Journal of Medical Systems

, Volume 33, Issue 4, pp 275–286 | Cite as

Combining Communication Technology Utilization and Organizational Innovation: Evidence from Canadian Healthcare Decision Makers

  • Jalila Jbilou
  • Réjean Landry
  • Nabil Amara
  • Salaheddine El Adlouni
Original Paper


Information and Communication Technology (ICT) and Organizational Innovation (OI) are seen as the miracle of post-modernity in organizations. In this way, they are supposed to resolve most organizational problems, efficiently and rapidly. OI is highly dependent on the capacity and the investment in knowledge management (internal and external) to support decision making process and to implement significant changes. We know what explains ICT utilization (ICTU) and what determines OI development (OID) in healthcare services. Moreover, the literature tends to link ICTU to OID and vice versa. However, this dependency has never been explored empirically through the lens of roles combination. To identify the existing combined roles profiles of ICTU and OID among healthcare decision makers and determine factors of the shift from a profile to another. We did the following: (1) a structured review of the literature on healthcare management by focusing on ICTU and OID which allowed us to build two indexes and a comprehensive framework; (2) a copula methodology to identify with high precision the thresholds for ICTU and OID; and (3) a cross-sectional study based on a survey done with a sample of 942 decision makers from Canadian healthcare organizations through a multinomial logit model to identify determinants of the shift. ICTU and OID are correlated at 22% (Kendal’s Tau). The joint distribution (combination) of ICTU and OID shows that four major profiles exist among decision makers in Canadian healthcare organizations: the traditional decision maker, the innovative decision maker, the technologic decision maker and the contemporary decision maker. We found out that classic factors act as barriers to the shift from one profile to the desired profile (from 1 to 4, from 2 to 4 and from 3 to 4). We have identified that the attitude toward research and relational capital are transversal barriers of shift. We have also found that some factors have a specific impact such as engaging in activities of research acquisition, the administrative position (being a manager), the preference for applied research results as source of information, the degree of novelty of research results, and the gender. Modern Canadian healthcare organizations need contemporary decision makers who use ICT and develop OI, if performance is the target. Our results let us suggest that the isolated administrative agents profile is no more effective in a dynamic and changing world. Contemporary decision makers need to be more active intellectually and to take risks in their decisions. Relying exclusively on research results and on their social network is no more helpful for a real shift. Moreover, the traditional factors, i.e. organization size, time, experience…are no more effective, especially when we consider combined roles. We propose some practical and theoretical recommendations to support these changes.


Information and communication technology utilization Decision makers Organizational innovation Healthcare organizations Empirical Canada 


