The Evolving Nature of Information Systems Controls in Healthcare Organisations

Abstract

Information Systems (IS) projects are found to be complex, unpredictable, and prone to time and cost overruns. Perhaps that is why organisations put a strong focus on IS controls during the planning and execution of such projects.IS control literature in the past has focussed on dyadic control relationships during an outsourced IS development project and relatively little is known about such controls during a complex enterprise systems project. Existing studies usually take a static view of IS controls and do not investigate how controls evolve during different phases of the system lifecycle, as well as across projects. This study presents a processual view of IS controls in the enterprise systems lifecycle in a national blood processing organisation. Traditional research in a blood banking context has focussed on optimising the process of blood collection, inventory management, and distribution with relatively limited attention to the implementation of the supporting information systems. This research focusses on the evolution of control based on a study of three enterprise system implementation projects in the case organisation. The study demonstrates that while all five control modes (input, outcome, behaviour, clan, and self-control) are applied across the phases of enterprise systems projects, the nature and extent of control mechanisms changes across the phases of the enterprise system lifecycle. The findings also suggest a teleological evolution of a project’s control portfolio in which the portfolio evolves based on adaptive learning processes from earlier projects. Finally, by exhibiting the influence of institutional and market context, this study also underlines the multi-stakeholder and contextual nature of enterprise systems implementation and associated controls in health service organisations.