Adoption and Implementation of Hospital IT Systems in Ambulatory Surgical Care

Abstract: Purpose - The purpose of this study is to receive an understanding for how to enable higher rates of adoption implementation success of hospital IT (HIT) systems in ambulatory surgical care settings.   Method - The study is an explorative deductive multiple case-study, incorporating 15 ambulatory surgical centers situated in Sweden, Germany, and the United States. In total, 24 interviews were conducted with managers and users at the selected ASCs in three waves and analyzed through thematic analysis.   Findings - The study resulted in the identification of six barriers and eight enablers in the adoption- and implementation phase of HIT systems. In addition, an implementation framework was developed based on the findings from RQ1 and RQ2, with critical activities to execute to facilitate adoption- and implementation success of HIT systems in ASCs.   Theoretical contribution - This study adds to the literature by identifying new barriers and enablers in HIT adoption and implementation characterizing ambulatory surgical centers. Furthermore, the findings extend on previous literature by presenting an new all-encompassing implementation framework, showing the necessity to approach the implementation process as a whole process-improvement project for successful HIT adoption and implementation.  Managerial implications - This study emphasizes the important role managers in ambulatory surgical centers hold in facilitating successful HIT implementation and provides managers with a practical implementation framework to serve as a roadmap to guide them in achieving a successful implementation of HIT systems.   Limitations and future research - The study is limited to investigating adoption- and implementation of HIT systems (EHR, EMR, HIS) in the context of ambulatory surgical centers. Future studies can explore the identified barriers and enablers in more ambulatory surgical settings and extend upon the developed implementation framework.