  1. 1.
    Ahire, S. L., and Devaray, S., An empirical comparison of statistical construct validation approaches. IEEE Trans. Eng. Manage. 48:3319–329, 2001. doi: 10.1109/17.946530.CrossRefGoogle Scholar
  2. 2.
    Albury, D., Fostering innovation in public services. Public Money Manag. 25:51–56, 2005, January.Google Scholar
  3. 3.
    Alfred Li-Ping, C., ICT industry development strategies and the formation of industrial innovation systems on the two sides of the Taiwan Strait. Int. J. Technol. Manag. 32:3/4264, 2005. doi: 10.1504/IJTM.2005.007333.CrossRefGoogle Scholar
  4. 4.
    Atun, R., Gurol-Uriganci, I., et al., Uptake and diffusion of pharmaceutical innovations in health systems. Int. J. Innov. Manage. 11:2299–321, 2007. doi: 10.1142/S1363919607001709.CrossRefGoogle Scholar
  5. 5.
    Atun, R. A., Kyratsis, I., et al., Diffusion of complex health innovations—implementation of primary health care reforms in Bosnia and Herzegovina. Health Policy Plan. 22:128–39, 2007. doi: 10.1093/heapol/czl031.CrossRefGoogle Scholar
  6. 6.
    Basrak, B., Klaassen, C. A. J., et al., Copulas in QTL mapping. Behav. Genet. 34:161–171, 2004. doi: 10.1023/ Scholar
  7. 7.
    Bessant, J., Enabling continuous and discontinuous innovation: Learning from the private sector. Public Money Manag. 25:135–42, 2005 January.Google Scholar
  8. 8.
    Boonstra, J., and Vink, M., Technological and organizational innovation: A dilemma for fundamental change and participation. Eur. J. Work Organ. Psychol. 6:84–112, 1996.Google Scholar
  9. 9.
    Bridges, J., Fitzgerald, L., et al., New workforce roles in health care: Exploring the longer-term journey of organisational innovations. J. Health Organ. Manag. 21:4–5381–392, 2007. doi: 10.1108/14777260710778916.CrossRefGoogle Scholar
  10. 10.
    Broos, A., Gender and information and communication technologies (ICT) anxiety: male self-assurance and female hesitation. Cyberpsychol. Behav. 8:121–31, 2005. doi: 10.1089/cpb.2005.8.21.CrossRefGoogle Scholar
  11. 11.
    Calista, D. J., and Melitski, J., E-Governement and E-governance: Converging constructs of public sector informations and communications technologies. Public Adm. Q. 31:187–120, 2007.Google Scholar
  12. 12.
    Canadian Health Facilities Directory, Accessed on April 2001.
  13. 13.
    Canadian Institute for Health Information, National Health Expenditure Trends, 1975–2007., 2007.
  14. 14.
    Damanpour, F., and Schneider, M., Phases of the adoption of innovation in organizations: Effects of environment, organization and top managers. Br. J. Manage. 17:3215–236, 2006. doi: 10.1111/j.1467-8551.2006.00498.x.CrossRefGoogle Scholar
  15. 15.
    Djellal, F., and Gallouj, F., Innovation in hospitals: A survey of the literature. Eur. J. Health Econ. 8:3181–193, 2007. doi: 10.1007/s10198-006-0016-3.CrossRefGoogle Scholar
  16. 16.
    Dobrow, M. J., Goel, V., et al., Evidence-based health policy: Context and utilisation. Soc. Sci. Med. 58:1207–217, 2004. doi: 10.1016/S0277-9536(03)00166-7.CrossRefGoogle Scholar
  17. 17.
    England, I., and Stewart, D., Executive management and IT innovation in health: Identifying the barriers to adoption. Health Informatics J. 13:275–87, 2007. doi: 10.1177/1460458207076462.CrossRefGoogle Scholar
  18. 18.
    Fenton, S. H., and Gamm, L. D., Evaluation and management documentation and coding technology adoption. Perspect. Health Inf. Manag. 4:7, 2007.Google Scholar
  19. 19.
    Gagliardini, P., and Gouriéroux, C., An efficient nonparametric estimator for models with nonlinear dependence. J. Econom. 137:189–229, 2006. doi: 10.1016/j.jeconom.2006.03.011.CrossRefGoogle Scholar
  20. 20.
    Hankivsky, O., and Blackwood, E., Gender, diversity and evidence-based decision-making. Health Law Can. 28:11–15, 2007.Google Scholar
  21. 21.
    Hansen, M. T., and Birkinshaw, J., The innovation value chain. Harv. Bus. Rev. 85:6121–30, 2007142.Google Scholar
  22. 22.
    Helfrich, C. D., Weiner, B. J., et al., Determinants of implementation effectiveness: Adapting a framework for complex innovations. Med. Care Res. Rev. 64:3279–303, 2007. doi: 10.1177/1077558707299887.CrossRefGoogle Scholar
  23. 23.
    Hurley, A. C., Bane, A., et al., Nurses’ satisfaction with medication administration point-of-care technology. J. Nurs. Adm. 37:7–8343–349, 2007. doi: 10.1097/01.NNA.0000285114.60689.02.Google Scholar
