Department of Management Information Systems, Faculty of Business Administration, Université Laval, 2325 Rue de la Terrasse, Quebec City, Quebec G1V 0A6, Canada.
Int J Med Inform. 2013 Aug;82(8):731-41. doi: 10.1016/j.ijmedinf.2013.04.001. Epub 2013 Apr 24.
Open source software (OSS) adoption and use in health care organizations (HCOs) is relatively low in developed countries, but several contextual factors have recently encouraged the consideration of the possible role of OSS in information technology (IT) application portfolios. This article aims at developing a research model for investigating the antecedents of OSS adoption decisions in HCOs.
Based on a conceptual framework derived from a synthesis of the literature on IT adoption in organizations, we conducted 18 semi-structured interviews with IT experts from all levels of the Province of Quebec's health and social services sector in Canada. We also interviewed 10 IT suppliers in the province. A qualitative data analysis of the interviews was performed to identify major antecedents of OSS adoption decisions in HCOs.
Eight factors associated with three distinct theoretical perspectives influence OSS adoption. More specifically, they are associated with the classical diffusion of innovations theory, the theory of resources, as well as institutional theory and its spin-off, the organizing vision theory. The factors fall under three categories: the characteristics of OSS as an innovation, the characteristics of the HCO with respect to its ability to absorb OSS, and the characteristics of the external environment with respect to institutional pressures and public discourse surrounding OSS. We shed light on two novel factors that closely interact with each other: (1) interest of the health care community in the public discourse surrounding OSS, and (2) clarity, consistency and richness of this discourse, whether found in magazines or other media.
OSS still raises many questions and presents several challenges for HCOs. It is crucial that the different factors that explain an HCO's decision on OSS adoption be considered simultaneously. Doing so allows a better understanding of HCOs' rationale when deciding to adopt, or not to adopt, OSS.
在发达国家，医疗机构（HCO）对开源软件（OSS）的采用和使用相对较低，但最近有几个背景因素促使人们考虑 OSS 在信息技术（IT）应用组合中的可能作用。本文旨在开发一个研究模型，以调查 HCO 中 OSS 采用决策的前因。
基于从组织中 IT 采用文献综述中得出的概念框架，我们对加拿大魁北克省卫生和社会服务部门各级别的 IT 专家进行了 18 次半结构化访谈。我们还采访了该省的 10 家 IT 供应商。对访谈进行了定性数据分析，以确定 HCO 中 OSS 采用决策的主要前因。
与三个不同理论视角相关的八个因素影响 OSS 的采用。更具体地说，它们与经典的创新扩散理论、资源理论以及制度理论及其衍生的组织愿景理论有关。这些因素分为三类：OSS 作为创新的特征、HCO 吸收 OSS 的能力特征以及与制度压力和围绕 OSS 的公共话语相关的外部环境特征。我们揭示了两个密切互动的新因素：（1）医疗保健界对围绕 OSS 的公共话语的兴趣，以及（2）这种话语的清晰性、一致性和丰富性，无论是在杂志还是其他媒体中找到的。
OSS 仍然引发了许多问题，并给 HCO 带来了一些挑战。至关重要的是，同时考虑解释 HCO 采用 OSS 决策的不同因素。这样做可以更好地理解 HCO 在决定采用或不采用 OSS 时的基本原理。
