IS/IT Governance in Health Care: An Integrative Model

  • Peter Haddad
  • Steven McConchie
  • Jonathan L. Schaffer
  • Nilmini Wickramasinghe
Part of the Healthcare Delivery in the Information Age book series (Healthcare Delivery Inform. Age)


In today’s healthcare environment, information systems/information technology (IS/IT) are being touted as enablers for enhancing hospitals’ overall performance without compromising the quality of patient care. Hence, we are witnessing more healthcare organizations investing in IS/IT. However, these investments rarely show significant tangible benefits as quantifiable outputs. Demonstrating the business value of IS/IT is even harder in view of the high failure rate of many of IS/IT implementations coupled with high user resistance and frustration.

To examine and address these problems, this chapter examines IS/IT governance structures and practices to build an integrative model. Not only will this identify the needs and requirements for various stakeholders in the context of healthcare, but it will also address the contextual conditions that currently affect the existing IS/IT governance structures and the control measures, which in turn limit their impacts. The study focuses on the case of an Australian not-for-profit tertiary healthcare environment.

The findings from this study provide evidence to support the perspective that maintaining robust IT governance has positive impacts on the business value of different IS/IT. Further, this study highlights several requirements for IT governance and the factors that affect its practices.


Business value of IT Information technology IT governance Value Well-being 


  1. Allen, B. A., Juillet, L., Paquet, G., & Roy, J. (2001). E-Governance & government on-line in Canada: Partnerships, people & prospects. Government Information Quarterly, 18(2), 93–104.CrossRefGoogle Scholar
  2. Alreemy, Z., Chang, V., Walters, R., & Wills, G. (2016). Critical success factors (CSFs) for information technology governance (ITG). International Journal of Information Management, 36(6, Part A), 907–916.CrossRefGoogle Scholar
  3. Australian Institute of Health and Welfare. (2005). Visiting medical officer.Google Scholar
  4. Bentley, C. (2010). Prince2: A practical handbook. New York: Routledge.CrossRefGoogle Scholar
  5. Bonoma, T. V., & Wong, K. B. (1983). A case study in case research. Boston: Division of Research, Graduate School of Business Administration, Harvard University.Google Scholar
  6. Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Thousand Oaks: Sage.Google Scholar
  7. Boynton, A. C., Jacobs, G. C., & Zmud, R. W. (1992). Whose responsibility is IT management? MIT Sloan Management Review, 33(4), 32.Google Scholar
  8. Chen, D. Q., Preston, D. S., & Xia, W. (2013). Enhancing hospital supply chain performance: A relational view and empirical test. Journal of Operations Management, 31(6), 391–408.CrossRefGoogle Scholar
  9. Chikhale, M. M., & Mansouri, M. (2015). An agile and collaborative framework for effective governance to enhance management in large-scale enterprise business systems: The case of Apple Inc. Global Journal of Flexible Systems Management, 16(3), 283–293.CrossRefGoogle Scholar
  10. Conrad, D. A., & Shortell, S. M. (1996). Integrated health systems: Promise and performance. Frontiers of Health Services Management, 13(1), 3.CrossRefPubMedGoogle Scholar
  11. Davenport, T. H. (2013). Thinking for a living: How to get better performances and results from knowledge workers. Boston: Harvard Business Press.Google Scholar
  12. De Haes, S., & Van Grembergen, W. (2009). An exploratory study into IT governance implementations and its impact on business/IT alignment. Information Systems Management, 26(2), 123–137.CrossRefGoogle Scholar
  13. Eisenhardt, K. M. (1989). Building theories from case study research. Academy of Management Review, 14(4), 532–550.CrossRefGoogle Scholar
  14. Eisenhardt, K. M. (1991). Better stories and better constructs: The case for rigor and comparative logic. The Academy of Management Review, 16(3), 620–627.CrossRefGoogle Scholar
  15. Flick, U. (2009). An introduction to qualitative research. London: Sage.Google Scholar
  16. Haddad, P., & Wickramasinghe, N. (2014). The role of IT governance in generating business value from IT investments in healthcare: Lessons from an Australian experience. In Bled 2015. Bled, Slovenia.Google Scholar
  17. Haddad, P., Gregory, M., & Wickramasinghe, N. (2014). Business value of IT in healthcare. In L. A.-H. C. G. N. Wickramasinghe & T. Joseph (Eds.), Lean thinking for healthcare. Healthcare delivery in the information age. New York: Springer.Google Scholar
  18. Haes, S. D., & Grembergen, W. V. (2015). Enterprise governance of information technology achieving alignment and value. Cham: Springer.Google Scholar
  19. He, W., & Da Xu, L. (2014). Integration of distributed enterprise applications: A survey. IEEE Transactions on Industrial Informatics, 10(1), 35–42.CrossRefGoogle Scholar
  20. Hedeman, B. (2006). Project management based on PRINCE2TM-PRINCE2 edition 2005. Zaltbommel: Van Haren Publishing.Google Scholar
  21. Heier, H., & Borgman, H. P. (2012). Improving the organizational integration of IT governance tools: An explorative study. In Business strategy and applications in enterprise IT governance (pp. 202–217). Hershey, PA: IGI Global.CrossRefGoogle Scholar
