For example, studies (Choudhury & Sabherwal, 2003; Susilo et al., 2007) report that while IS projects initially usually rely on output-based controls, behavioral control mechanisms are often added in the later stages of the project. A blood banking organization was considered an exemplary case (Yin, 2017) for this study as the level of controls is generally very high in the healthcare sector. Since the research question is of the "how" type and the research was being conducted in a real-world context, a case approach (Yin, 2017; Murungi et al., 2019) was deemed appropriate.
Thus, a longitudinal qualitative case study approach with a process lens (Niederman et al., 2018) was adopted to gain an understanding of portfolio control development in the case organization. Interviews were conducted by the first author at the organization's premises to allow for a natural interview environment (Langley & Meziani, 2020). The case narrative was written in a process-tracing format (George & Bennett, 2005) with an emphasis on the sequence of events.
In the first stage, text blocks were assigned a short phrase indicating the nature of the block. In the second stage, the first-level codes were grouped based on similarities in their nature. The organization remained with the same vendor, as not much has changed in the blood bank market since the bid evaluation for the first project.
By May 2011, pilot testing of the system with a nearby hospital was completed and changes were made to the software based on feedback received from the pilot test site.
Blood Enterprise System-III (2011-17)
The reporting module, developed by the New York Blood Bank, retrieved data from BES-I and produced the reports. Around 2011, the NBPS began the development of a web-based electronic ordering system to receive online orders from the hospitals, thereby intending to replace the manual, telephone-based ordering process. The project was conceived by the operations manager in NBPS with the IT unit that develops the solution.
Negotiations with the seller were finally concluded in June 2014 and the final agreement was subsequently approved by the Finance Committee. Two smaller modules (one on tracking blood requests, the other a risk management module on non-compliant cases) went live in the first half of 2014. The core module BES-III (centered on blood processing) would go live in 2014. the fourth quarter of 2014.
However, the implementation was consistently delayed due to technical and change management issues, and finally went live in September 2015. Finally, the last module for BES-III, a module for managing tissue banking information, went live in 2017. While BES-III project exceeded some time and budget, it was deemed at an acceptable level and did not invite any additional scrutiny, much to the relief of NBPS.
5 Analysis and Discussion
- Input Control
- Outcome Control
- Behaviour Control
- Clan Control
- Self-control
This illustrates a form of passive resistance (Murungi et al., 2019), which may be the result of a conflict between multiple institutional logics (Bunduchi et al., 2020) in the healthcare setting. The niche nature of the blood banking industry led to the market acting as an input control mechanism (Ouchi during the pre-implementation phase. Although there is a lot of capacity in the health informatics sector in general (Miah, Shen, Lamp, Kerr, & Gammack, 2019), few IT providers have the appropriate capabilities and skills to fully support the evolving needs of the blood banks (Li et al., 2007).
While the ostensible purpose of a business case was to provide a rationale for implementation (Nafeeseh & Al-Mudimigh, 2011), the demonstrative nature of preparing a business case (Berente, Gal, & Yoo, 2010; Einhorn, Marnewick, & Meredith, 2019) can also be seen in case studies. The findings support the claim that involving users in the early stages may not be feasible due to their inexperience (Wagner & Newell, 2007). This reflects a teleological dimension (Van de Ven & Poole, 1995; Wiener et al., 2016) in the form of learning from previous projects.
Perhaps because of the public context, behavioral control in the pre-implementation phase is characterized by administrative controls in the form of departmental approvals and public procurement processes. As stated in the case, the main reason for this was that BES-II was an upgrade of the BES-I system and unchanged market conditions. Thus, the pre-implementation phase demonstrates the politically contested and negotiated nature of the procurement process (Matinheikki et al., 2019; Moe et al., 2017) in the public sector.
For BES-I, separate project groups worked in the two major centers and there were no joint meetings. Perhaps this is why the NBPS, being “very aware of (what) happened in the past” (R1), included project audit and review as a monitoring mechanism even during the implementation phase of BES-III. A high level of behavioral control was also seen in the control of changes in the post-implementation phase.
This specific element of change management also relates to the clan control discussed in the next section. A high level of change control (mentioned in section 5.3) is justified in the organization because “there is a certain safety in it. I did notice that we ended up choosing a lot of things in the project that were not strictly our responsibility.
It is clear from the minutes of the NBPS Board that the General Manager presented the reasons for the implementation in meetings of the NBPS Board, which led to the Board accepting the proposal for the implementation of the new system. In the post-implementation phase, self-control from management played a major role in the introduction of new modules.
6 Conclusion
Contribution
Implications
Limitations and future development
In terms of future developments, the findings of this study suggest that it is worthwhile to continue research on the evolving nature of control portfolios in enterprise systems initiatives in different contexts. Moreover, as the business systems industry moves toward cloud implementation, future research may focus on examining the difference between the control mechanisms that operate in a traditional on-premises implementation versus those in a cloud environment. Of particular interest here is an in-depth exploration of the role and impact of IS audit and evaluation functions in the design of control portfolios that directly contribute to the achievement of positive business changes enabled by IS.
Research Note – The Role of Organizational Controls and Boundary Removal in Software Development Outsourcing: Implications for Project Performance. Control, trust, power, and the dynamics of information systems outsourcing relationships: A process study of contractual software development. Control and emotions: Understanding the dynamics of controlled behavior in a health care information systems project.
Investing in information systems: On the behavioral and institutional research mechanisms supporting hospital IS investment decisions. In Proceedings of the Twelfth Conference of the Midwest Association for Information Systems, USA: Springfield, Illinois, May 2017. In Proceedings of the Thirteenth Conference of the Midwest Association for Information Systems, USA: Saint Louis, Missouri 2018.
Exploring the importance of participation in the post-implementation period of an ES project: a neglected area. The view from the top – how senior executives exercise control over information systems projects to improve performance.
Appendix -1: Coding Tree
