IS Avoidance in Health-Care Groups: A Multilevel Investigation

The information systems (IS) literature has focused considerable research on IS resistance, particularly in the health-care industry. Most of this attention has focused on the impact of IS resistance on systems' initial implementation, but little research has investigated whether and how post-adoption resistance affects performance. We focus on a particular type of post-adoption resistance, which we call IS avoidance, to identify situations in which individuals avoid working with adopted IS despite the need and opportunity to do so. We examine the effects of IS avoidance on patient care delivered by health-care groups across three levels of analysis: the individual level, the shared group level, and the configural group level. We find that IS avoidance is significantly and negatively related to patient care only at the configural group level, which suggests that patient care is not degraded by the number of doctors and/or nurses in a group avoiding a system, but rather by their locations in the group's workflow network configuration. We use qualitative data collected over 16 months at the research site to help explain these results. Implications for theory and practice are discussed.