Managing information systems for health services in a developing country: a case study using a contextualist framework

摘要

Investments in information technology (IT) have been escalating in the health sector in both developed and developing countries. However, the failure rate of applications is of concern especially for countries with scarce resources. There is insufficient understanding of factors that lead to such failures in developing countries. A case study of implementing a computerised information system (IS) for health services in the Philippines is analysed using a contextualist framework. Factors that led to the failure included ambiguity in the organisation and in responsibility for the project, lack of capacity to undertake large information systems development projects and inability to retain appropriate staff. However, when the historical and contextual issues were revealed and the interplay between the content, process and context of the change was analysed it was revealed that the content of the IS was not responsive to the changes in the wider health system. The case study confirms the need to analyse and understand organisational, environmental and cultural issues in adopting models and procedures used elsewhere when managing information systems in developing countries.