Pre-Implementation evaluation of a nationwide information system for university hospitals: lessons learned from a study in Brazil

Initiatives to implement nationwide health information systems (HIS) have been developed in different countries. Despite the potential of these initiatives of improving the quality of healthcare, the evidence of failures are numerous. We analysed the perceptions of a nationwide hospital information system by a group of 36 managers and healthcare professionals of a university hospital, prior to its adoption (pre-implementation evaluation), with the purpose of identifying issues which were likely to affect its implementation and use. This research takes a qualitative approach. Interviews, questionnaires and documentary research were used to collect data. Analysis was based on coding and categorisation. The results point out to seven areas of concern of the participants of the research those emerged from the analysis: hardware and software; government management, politics and trade unions; workplace practices; education, training and support; implementation management; staff skills; and communication. We identified that these issues are similar to problems resulting from HIS evaluations performed after their adoption. This discovery reveals that problems that usually arise from the implementation and use of nationwide HIS can be anticipated and dealt with beforehand when pre-implementation qualitative evaluations are performed. These evaluations contribute to improve intra-organisational and inter-stakeholders' communication in comprehensive nationwide HIS adoption programmes.