Campion Thomas R, Gadd Cynthia S
Department of Biomedical Informatics & Implementation Sciences Laboratory Vanderbilt University School of Medicine, Nashville TN.
AMIA Annu Symp Proc. 2010 Nov 13;2010:86-90.
According to the U.S. National Research Council, current health information technology (HIT) efforts are insufficient and arguably detrimental to healthcare transformation. Many hospitals have already implemented HIT, and federal stimulus funding will further adoption efforts. Organizations become more similar through the adoption of innovations like HIT, but the effects of the changes do not necessarily improve efficiency. This view from sociology and organizational studies, called institutional isomorphism, suggests that organizations pursue changes endorsed by peers, regulators, and professional societies through mimetic, coercive, and normative mechanisms, respectively, that improve legitimacy, a socially constructed value that determines an organization's ability to obtain resources and survive. In this paper we examine mimetic, coercive, and normative influences in the adoption of three HIT innovations as well as evidence of resulting inefficiency. Institutional isomorphism provides a useful framework for researchers and practitioners to examine variation in HIT adoption.
根据美国国家研究委员会的说法，当前的健康信息技术（HIT）工作并不充分，而且可以说对医疗保健转型有害。许多医院已经实施了HIT，联邦刺激资金将进一步推动其采用。通过采用HIT等创新，组织变得更加相似，但这些变革的效果不一定能提高效率。这种来自社会学和组织研究的观点，称为制度同构，表明组织分别通过模仿、强制和规范机制来追求同行、监管机构和专业协会认可的变革，这些机制提高了合法性，合法性是一种社会建构的价值，决定了组织获取资源和生存的能力。在本文中，我们研究了在采用三项HIT创新过程中的模仿、强制和规范影响，以及由此产生的低效率的证据。制度同构为研究人员和从业者研究HIT采用的差异提供了一个有用的框架。
