Anticipating Mismatches of HIT Investments: Developing a Viability-Fit Model for E-Health Services

Objectives:Albeit massive investments in the recent years, the impact of health information technology (HIT) has been controversial and strongly disputed by both research and practice. While many studies are concerned with the development of new or the refinement of existing measurement models for assessing the impact of HIT adoption (ex post), this study presents an initial attempt to better understand the factors affecting viability and fit of HIT and thereby underscores the importance of also having instruments for managing expectations (ex ante).Methods:We extend prior research by undertaking a more granular investigation into the theoretical assumptions of viability and fit constructs. In doing so, we use a mixed-methods approach, conducting qualitative focus group discussions and a quantitative field study to improve and validate a viability-fit measurement instrument.Results:Our findings suggest two issues for research and practice. First, the results indicate that different stakeholders perceive HIT viability and fit of the same e-health services very unequally. Second, the analysis also demonstrates that there can be a great discrepancy between the organizational viability and individual fit of a particular e-health service.Conclusion:The findings of this study have a number of important implications such as for health policy making, HIT portfolios, and stakeholder communication.Keywords: viability-fit model; decision-making; e-health; health information technology; implementation research; investment decision; mixed-methods approach; portfolio