Workarounds in the use of IS in healthcare: A case study of an electronic medication administration system

Healthcare information systems such as an Electronic Medication Administration System (EMAS) have the potential to enhance productivity, lower costs, and reduce medication errors. However, various issues have arisen from the use of these systems. A key issue relates to workarounds as a result of a misfit between the new information system (IS) implementation and existing work processes. However, there is a lack of understanding and studies on healthcare IS workarounds and their outcomes. This paper applies the theoretical perspectives of accommodation to misfit and IS evolution to understand the phenomenon through an in-depth case study of an EMAS implemented in a large public hospital. Based on the findings, it develops a process framework to explain how the benefits, issues, and workarounds inter-relate and determine the impacts of the system. The findings have implications for research and practice on workarounds in the use of healthcare IS.

► Our process framework explains healthcare IS workarounds, causes, and impacts.
► Users may respond to issues of a new IS by augmenting, fitting, or working around.
► Accommodations that are fitted may enhance system benefits.
► Accommodations that are not fitted may lower system efficiency and effectiveness.