Bridging the socio-technical gap

As can be seen in recent articles (for example at ictzorg.com), hospitals increasingly take an agile and iterative approach to EHR development.
As appears, the EHR implementation trajectory is a very bumpy journey where planning beforehand seems nearly impossible, inducing these kind of approaches. Continuously, there seems to be a socio-technical gap during and after design and implementation leading to delays, high extra costs and partly failure due to a lack of acceptance. Involving the end-users in premature stages seems the only way to overcome this gap.

Where does this gap come from? Partly this has to do with a lack of system and software flexibility, including the existing often fragmented IT architecture and infrastructure of hospital organizations at the time of EHR implementation. EHR software often does not contain the amount of flexibility needed to match the individual professional communities within a hospital. However, at the same time we see so-called 'over-functionality' of EHR systems in other areas. Hospitals want to get the most functionality when engaging in EHR implementation and purchase. Of course; when you know you need the system for the next ten years you want to but top-off the bill now. A frequent error however is that hospitals overestimate the absorptive capacity of their organization in achieving their often high-set ambitions; 'we want workflow functionality implemented in year 2" and still working on paper and stick-its at year 0....

In other words, in able to effectively being able to close the socio-technical gap, hospitals need to establish realistic goals, ambitions and estimation of their organization's absorptive capacity. Setting these goals in an agile, iterative and participative way is the first step to minimize the gap.
This first alignment at least makes sure the metaphoric innovation journey is started from the same starting point...
Now, we can effectively engage in monitoring the environment and engaging them to ensure 'controlled agile implementation'. How? To be continued....