Information technology and the employment relationship : an examination of the adoption and use of electronic health records
Thesis (Ph. D.)--Massachusetts Institute of Technology, Sloan School of Management, 2008.
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | eng |
| Published: |
Massachusetts Institute of Technology
2009
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/1721.1/45152 |
| _version_ | 1811085219427516416 |
|---|---|
| author | Litwin, Adam Seth |
| author2 | Thomas A. Kochan. |
| author_facet | Thomas A. Kochan. Litwin, Adam Seth |
| author_sort | Litwin, Adam Seth |
| collection | MIT |
| description | Thesis (Ph. D.)--Massachusetts Institute of Technology, Sloan School of Management, 2008. |
| first_indexed | 2024-09-23T13:05:32Z |
| format | Thesis |
| id | mit-1721.1/45152 |
| institution | Massachusetts Institute of Technology |
| language | eng |
| last_indexed | 2024-09-23T13:05:32Z |
| publishDate | 2009 |
| publisher | Massachusetts Institute of Technology |
| record_format | dspace |
| spelling | mit-1721.1/451522019-04-10T14:52:43Z Information technology and the employment relationship : an examination of the adoption and use of electronic health records Examination of the adoption and use of EHRs Litwin, Adam Seth Thomas A. Kochan. Sloan School of Management. Sloan School of Management. Sloan School of Management. Thesis (Ph. D.)--Massachusetts Institute of Technology, Sloan School of Management, 2008. This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections. Includes bibliographical references. This dissertation advances theory on the interplay of workplace technological change and features of the employment relationship to inform an active policy debate. In particular, many connect US healthcare's lackluster economic performance -- both historically and relative to other industries -- to its apparent reluctance to adopt electronic health record (EHR) systems. Drawing on management and employment relations theory as well as a multi-method field study of a large-scale healthcare provider, I first demonstrate that performance improvements depend not on the technology per se, but rather on the concomitant adoption of both the information technology (IT) and the rest of its reinforcing work system. In line with prior research, the work system includes workplace-level employment practices like teamwork and training. However, I advance our understanding of these complementarities by showing that their emergence depends on the scope of participatory structures included in the work system. Irrespective of how engaged workers are in the IT initiative, participation only complements the effectiveness of the EHR system where workers could 1.) renegotiate IT-engendered changes in the terms and conditions of employment, and 2.) influence the configuration and deployment of the technology. Based on these findings, IT adoption does not ensure improved performance, implying a shortcoming in policies promoting the diffusion of EHRs rather than the adoption of EHR-inclusive work systems. Drawing once again on both theory and the field study, I propose that only certain medical practices -- most notably, those that finance patient care on a prepaid or "capitated" basis -- internalize the benefits of EHR investment. (cont.) Therefore, physicians affiliated with such organizations are more likely to report that their practice adopted the technology along with financial incentives to encourage its optimal use. Those practices whose IT adoption cannot be explained by their business strategy will be less likely to introduce the requisite incentives. Econometric evidence derived from a nationwide sample of physicians finds strong support for these hypotheses. Therefore, this dissertation warns of the imminent decoupling of EHR technology from its work system while advancing management and employment relations theory. by Adam Seth Litwin. Ph.D. 2009-04-29T14:46:46Z 2009-04-29T14:46:46Z 2008 2008 Thesis http://hdl.handle.net/1721.1/45152 315870120 eng M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission. http://dspace.mit.edu/handle/1721.1/7582 154 p. application/pdf Massachusetts Institute of Technology |
| spellingShingle | Sloan School of Management. Litwin, Adam Seth Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title | Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title_full | Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title_fullStr | Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title_full_unstemmed | Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title_short | Information technology and the employment relationship : an examination of the adoption and use of electronic health records |
| title_sort | information technology and the employment relationship an examination of the adoption and use of electronic health records |
| topic | Sloan School of Management. |
| url | http://hdl.handle.net/1721.1/45152 |
| work_keys_str_mv | AT litwinadamseth informationtechnologyandtheemploymentrelationshipanexaminationoftheadoptionanduseofelectronichealthrecords AT litwinadamseth examinationoftheadoptionanduseofehrs |