that promote patient safety. Health Care Manag Rev. 2009;34(4):300–11.CrossRef
26.
Jacobs R, Mannion R, Davies HT, Harrison S, Konteh F, Walshe K. The relationship between organizational culture and performance in acute hospitals. Soc Sci Med. 2013;76:115–25.CrossRefPubMed
27.
Burns T, Stalker GM. Mechanistic and organic systems. Organ Behav. 2005;2:214–25.
28.
Perry JL, Rainey HG. The public-private distinction in organization theory: a critique and research strategy. Acad Manag Rev. 1988;13(2):182–201.CrossRef
29.
Van der Wal Z, de Graaf G, Lasthuizen K. What’s valued most? A comparative empirical study on the differences and similarities between the organizational values of the public and private sector. Public Adm. 2008;86(2):465–82.CrossRef
30.
Camilleri D, O’Callaghan M. Comparing public and private hospital care service quality. Int J Health Care Qual Assur. 1998;11(4):127–33.CrossRef
31.
Owusu-Frimpong N, Nwankwo S, Dason B. Measuring service quality and patient satisfaction with access to public and private healthcare delivery. Int J Public Sector Manag. 2010;23(3):203–20.CrossRef
32.
Tiemann O, Schreyögg J, Busse R. Hospital ownership and efficiency: a review of studies with particular focus on Germany. Health Policy. 2012;104(2):163–71.CrossRefPubMed
33.
Acar A, Acar P. Organizational culture types and their effects on organizational performance in Turkish hospitals. Emerg Markets J. 2014;3(3):18.CrossRef
34.
Davis FD. A technology acceptance model for empirically testing new end-user information systems: theory and results, doctoral dissertation. Cambridge: MIT Sloan School of Management; 1986.
35.
Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989:319–40.
36.
Venkatesh V, Davis FD. A theoretical extension of the technology acceptance model: four longitudinal field studies. Manag Sci. 2000;46(2):186–204.CrossRef
37.
Tabibi SJ, Nasiripour AA, Kazemzadeh RB, Ebrahimi P. The role of organizational culture according to Hofstede model on information technology acceptance in hospital environment. J Health Manag. 2015;17(1):42–50.CrossRef
38.
Callen JL, Braithwaite J, Westbrook JI. Cultures in hospitals and their influence on attitudes to, and satisfaction with, the use of clinical information systems. Soc Sci Med. 2007;65(3):635–9.CrossRefPubMed
39.
Yarbrough AK, Smith TB. Technology acceptance among physicians: a new take on TAM. Med Care Res Rev. 2007;64(6):650–72.CrossRefPubMed
40.
Barney JB. Organizational culture: can it be a source of sustained competitive advantage? Acad Manag Rev. 1986;11(3):656–65.CrossRef
41.
Tushman ML, O’Reilly CA. Ambidextrous organizations: managing evolutionary and revolutionary change. Calif Manag Rev. 1996;38:8–30.CrossRef
42.
Zammuto RF, O’Connor EJ. Gaining advanced manufacturing technologies' benefits: the roles of organization design and culture. Acad Manag Rev. 1992;17(4):701–28.CrossRef
43.
Agrifoglio R, Metallo C, Lepore L. Success factors for using case management system in Italian courts. Inf Syst Manag. 2016;33(1):42–54.CrossRef
44.
Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inform. 2001;64(2):143–56.CrossRefPubMed
45.
Jaskyte K, Dressler WW. Organizational culture and innovation in non profit human service organizations. Adm Soc Work. 2005;29(2):23–41.CrossRef
46.
Asagbra OE, Burke D, Liang H. Why hospitals adopt patient engagement functionalities at different speeds? A moderated trend analysis. International journal of medical informatics. 2017;
47.
Denison DR, Mishra AK. Toward a theory of organizational culture and effectiveness. Organ Sci. 1995;6(2):204–23.CrossRef
48.
Gordon GG, Di Tomaso N. Predicting corporate performance from organizational culture. J Manag Stud. 1992;29(6):783–98.CrossRef
49.
Coles JW, Hesterly WS. The impact of firm-specific assets and the interaction of uncertainty: an examination of make or buy decisions in public and private hospitals. Journal of Economic Behaviour & Organization. 1998;36(3):383–409.CrossRef
50.
Barbetta GP, Turati G, Zago AM. Behavioral differences between public and private not for profit hospitals in the Italian national health service. Health Econ. 2007;16(1):75–96.CrossRefPubMed
51.
Sloan FA. Not-for-profit ownership and hospital behavior. Handb Health Econ. 2000;1:1141–74.
