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e-Business connections in the health sector: IT challenges and the effects of practice size

Published online by Cambridge University Press:  02 February 2015

Jenny L Gibb
Department of Strategy & Human Resource Management, University of Waikato, Hamilton, New Zealand
Jarrod M Haar
Department of Strategy & Human Resource Management, University of Waikato, Hamilton, New Zealand


The use of information technology (IT) in the health sector is critically important for enhanced patient care and ultimately cost savings. However, the uptake of IT in health has been slow when compared with other industry sectors, due to the range of issues and IT inconsistencies associated with the needs of its stakeholders. This study explored the challenges experienced by 108 New Zealand medical practitioners in their IT interface with other key primary and secondary health providers. We found IT interface challenges were negatively related to e-business activity (receiving) but held no effect on e-business activity (sending). Further, we tested for and found significant moderating effects of practice size, based on patient numbers. Large practices were able to buffer the negative influence of IT interface challenges on e-business activity (receiving), while small practices were severely hampered by IT interface challenges. The implications of operating in a modular industry structure are discussed.

Research Article
Copyright © Cambridge University Press and Australian and New Zealand Academy of Management 2009

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Aiken, LG and West, SG (1991) Multiple Regression: Testing and Interpreting Interactions. Newbury Park CA: Sage.Google Scholar
Arroll, BGoodyear-Smith, FPatrick, DKerse, NHarrison, JHalliwell, JPearson, JLay-Yee, R and von Randow, M (2005) Prescribing Information Resources: Use and preference by general practitioners: An exploratory survey of general practitioners. Report to the Ministry of Health, 07 2005. Wellington: Ministry of Health.Google Scholar
Baldwin, C and Clark, K (1997) Managing in an age of modularity. Harvard Business Review, 75: 8493.Google Scholar
Baron, RJFabens, ELSchiffman, M and Wolf, E (2005) Electronic health records: Just around the corner? Or over the cliff? Annals of Internal Medicine 143(3): 222226.Google Scholar
Bates, D and Gawande, A (2003) Patient safety: Improving safety with information technology. New England Journal of Medicine 346: 25262534.Google Scholar
Bowen, HP and Wiersema, MF (2005) Foreign-based competition and corporate diversification strategy. Strategic Management Journal 26: 11531171.Google Scholar
Brailer, DJ (2005) Economic Perspectives on Health Information Technology. Business Economics 40(3): 614.Google Scholar
Busenitz, L and Barney, J (1997) Differences between entrepreneurs and managers in large organizations: Biases and heuristics in strategic decision making. Journal of Business Venturing 12: 930.Google Scholar
Chen, JCHHough, CBH & Lin, B (2005) Virtual health/electronic medical record: Current status and perspective. International Journal of Healthcare Technology and Management 6(3): 257275.Google Scholar
Cohen, J and Cohen, P (1983) Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences (2nd Edition). Hillsdale, NJ: Erlbaum.Google Scholar
Diamond, CHalamka, JOverhage, JMRicciardi, LRishel, W and Shirky, C (2005) Exchanging health information: local distribution, national coordination. Health Affairs 24(5): 11701179.Google Scholar
Didham, RMartin, IWood, R and Harrison, K (2004) Information technology systems in general practice medicine in New Zealand. The New Zealand Medical Journal 117(1198): 117.Google Scholar
Dowd, BGans, DHammons, T and Kralewski, J (2005) Medical groups' adoption of electronic health records and information systems. Health Affairs, 24(5): 13231333.Google Scholar
Ebben, JJ and Johnson, AC (2005) Efficiency, flexibility, or both? Evidence linking strategy to performance in small firms. Strategic Management Journal 26: 12491259.Google Scholar
Frigant, V and Talbot, D (2005) Technological determinism and modularity: Lessons from a comparison between aircraft and auto industries in Europe. Industry and Innovation 12 (3): 337355.Google Scholar
Ginneken, AM (2002) The computerized patient record: balancing effort and benefit. International Journal off Medical Informatics 65: 97102.Google Scholar
Goldschmidt, PG (2005) HIT and MIS: implications of health information technology and medical information systems. Communications of the ACM 48(10): 6974.Google Scholar
Hannan, MT and Freeman, J (1984) Structural inertia and organizational change. American Sociological Review 49: 149164.Google Scholar
Harris, D (2008) Imaging seamless healthcare transactions Journal of Healthcare Management 53(4): 217220.Google Scholar
Harrison, JP and Lee, A (2006) The role of e-health in the changing health care environment. Nursing Economics 24(6):283289.Google Scholar
Kerr, K (2004) The electronic health record in New Zealand. Heath Care and Informatics Review Online. Retrieved 05 5 2007 from Scholar
Larsen, MG (2008) Technology in healthcare leveraging new innovations. Healthcare Executive 23(5): 913Google Scholar
Lee, JCain, CYoung, SChockley, N and Burstin, H (2005) The adoption gap: Health information technology in small physician practices. Health Affairs 24(5): 13641366.Google Scholar
Leonard, T (2007) Paving the way for the second wave of EHR adoption. Health Management Technology 28(2): 2426.Google Scholar
Macher, JT and Boerner, CS (2006) Experience and scale and scope economies: Trade-offs and performance in development. Strategic Management Journal 27: 845865.Google Scholar
Menachemi, N (2007) Hospital adoption of information technologies and improved patient safety: A study of 98 hospitals in Florida. Journal of Healthcare Management 52(6): 398408.Google Scholar
Ministry of Health (2005) Health Information Strategy for New Zealand. New Zealand Ministry of Health: Wellington, pp. 194.Google Scholar
Ryan, TP (1997) Modern regression methods. New York: Wiley.Google Scholar
Sanchez, R (2000) Product and process architectures in the management of knowledge resources. pp 100122. In Resources, Technology and Strategy, Foss, N and Roberston, PL (Eds), London: Routledge.Google Scholar
Shakir, M and Viehland, D (2005) The selection of the IT platform: enterprise system implementation in the NZ Health Board, Journal of Cases on Information Technology. 7(1): 2233.Google Scholar
Thielst, CB (2007a) The future of healthcare technology Journal of Healthcare Management. 52(1): 79.Google Scholar
Thielst, CB (2007b) Regional health information networks and the emerging organizational structures. Journal of Healthcare Management 52(3): 146150.Google Scholar
Thielst, CB (2007c) The new frontier of electronic, personal, and virtual health records. Journal of Healthcare Management 52(2): 7578.Google Scholar
Wicks, AM (2007) Competing values in healthcare: Balancing the (un)balanced scorecard. Journal of Healthcare Management 52(5) 309324.Google Scholar