Leveraging performance

The third process in the model is leveraging performance. The purpose of this process is to exploit IS competencies and capabilities to meet the unique needs of preventive care. When hospital IS resources have been successfully structured and bundled, they must be effectively leveraged to improve preventive care performance, including

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administrative efficiency, quality of patient care, cost effectiveness and health promotion.

This conceptual model introduces a new concept as a paradigm shift for preventive care research. In this research, the proposed conceptual model shows that preventive care is not only confined to administration-related matters, but should also include quality of care (Frimpong et al. 2013; Krist et al. 2013), health promotion (Gullotta & Bloom 2003) and cost effectiveness (Probstfield 2003; Rezayatmand, Pavlova & Groot 2013). These four concepts of preventive care were defined and explained in Section 2.3.

The proposed concept is supported by past studies as it describes how administrative efficiency and quality of patient care are achieved with HIS. It allows healthcare practitioners to obtain critical patient information as soon as it is needed so that the healthcare specialist can quickly provide quality patient care (Frimpong et al. 2013; Krist et al. 2011). For example, cancer management is improved with the use of HIS through shared decision-making, symptom management and treatment (Bauer et al. 2014b; Clauser et al. 2011). Moreover, obesity surveillance can be improved using health data from HIS, as it helps to increase the timeliness and availability of relevant information about obesity in children and adults (Bauer et al. 2014b). Thus, administrative and quality of care are two important and interrelated concepts because they will determine the right treatment strategy to ensure patients receive the appropriate care (Shelley et al. 2011).

Another aspect is health promotion, which refers to a range of activities with the purpose of improving the health of individuals, groups and communities through general activities like health education, health communication and social activities (Gullotta & Bloom 2003). Previous studies have found that the effectiveness of various health-promotion methods in primary prevention is lacking, thus it becomes a challenge to reduce the incidence of chronic diseases (Golechha 2016). Therefore, health promotion is an important aspect of preventive care because it helps healthcare organisations increase knowledge and create awareness among the population, thus delaying the onset of chronic diseases (Srinivas & Paphitis 2016).

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Cost effectiveness is also an important aspect included in the conceptual model to assess whether the resources used to provide preventive care services offer positive outcomes to benefit patients (Probstfield 2003). For instance, with the application of HIS, the healthcare organisation could potentially reduce hospital fees by increasing precision and improving disease-prevention initiatives (Tuckson 2013). Moreover, early identification and accurate treatment-related information, provided by HIS for individuals at risk of chronic diseases, could contribute to a reduction in the overall health system costs and improved preventive care (Clauser et al. 2011; Schade et al. 2015). Hence, the four preventive care concepts of administrative efficiency, quality of care, health promotion and cost effectiveness are presented in the conceptual model in the far-right box under the leveraging process (refer to Figure 2.6).

Thus, the purpose of this research was to develop the theoretical link between IS competencies and IS capabilities from IS resources using the resource orchestration perspective and the CEM as the theoretical lens to produce a model to illustrate the transformation process of IS resources, IS competencies and IS capabilities in achieving preventive care performance.

Conclusion

This chapter provided a comprehensive literature review that recognised the importance of preventive care as an important strategy to address chronic diseases, especially in developing countries. However, due to resource scarcity, preventive care is poorly delivered. Nevertheless, previous studies found that the use of HIS could improve preventive care delivery when it is integrated with other IS resources such as human-IT and intangible-IT resources. The integration of these IS resources was found crucial in that the integration results in the development of IS competencies and IS capabilities that become valuable resources to facilitate preventive care performance. Indeed, there is limited understanding about how IS competencies and IS capabilities are developed from the integration of IS resources and are leveraged to achieve preventive care. Whilst factors like cultural norms, digital divide, poverty and treatment pluralism are important, but they were not been included in the initial scope of the research because the research aim is on answering the main research question:

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How does a hospital integrate resources that lead to information system competencies and information system capabilities in preventive care performance?

Therefore, this research attempted to address this deficiency by proposing a modified resource orchestration model as a theoretical lens to conduct a case study in the selected public hospital from one of developing countries; Malaysia.

In summary, the review of the literature supports the search for the answers to the main research question. This question is answered by breaking it down into the two following sub-questions:

What information system competencies and information system capabilities are utilised in preventive care?

How are information system competencies and information system capabilities developed in preventive care?

The next chapter describes the methodology employed to research the phenomenon of IS competency and IS capability development in preventive care.

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