Design participation as an insurance: risk-management and end-user participation in the development of information systems in healthcare organizations.
OBJECTIVE
The aim of this paper is to build a theoretical framework for analysis of when decision-makers should use end-user participation as a form of insurance for unforeseen consequences of implementing information systems in healthcare organizations.


METHODS
Data were collected in a case study of an information system development project in a small clinical setting. During the initial phase, the future end-users of the system were allowed to actively influence the system design and test every new tool that was considered for implementation.


RESULTS
The results of the case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs throughout the life cycle of the project. Risk-averse decision-makers fearing negative secondary consequences of a HIS, with regard to clinical work flow, will always adopt measures to prevent future failures, if they can find a possibility of shifting these risks. Therefore, they calculate the present discounted value of the effects accrued over time to the unit and predict the amount of resources they are willing to pay to acquire on insurance (such as design participation) that will protect the organization from future losses.


CONCLUSIONS
End-user participation in the design process can be the key positive influence on the quality of the service and, thereby, organizational effectiveness. Investments in broad design participation can, consequently, be a productive activity that transforms potential current income into future benefits.
Vimarlund
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Departments of Computer Science and Social Medicine, Linköping University, Linköping, Sweden. vivvi@ida.liu.se
Timpka
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D003256:Community Participation; D003657:Decision Making; D006801:Humans; D007256:Information Systems / Q000458:organization & administration*; D008490:Medical Informatics; D008503:Medical Staff