Stakeholder management in IOS projects: analysis of an attempt to implement an electronic patient file

Implementing an inter-organizational system (IOS) requires significant organizational as well as technical changes. These will affect stakeholders (upon whom promoters depend) with varying degrees of power and with varying degrees of interest in the system. Identifying stakeholders and understanding the sources of their attitudes will enable promoters to meet their expectations more fully, and hence encourage acceptance. We examine these issues through a theoretically based study of an attempt to introduce an Electronic Patient File system in The Netherlands. All saw that the system would benefit patients, yet powerful players resisted its implementation, fearing it would affect their interests. This paper develops and tests a model of stakeholder management, showing that those with high interest in the system lacked the power to implement it, while those with low interest had the power to block it. These negative attitudes were shaped by concerns not about the system itself, but about the likely effects on working routines, power, culture and finance. This paper implies that those promoting an IOS (in any sector) should, from the outset of a project, identify their power sources and seek to reconcile stakeholder interests.