The Effect of Innovation Capabilities of Health Care Organizations on the Quality of Health Information Technology: Model Development With Cross-sectional Data

Abstract

Background: Large health organizations often struggle to build complex health information technology (HIT) solutions and are faced with ever-growing pressure to continuously innovate their information systems. Limited research has been conducted that explores the relationship between organizations' innovative capabilities and HIT quality in the sense of achieving high-quality support for patient care processes.

Objective: The aim of this study is to explain how core constructs of organizational innovation capabilities are linked to HIT quality based on a conceptual sociotechnical model on innovation and quality of HIT, called the IQ_HIT model, to help determine how better information provision in health organizations can be achieved.

Methods: We designed a survey to assess various domains of HIT quality, innovation capabilities of health organizations, and context variables and administered it to hospital chief information officers across Austria, Germany, and Switzerland. Data from 232 hospitals were used to empirically fit the model using partial least squares structural equation modeling to reveal associations and mediating and moderating effects.

Results: The resulting empirical IQ_HIT model reveals several associations between the analyzed constructs, which can be summarized in 2 main insights. First, it illustrates the linkage between the constructs measuring HIT quality by showing that the professionalism of information management explains the degree of HIT workflow support (R²=0.56), which in turn explains the perceived HIT quality (R²=0.53). Second, the model shows that HIT quality was positively influenced by innovation capabilities related to the top management team, the information technology department, and the organization at large. The assessment of the model's statistical quality criteria indicated valid model specifications, including sufficient convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and innovation capabilities.

Conclusions: The proposed sociotechnical IQ_HIT model points to the key role of professional information management for HIT workflow support in patient care and perceived HIT quality from the viewpoint of hospital chief information officers. Furthermore, it highlights that organizational innovation capabilities, particularly with respect to the top management team, facilitate HIT quality and suggests that health organizations establish this link by applying professional information management practices. The model may serve to stimulate further scientific work in the field of HIT adoption and diffusion and to provide practical guidance to managers, policy makers, and educators on how to achieve better patient care using HIT.

Keywords: diffusion of innovation; health information management; hospital information systems; organizational change management; organizational culture; organizational innovation.

Figure 1

Initial conceptual innovation and quality of health information technology model of the layered relationship between innovation capabilities, health information technology quality, and covariates. HIT: health information technology.

Figure 2

The structural model of innovation and quality of health information technology with path coefficients, explained variance (R²), and predictive relevance measures (Q²) of the endogenous constructs. Latent constructs are displayed with rounded edges, the exogenous covariates as ellipses and the moderator variable with a cut-off corner. *P<.05; **P<.01. HIT: health information technology.

Figure 3

The innovation and quality of health information technology model. HIT: health information technology; IT: information technology.