52.
53.
Helmig B, Lapsley I. On the efficiency of public, welfare and private hospitals in Germany over time: a sectoral data envelopment analysis study. Health Serv Manag Res. 2001;14(4):263–74.CrossRef
54.
Ferrier GD, Valdmanis V. Rural hospital performance and its correlates. J Prod Anal. 1996;7(1):63–80.CrossRef
55.
Sari N. Efficiency outcomes of market concentration and managed care. Int J Ind Organ. 2003;21(10):1571–89.CrossRef
56.
Saltman RB. Melting public–private boundaries in European health systems. European Journal of Public Health. 2003;13(1):24–9.CrossRefPubMed
57.
Brown L, Barnett JR. Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia. Soc Sci Med. 2004;58(2):427–44.CrossRefPubMed
58.
Romeo AA, Wagner JL, Lee RH. Prospective reimbursement and the diffusion of new technologies in hospitals. J Health Econ. 1984;3(1):1–24.CrossRefPubMed
59.
Sloan FA, Valvona J, Perrin JM, Adamache KW. Diffusion of surgical technology: an exploratory study. J Health Econ. 1986;5(1):31–61.CrossRefPubMed
60.
Bretschneider S. Management information systems in public and private organizations: an empirical test. Public Adm Rev. 1990:536–45.
61.
Hu PJH, Chau PY, Sheng ORL. Investigation of factors affecting healthcare organization's adoption of telemedicine technology. In: System Sciences. Proceedings of the 33rd annual Hawaii International Conference; 2000.
62.
Walker CL, Humphreys LW. Hospital control and decision making: a financial perspective. Healthc Financ Manage. 1993;47:90.PubMed
63.
Etezadi-Amoli J, Farhoomand AF. A structural model of end user computing satisfaction and user performance. Inform Manag. 1996;30(2):65–73.CrossRef
64.
Brewer GA, Brewer GA Jr. Parsing public/private differences in work motivation and performance: an experimental study. J Public Adm Res Theory. 2011;21(suppl_3):i347–62.CrossRef
65.
Padma RN, Nair VS. Organizational culture and its impact on organizational commitment in public and private organizations. Global Management Review. 2009;4(1)
66.
Obenchain AM, Johnson WC, Dion PA. Institutional types, organizational cultures, and innovation in Christian colleges and universities. Christ High Educ. 2004;3(1):15–39.CrossRef
67.
Akhtar Shoaib C, Zainab N, Maqsood H, Sana R. Impact of organizational culture on organizational commitment: a comparative study of public and private organizations. Res J Recent Sci. 2013;
68.
Houston DJ. Public-service motivation: a multivariate test. J Public Adm Res Theory. 2000;10(4):713–28.CrossRef
69.
Peters DH, Chakraborty S, Mahapatra P, Steinhardt L. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states. Hum Resour Health. 2010;8(1):27.CrossRefPubMedPubMedCentral
70.
Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative performance of private and public healthcare systems in low-and middle-income countries: a systematic review. PLoS Med. 2012;9(6)
71.
Kimberly JR, Evanisko MJ. Organizational innovation: the influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. Acad Manag J. 1981;24(4):689–713.
Metadata
Title
Cultural orientations and information systems success in public and private hospitals: preliminary evidences from Italy
Authors
Luigi Lepore
Concetta Metallo
Francesco Schiavone
Loris Landriani
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3349-6

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue

Research article

Understanding perceived availability and importance of tobacco control interventions to inform European adoption of a UK economic model: a cross-sectional study

Research article

Research on the horizontal equity of inpatient benefits among NCMS enrollees in China: evidence from Shaanxi Province

Research article

Does risk-adjusted payment influence primary care providers’ decision on where to set up practices?

Research article

Cost-effectiveness analysis of doctor-pharmacist collaborative prescribing for venous thromboembolism in high risk surgical patients

Research article

Hospital length of stay variation and comorbidity of mental illness: a retrospective study of five common chronic medical conditions

Research article

The effectiveness of treatment for Severe Acute Malnutrition (SAM) delivered by community health workers compared to a traditional facility based model