Computer deployment in the health services of developed and developing countries : a comparative case study of the UK and Oman
Organisations are increasingly deploying and using computer technology in various ways, involving the allocation of large amounts of capital and human resources. However, in many cases, computer deployment has been accompanied by failure, particularly in health care services. Therefore, information technology has raised grave questions, misunderstanding, fears, and hostility. This study emphasises the importance of computer deployment and development in developed and developing countries' health care services with examples from advanced and less advanced nations. It describes strategy development for IT/ISs using information system methodologies and explores the development of ISs strategy in the NHS in the light of fundholding and the internal market. A number of problems that commonly influence the success or failure of computer deployment and development are identified. These issues are explained through two case studies: the Omani health system and General Practices (GPRs) in the UK, which have introduced computers. The research focuses on five main sets of issues related to computer deployment and utilisation in health care: strategic planning; computer utilisation; computer fears; computer impact; and computer technical problems and performance. Users' overall satisfaction with systems in use is also considered. Data collection was carried out using two surveys. One survey was conducted in GPRs in Humberside and the other conducted in Royal Hospital and Sultan Qaboos University Hospital in Oman. Data sources included observations, review of relevant documents, such as reports, research papers and manuals, structured and non-structured interviews with selected users and a questionnaire. A number of conclusions can been drawn from this study: firstly, computer deployment, utilisation and development still faces problems in both the systems studied, more especially the Omani system. Secondly, GPRs have carried out strategic planning for computer deployment and utilisation and are prepared to use information system methodology for IT/IS strategy and there is a plan to use this for competitive advantage but Omani hospitals did not set a constructive strategic plan for their systems. Thirdly, the main problems of computer failure are related to human issues rather technical issues. The most important of these human issues are the style of the leadership planning, poor utilisation of computer applications, lack of skills and poor training. Finally, the results of the survey suggested that though the respondents were aware of the potential of computer technology, the problems of computer fears, training and lack of skills were experienced, and often, few individuals possessed computing knowledge. The author suggests several points to be considered: 1) that any thinking about computer deployment and development should employ appropriate information system development methodologies; 2) the decisions on computer deployment, use and development should be made by a special committee that has expertise in IT matters; 3) good strategic planning for computer deployment, use and development; should be connected to the organisation's overall strategy and 4) there is a need of mandate review for such development and planning. With these points in mind the researcher presents a diagram to help improving strategic planning and development of IT/IS methods with particular emphasis on the Omani environment.