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An empirical examination of antecedents and consequences of IT governance in US hospitals

  • Research Article
  • Published:
Journal of Information Technology

Abstract

Intense pressure to control costs and improve patient care quality is driving hospitals to increasingly look to information technology (IT) for solutions. As IT investment and IT capability have grown in hospitals, the need to manage IT resources aggressively has also increased. The rise in complexity and sophistication of the IT capability in hospitals has also increased the importance of IT governance in these organizations. Yet, there is limited empirical data about the antecedents and consequences of IT governance. We draw upon extant literature related to power and politics and capability management to propose, operationalize, and empirically examine a nomological model that explains and predicts IT governance and its ensuing impact on risk management and IT contribution to hospital performance. We empirically tests our hypotheses based on survey data gathered from 164 CIOs of US hospitals. The results have implications for hospitals’ readiness and predisposition for IT governance, as their structural and relational mechanisms can affect IT governance and, indirectly, IT value creation. A contribution of this study is that it is one of the first to empirically examine antecedents to IT governance and its impact on IT performance in a high-velocity environment that is riddled with technological turbulence.

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Authors and Affiliations

  1. Department of Accounting and Information Management, The University of Tennessee, Knoxville, TN, USA

    Randy V Bradley

  2. Department of Management, Auburn University, College of Business, Auburn, AL, USA

    Terry Anthony Byrd

  3. Department of Information Systems and Operations Management, Loyola University Maryland, Baltimore, MD, USA

    Jeannie L Pridmore

  4. Department of Information Systems, Western Kentucky University, Bowling Green, KY, USA

    Evelyn Thrasher

  5. Department of Business Administration, Washington and Lee University, Williams School of Commerce, Economics and Politics, Lexington, VA, USA

    Renée ME Pratt

  6. Southern University and A&M College, College of Business, Baton Rouge, LA, USA

    Victor WA Mbarika

Authors
  1. Randy V Bradley
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  2. Terry Anthony Byrd
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  3. Jeannie L Pridmore
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  4. Evelyn Thrasher
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  5. Renée ME Pratt
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  6. Victor WA Mbarika
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Corresponding author

Correspondence to Randy V Bradley.

Appendices

Appendix A

Construct operational definitions and scales

CIO structural power

The CIO's reporting level and TMT membership.Sources: Preston et al. (2008) and GuideStar (www.guidestar.com) CIORptLev:Who do you report to? If the person is not the CEO,  how many reporting levels are between you and the CEO? (a) 0 (I report directly to the CEO); (b) 1; (c) 2 or more  (reverse coded (a) 3, (b) 2, (c)1).CIO–TMT: Is the CIO a formal member of the organiza tion's top management team (TMT)? Yes/No

IT-business mutual participation

The degree to which IT personnel participate in business  initiatives and business personnel participate in IT planning.Sources: Adapted from Chan (2002) and King and Teo (1997).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7)Please rate your level of agreement with each of the  following:

ITBMP1: CEO and CIO have a strong working relationship.ITBMP2: Business personnel participate in IT planning.ITBMP3: IT personnel participate in new product/service  development

Entrepreneurial culture

The degree to which the hospital exhibits an entrepreneur ial culture.Source: Quinn and Spreitzer (1991).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7)Please rate your level of agreement with each of the  following:

EC1: My organization is very dynamic and entrepreneurial.EC2: My organization's CEO is an innovator or risk taker.EC3: The glue that holds my organization together is  commitment to innovation and development.EC4: My organization emphasizes growth and the acquisi tion of new resources.

IT governance-enterprise management methodologies

Sources: Adapted from Sambamurthy and Zmud (1999); Ross (2003); Brown and Grant (2005).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7).Please rate your level of agreement with each of the  following:

ITGov1: My organization employs a methodology to  increase the effectiveness of IT investments.ITGov2: My organization employs a methodology to  manage enterprise-wide technical standards.ITGov3: My organization employs a methodology to align  IT project priorities with business priorities.ITGov4: My organization employs a methodology to  encourage business process module reuse.

IT governance-metric and compliance processes

Sources: Adapted from Sambamurthy and Zmud (1999); Ross (2003); Brown and Grant (2005).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7).Please rate your level of agreement with each of the  following:

ITGov5: My organization employs a formal compliance  process for IT projects.ITGov6: My organization employs metrics (e.g., six sigma)  to assess IT projects.ITGov7: My organization employs a formal technology  adoption process.ITGov8: My organization conducts post-implementation  assessment of business impacts of IT (including IT projects).

Social risk management

Sources: Adapted from Jiang et al. (2001); Wallace et al. (2004).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7).Please rate the extent to which your organization has  addressed the risk posed by each of the following:

SRSK1: The negative effects of corporate politics on IT  projects.SRSK2: An unstable organizational environment (e.g.,  excessive turnover, organization undergoing restructuring during project, change in organizational management during project).SRSK3: The negative attitudes of senior business stake holders towards IT projects.SRSK4: Lack of cooperation from business stakeholders in  adopting new technologies (e.g., not committed to project, resistant to change).

Technical risk management

Sources: Adapted from Jiang et al. (2001); Wallace et al. (2004).Scale: 7-point scale ranging from strongly disagree (1) to  strongly agree (7).Please rate the extent to which your organization has  addressed the risk posed by each of the following:

TRSK1: The use of new/emerging information technology  (e.g., open source, web services).TRSK2: The high level of technical complexity of IT  projects.TRSK3: The use of leading edge information technologies.TRSK4: The use of information technology that has not  been used in prior projects.

Market responsiveness

Sources: Adapted from Weill (1992); Bharadwaj (2000).Scale: 7-point scale ranging from not at all (1) to very great  extent (7).On the basis of the past 5 years, please rate the extent to  which IT has improved each of the following:

MKTR1: My organization's speed of response to stake holders’ needs.MKTR2: My organization's ability to tailor products/ services to individual stakeholder needs.MKTR3: The speed at which my organization can enter new  markets.MKTR4: The rate at which my organization can introduce  new products/services.

External relationship management

Sources: Adapted from Feeny and Willcocks (1998); Bharadwaj (2000).Scale: 7-point scale ranging from not at all (1) to very great  extent (7).On the basis of the past 5 years, please rate the extent to  which IT has improved each of the following:

EXRM1: My organization's ability to work with external  suppliers to leverage shared IT capabilities to create high-value IT resources.EXRM2: My organization's ability to manage relationships  with outsourcing partners.EXRM3: My organization's ability to manage relationships  with contracted caregivers who are not employed by this organization.

Operational IT effectiveness

The extent to which IT has improved the hospital's  performance in terms of aiding in detection and reduction of clinical errors.Sources: Adapted from Hamilton and Chervancy (1981a, 1981b).Scale: 7-point scale ranging from not at all (1) to very great  extent (7).On the basis of the past 5 years, please rate the extent to  which IT has improved each of the following:

OITE1: My organization's ability to reduce clinical errors.OITE2: My organization's ability to detect/catch clinical  errors.

Appendix B

Table B1

Table B1 Factor loadings
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Bradley, R., Byrd, T., Pridmore, J. et al. An empirical examination of antecedents and consequences of IT governance in US hospitals. J Inf Technol 27, 156–177 (2012). https://doi.org/10.1057/jit.2012.3

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