Evaluating healthcare information systems through an “enterprise” perspective

Here we reflect upon the design and implementation of large-scale healthcare IS, noting the tendency of such systems to gravitate from a delivery (clinical) to a control (managerial) emphasis. Drawing on the concept of the ‘enterprise model’, we examined how adopting different perspectives of the enterprise might inform both design and evaluative criteria. Three areas of tension were identified; these prompted us to consider some elements that contribute to a framework that can guide the implementation and evaluation of healthcare applications. We proposed an illustrative conceptual model which, while not claiming to identify causal factors for success or failure, nevertheless gives indications of the interplay between the areas of tension.