Towards a better understanding of IT deployment to improve healthcare performance: A qualitative analysis of healthcare service operations in Norway

English summary Finding a balance between dwindling resources and escalating demand is a challenge faced by healthcare services in many parts of the world. Application of technology is often seen as a solution to deal with this challenge and consequently, the investment in IT deployment is rapidly increasing. However, the relationship between IT and healthcare performance is ambiguous: research indicates both positive and negative effects of IT in healthcare without explaining why and under which circumstances what kind of effect can be anticipated. Taking this situation as the point of departure, this thesis aims to create pragmatic knowledge on IT deployment in relation to healthcare performance from an operations management perspective. The specific problem statement is: How can IT deployment lead to performance improvement, and why does it fail to do so in many cases? A case study design has been used to examine two different telemedicine services, i.e., distance monitoring and remote consultation, for more than two years. A systematic literature review and three empirical papers have been written as part of this thesis. The changes triggered by IT deployment in service operations within the care delivery processes are new ways of interacting using telephone and video calls; categorizing patients’ needs to offer them the most suitable service channel; new coordination mechanisms, such as the distance monitoring app, individual treatment plan, and teamwork among GPs, nurses, and patients; and delegation of GPs’ and clinicians’ responsibilities to nurses and patients. These changes lead to improved efficiency and effectiveness of the care service through different mechanisms: generating less-expensive capacity leads to service cost reduction (efficiency); generating additional capacity leads to responsive service and reduction of waiting time (effectiveness); providing service alternatives leads to improved customization (effectiveness); providing preventive services leads to improved responsiveness and customization (effectiveness). Next, a set of operational paradoxes was identified: the paradox of coordination, paradox of decision-making, and paradox of changing roles. Each of these has two contradictory facets, which create challenges for the healthcare organizations implementing the IT. Lastly, a theoretical explanation of why, despite having the potential, IT deployment often fails to improve healthcare performance, was developed.