The worldwide trend in healthcare has been to look to healthcare information technology (HCIT) for solutions to prominent challenges such as process improvement, patient satisfaction, cost reduction and labour market shortages. Yet recent reviews of the electronic health record (EHR) literature show that all is not well especially with respect to the alignment of organizational design and the engineered artifact.

Niazkhani et al (2009, p. 546) concluded "When put in practice, the formal, predefined, stepwise, and role-based models of workflow underlying CPOE systems may show a fragile compatibility with the contingent, pragmatic, and co-constructive nature of workflow.” Two of the findings of Greenhalgh et al (2009, p. 767) were “While secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work is often made less efficient” and “The EPR may support, but will not drive, changes in the social order of the workplace”. In addition, Fontaine et al (2010) concluded from a systematic literature review in primary care that “The potential for HIE to reduce costs and improve the quality of healthcare in ambulatory primary care practices is well recognized but needs further empiric substantiation.”

Organisational design and engineering (ODE) takes the position that the “either-or” mindset must be replaced with an integrated and more holistic view of designing the organisation and artifact. The complex interplay between organisation and engineering, often intangible, requires a multi-disciplinary approach to solve the challenge of the social and technological world of healthcare being inextricably linked to healthcare policy.

This special issue seeks contributions from the spectrum of disciplines that are involved directly in HCIT or broader healthcare fields that implicitly rely on HCIT (e.g., policies for care coordination). These contributions must have both the elements of organisational design and an engineered artifact regardless of research discipline. These might address theoretical, empirical and design-based studies on medical- technical infrastructures, tools and applications, health information behaviour, or cost/benefits, policy, as well as social implications. HCITs are broadly defined to include technologies in clinical informatics, e-health, m-health, consumer health, public health, and health policy.

Guest Editors:
Dr. Nelson King, American University of Beirut, Lebanon
Dr. Ronald Batenburg, Utrecht University, The Netherlands