  24. 24.
    Iakovidis, I., and Purcarea, O., eHealth in Europe: From vision to reality. Stud. Health Technol. Inform. 134:163–168, 2008.Google Scholar
  25. 25.
    Jbilou, J., and Amara, N., Research-based-decision-making in Canadian health organizations: a behavioural approach. J. Med. Syst. 31:3185–196, 2007. doi: 10.1007/s10916-007-9054-3.CrossRefGoogle Scholar
  26. 26.
    Kern, L. M., and Kaushal, R., Health information technology and health information exchange in New York State: New initiatives in implementation and evaluation. J. Biomed. Inform. 40:6S17–S20, 2007. doi: 10.1016/j.jbi.2007.08.010.CrossRefGoogle Scholar
  27. 27.
    Kirigia, J. M., and Seddoh, A., E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region. BMC Public Health. 5:137, 2005. doi: 10.1186/1471-2458-5-137.CrossRefGoogle Scholar
  28. 28.
    McInnes, D., Ladon, B., et al., The impact of a quality improvement program on systems, processes, and structures in medical clinics. Med. Care 45(5):463–71, 2007CrossRefGoogle Scholar
  29. 29.
    Meyer, L. D., Hodgkinson, A. R., et al., Graduate capabilities for health service managers: Reconfiguring health management education @UNSW. Aust. Health Rev. 31:3379–384, 2007.CrossRefGoogle Scholar
  30. 30.
    Millward, L. J., and Freeman, H., Role expectations as constraints to innovation: The case of female managers. Creativity Res. J. 14:193–109, 2002. doi: 10.1207/S15326934CRJ1401_8.CrossRefGoogle Scholar
  31. 31.
    Nelsen, R. B., An introduction to Copulas. Springer, New York, 1999.zbMATHGoogle Scholar
  32. 32.
    Neumann, E., and Prusak, L., Knowledge networks in the age of the semantic Web. Brief. Bioinform. 8:3141–1419, 2007. doi: 10.1093/bib/bbm013.CrossRefGoogle Scholar
  33. 33.
    Orton, S., Umble, K., et al., Management academy for public health: Creating entrepreneurial managers. Am. J. Public Health. 97:4601–605, 2007. doi: 10.2105/AJPH.2005.082263.CrossRefGoogle Scholar
  34. 34.
    Reid, J., A telemedicine primer: Understanding the issues. Artcraft Printers, Billings, MT, 1996.Google Scholar
  35. 35.
    Rogers, E. M., Diffusion of innovations. The Free Press, New York, 1995.Google Scholar
  36. 36.
    Scott’s Government, Index Scott’s Government Index. Southam Information Products Group. Ontario, CA, Don Mills, 2001.Google Scholar
  37. 37.
    Sklar, A., Fonctions de répartition à n dimensions et leurs marges. Publ. Inst. Statist. Univ. Paris. 8:229–231, 1959.MathSciNetGoogle Scholar
  38. 38.
    Solomon, M. R., Regional health information organizations: A vehicle for transforming health care delivery? J. Med. Syst. 31:135–47, 2007. doi: 10.1007/s10916-006-9041-0.CrossRefGoogle Scholar
  39. 39.
    Syvajarvi, A., and Stenvall, J., et al., The impact of information technology on human capacity, interprofessional practice and management. Probl Perspectives Manag. 1:82–95, 2005.Google Scholar
  40. 40.
    Tamburis, O., The specific role of ICT: different perspectives between traditional healthcare service and e-healthcare service. Int. J. Electron. Healthc. 2:3250–262, 2006.Google Scholar
  41. 41.
    Tyrrell, S., Using information and communication technology in healthcare. Radcliffe Medical Press, London, UK, 2002.Google Scholar
  42. 42.
    Viney, M. A., and Rivers, N., Frontline managers lead an innovative improvement model. Nurs. Manage. 38:610, 14, 2007.Google Scholar
  43. 43.
    Weiss, C. H., The many meanings of research utilization. Public Adm. Rev. 39:5426–431, 1979. doi: 10.2307/3109916.CrossRefGoogle Scholar
  44. 44.
    Williams, D., Hammes, P., Real options reasoning in healthcare: an integrative approach and synopsis. J. Healthc. Manag. 52(3):170–186, 2007.Google Scholar
  45. 45.
    Wolfe, R. (1994). Organizational innovation: Review, critique, and suggested research directions. J. Manage. Stud. 31(3):405–31, 1994.CrossRefMathSciNetGoogle Scholar
  46. 46.
    Yang, C. W., and Fang, S. C., Isomorphic pressures, institutional strategies, and knowledge creation in the health care sector. Health Care Manage. Rev. 32:3263–270, 2007.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jalila Jbilou
    • 1
  • Réjean Landry
    • 1
  • Nabil Amara
    • 1
  • Salaheddine El Adlouni
    • 2
  1. 1.Université LavalQuebec CityCanada
  2. 2.Université du Québec, INRS-ETEQuebec CityCanada

Personalised recommendations