  22. Hiatt, R. A., Tai, C. G., Blayney, D. W., Deapen, D., Hogarth, M., Kizer, K. W., Lipscomb, J., Malin, J., Phillips, S. K., & Santa, J. (2015). Leveraging state cancer registries to measure and improve the quality of cancer care: A potential strategy for California and beyond. Journal of the National Cancer Institute, 107(5), djv047.CrossRefPubMedGoogle Scholar
  23. Johnson, R. B. (1997). Examining the validity structure of qualitative research. Education, 118(2), 282.Google Scholar
  24. Joshi, A., Bollen, L., & Hassink, H. (2013). An empirical assessment of IT governance transparency: Evidence from commercial banking. Information Systems Management, 30(2), 116–136.CrossRefGoogle Scholar
  25. Korac-Kakabadse, N., & Kakabadse, A. (2001). IS/IT governance: Need for an integrated model. Corporate Governance: The International Journal of Business in Society, 1(4), 9–11.CrossRefGoogle Scholar
  26. Luftman, J. N., Ben-Zvi, T., Dwivedi, R., & Rigoni, E. H. (2012). IT Governance: An alignment maturity perspective. In Business strategy and applications in enterprise IT governance (pp. 87–101). Hershey, PA: IGI Global.CrossRefGoogle Scholar
  27. Melville, N., Kraemer, K., & Gurbaxani, V. (2004). Review: Information technology and organizational performance: An integrative model of it business value. MIS Quarterly, 28(2), 283–322.CrossRefGoogle Scholar
  28. Mirbaha, M. (2008). IT governance in financial services and manufacturing. Citeseer.Google Scholar
  29. Nguyen, L., Bakewell, L., Wickramasinghe, N., Haddad, P., Muhammad, I., Moghimi, H., et al. (2015). Transition from paper to electronic nursing documentation in residential aged care: An actor network theory analysis. electronic Journal of Health Informatics, 9(1), 4.Google Scholar
  30. Orozco, J., Tarhini, A., & Tarhini, T. (2015). A framework of IS/business alignment management practices to improve the design of IT Governance architectures. International Journal of Business and Management, 10(4), 1.CrossRefGoogle Scholar
  31. Peterson, R. R. (2004). Integration strategies and tactics for information technology governance. In Strategies for information technology governance (Vol. 2, pp. 37–80). Hershey, PA: Idea Group Publishing.CrossRefGoogle Scholar
  32. Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: Creating value-based competition on results. Boston: Harvard Business School Press.Google Scholar
  33. Posavac, E. (2015). Program evaluation: Methods and case studies. New York: Routledge.Google Scholar
  34. Rouse, W. B., & Cortese, D. A. (2010). Engineering the system of healthcare delivery. Amsterdam: IOS Press.Google Scholar
  35. Schyve, P. M. (2009). Leadership in healthcare organizations: A guide to joint commission leadership standards, a governance institute white paper. Governance Institute.Google Scholar
  36. Stebbins, R. A. (2001). Exploratory research in the social sciences. Thousand Oaks: Sage.CrossRefGoogle Scholar
  37. Stufflebeam, D. L., & Shinkfield, A. J. (2007). Evaluation theory, models, and applications (1st ed.). San Francisco: Wiley.Google Scholar
  38. Van Grembergen, W., & DeHaes, S. (2008). Implementing information technology governance: Models, practices, and cases. Hershey, PA: IGI Publishing.CrossRefGoogle Scholar
  39. Weill, P. (2004). Don’t just lead, govern: How top-performing firms govern IT. MIS Quarterly Executive, 3(1), 1–17.Google Scholar
  40. Weill, P., & Broadbent, M. (1998). Leveraging the new infrastructure: How market leaders capitalize on information technology. Boston: Harvard Business School Press.Google Scholar
  41. Weill, P., & Ross, J. W. (2004). IT governance: How top performers manage IT decision rights for superior results. Boston: Harvard Business Press.Google Scholar
  42. Weill, P., & Ross, J. (2005). A matrixed approach to designing IT governance. MIT Sloan Management Review, 46(2), 26–34.Google Scholar
  43. Wickramasinghe, N., & Schaffer, J. (2010). Realising value driven e-health solutions. Washington, DC: IBM Center for the Business of Government.Google Scholar
  44. Wim Van, G., & Steven De, H. (2012). A research journey into enterprise governance of IT, business/IT alignment and value creation. In Business strategy and applications in enterprise IT governance (pp. 1–13). Hershey, PA: IGI Global.Google Scholar
  45. Wong, D. H., Gallegos, Y., Weinger, M. B., Clack, S., Slagle, J., & Anderson, C. T. (2003). Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system. Critical Care Medicine, 31(10), 2488–2494.CrossRefPubMedGoogle Scholar
  46. Wu, S. P.-J., Straub, D. W., & Liang, T.-P. (2015). How information technology governance mechanisms and strategic alignment influence organizational performance: Insights from a matched survey of business and IT managers. Mis Quarterly, 39(2), 497–518.CrossRefGoogle Scholar
  47. Yin, R. K. (2011). Applications of case study research. Los Angeles: Sage.Google Scholar
  48. Yin, R. K. (2013). Validity and generalization in future case study evaluations. Evaluation, 19(3), 321–332.CrossRefGoogle Scholar
  49. Yin, R. K. (2014). Case study research: Design and methods (5th ed.). London: SAGE.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Peter Haddad
    • 1
  • Steven McConchie
    • 2
  • Jonathan L. Schaffer
    • 1
    • 3
  • Nilmini Wickramasinghe
    • 1
    • 2
  1. 1.Deakin UniversityBurwoodAustralia
  2. 2.Epworth HealthCareRichmondAustralia
  3. 3.Cleveland ClinicClevelandUSA

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