Randy V. Bradley

Information Systems Success in the Context of Different Corporate Cultural Types: An Empirical Investigation

Previous studies surrounding the DeLone and McLean model of information systems (IS) success have called for future research and further examination of its measure in different contexts. We draw from the literature on strategic IS planning and organizational culture to contextualize the DeLone and McLean model. There is some evidence that a high-quality information technology (IT) plan leads to system success; therefore, we empirically examine the inclusion of the IT plan quality construct as an antecedent to IS success. We also empirically examine the relationships among constructs in the model of IS success in the context of different corporate cultural types-entrepreneurial and formal. The results provide strong support for the research model and suggest that variations in IS success are explained by the quality of the IT plan and the corporate culture exhibited by a firm. We discuss implications related to our finding that IT plan quality has a greater impact on IS success in organizations that exhibit an entrepreneurial corporate culture than in those that exhibit a formal corporate culture. Furthermore, we discuss how the relationships in the DeLone and McLean model of IS success differ in diverse corporate cultural types and the meaning of these differences.

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

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.

IT Governance Characteristics, Electronic Medical Records Sophistication, and Financial Performance in U.S. Hospitals: An Empirical Investigation

As a result of a recent federal government mandate, an increasing number of hospitals have decided to adopt electronic medical record (EMR) systems. This initiative is expected to lead toward more efficient and higher quality health care; however, little is known about governance characteristics and organizational performance for EMR adopters. Our goal is to inform theory and practice by examining hospitals with a sophisticated EMR and comparing those hospitals to similar hospitals (with a less sophisticated EMR) to understand the association between information technology (IT) governance characteristics and the implications on financial performance. Leveraging elements of the upper echelon theory, we posit that hospitals in which the chief information officer (CIO) reports to the chief executive officer, CIO turnover is low, and an IT steering committee is present are more likely to have a sophisticated EMR. We argue that EMR sophistication leads to improved financial performance. Our results underscore the importance of continuity in the CIO position on successful EMR implementations. Results also show that hospital size and financial performance are strongly associated with EMR sophistication. In addition, we find that a sophisticated EMR appears to be a fundamental element in improving hospitals’ revenue cycle management. Moreover, we find that hospitals with a sophisticated EMR appear to be more profitable. Finally, we observe that total payroll expense adjusted by total discharges drops among the sophisticated hospitals, potentially due to an increase in employee productivity. These insights can serve as a basis for tempering expectations relative to the financial impact of EMR adoption.

A Theoretical Investigation and Extension of a Model of Information Technology Architecture Maturity

Organizations that lack a coherent strategy for managing and evolving their IT platform and resources end up with fragmentation within the organization. Because the need for data sharing and systems integration is not always limited to the internal organization, the boundaries between the organization and its customers, vendors, suppliers, and partners are often blurred. It appears to be evident that organizations must have a clear idea of where they stand in regards to their own Information Technology Architecture (ITA) before preparing to adopt a new, shared ITA. This paper applies the reach and range concept and theory associated with strategic information systems planning to conceptually position ITA as a concept that provides convergence of a variety of frameworks related to IT and business alignment. DOI: 10.4018/978-1-60960-577-3.ch017

An Examination of the Relationships among IT Capability Intentions, IT Infrastructure Integration and Quality of Care: A Study in U.S. Hospitals

This study employs a multiple respondent research technique to assess the efficacy of a framework intended to improve the quality of health care provided to patients. We use survey data from 78 matched respondents to answer the question to what extent does IT capability intentions affect a hospitals ability to detect and reduce clinical errors. We investigate empirically the impact of IT capability intentions and IT infrastructure integration on elements of IT-enabled quality of care. Our findings position IT capability intentions as an antecedent to IT infrastructure integration and suggest IT infrastructure integration is the key component in overcoming a highly fragmented delivery system. The degree of IT infrastructure integration has significant effects on quality of care, in terms of both patient-centric responsiveness and error detection and reduction.

Improving risk stratification in a community-based African American population using cell cycle progression score

Background Current clinical nomograms such as American Urological Association/National Comprehensive Cancer Network (AUA/NCCN) risk categories or CAPRA may not always reflect prostate cancer (PCa) risk among African American men. We evaluated the usefulness of adding a commercially available cell cycle progression (CCP) score to improve risk stratification in a community-based African American population. Methods Biopsy tissues from 150 African American and 60 Caucasian men were obtained from a single community urologic oncology practice in Memphis, TN. The biopsy samples were evaluated with a commercially available CCP panel (Prolaris). Clinical variables such as Gleason score, prostate-specific antigen (PSA), age, clinical stage, and extent of disease were combined to determine a single category of low-, intermediate-, or high-risk. AUA risk stratification for cancer aggressiveness was then compared between the CCP score vs. the clinical parameters to determine potential risk improvement by the CCP score. Results Based on the clinical parameters, of the 150 African American men evaluated, 20% were classified as low-risk, 40% were classified as intermediate-risk, and 40% were classified as high-risk. Of the 60 Caucasian men evaluated, 42% were low-risk, 42% were intermediate-risk, and 17% were high-risk. However, when re-evaluating the African American patients using the CCP score, 30% of the patients were determined to be more aggressive than the clinical low-risk category. Similarly, 21.67% of the patients were found to be more aggressive than the clinical intermediate-risk category, and 23.33% of the patients were more aggressive than the high-risk category. When compared to our Caucasian cohort, 12% of the low-risk patients, 8% of the intermediate-risk patients, and 10% of the high-risk patients were found to be more aggressive by the CCP score. Overall, 24% of African American men vs. 10% of Caucasian men were reclassified to a higher risk by CCP score. When we compared the mean CCP score in the African American population vs. the Caucasian population, the mean CCP score in the AUA low-risk was 3.2 vs. 2.9; 3.4 vs. 3.2 in the AUA intermediate-risk; and 3.8 vs. 3.5 in the AUA high-risk category, respectively. Despite the higher mean CCP score in the African American population, the difference between the African American men and the Caucasian men was not significant (P=0.064 for low-risk, P=0.204 for intermediate-risk, and P=0.209 for high-risk). Conclusions Our data extends the evidence that CCP score derived from a biopsy specimen can be clinically useful. Our findings showed that the CCP score could stratify 10-year mortality risk in African American men beyond the current clinicopathologic features, which may better prepare patients for follow-up visits and discussions with their health care provider(s) and enhance their ability to select the most appropriate treatment option.

Team and Organizational Identification among Information Systems Personnel: An Exploratory Investigation of Post IT Outsourcing Personnel Impacts

This study examines the impact of social identification of IT employees in IT outsourcing firms. Specifically, we ask: What effect does social identification have on employee attitudes in the wake of major outsourcing initiatives? We examine social identification through the separate dimensions of team identification and organizational identification. The results suggest that when team identification and organizational identification are viewed as two distinct measures of social identity, the effect on the workplace attitudes of IT employees vary.