Examining IT for Competitive Advantage in the Healthcare Industry

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Thesis and Dissertation
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This thesis investigates the use of information technology (IT) to gain a competitive advantage in the healthcare industry. The research explores the impact of IT on healthcare standards, patient safety, and the reduction of medical errors. The study examines the relationship between IT integration and factors such as implementation costs and cultural beliefs, using a quantitative research design with survey data from North America. The findings reveal significant associations between IT integration and both implementation costs and cultural/belief factors. The thesis includes an extensive literature review covering IT in healthcare, competitive advantage, and relevant methodologies. The research provides valuable insights into how IT can be leveraged to improve healthcare delivery, reduce errors, and enhance overall organizational performance, with recommendations for further research and practical implications for healthcare providers.
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Running head: USE OF IT IN HEALTHCARE INDUSTRY
Use of Information Technology to Gain Competitive Advantage in Healthcare Industry
Grad 699-90-2017/LS Thesis
Kirandeep K. Gill
Harrisburg University of Science and Technology
Assignment submitted to Dr. Stanley Nwoji in Fulfillment of GRAD 699
Submission Date: December 13, 2017
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USE OF IT IN HEALTHCARE INDUSTRY
Abstract
The use of information technology in the healthcare industry has been attracting many scholars and medical
staff from last few years.IT has positive effect on healthcare system resulting in gaining the competitive advantage
but on the other hand, there are few factors like cost of implementation and reluctant to use IT due to
cultures/beliefs, which, has negative effect on gaining competitive advantage. This research therefore, evaluated
how the two factors affect the gain of competitive advantage in healthcare system.The research questions addressed
the relationships between these two factors and integration of the IT into health care system.Quantitative research
design was suitable for this research,the research strategy was a survey utilizing closed -ended questionnaires to
collect primary data for analysis.Quantitave method was used for analysis,where descriptives were first carried out
to describe the data and then inferential statistics was done to test hypotheses.Correlation analysis were done at 5%
level ofsignificance.The results revealed that was a significant association between those health units that have
managed to integrate IT in all departments and their views on the cost of implementation of IT and there was a
significant association between integration of IT into the health system and cultures/beliefs.It was recommended
that further research be carried out in other parts of America as our study focused only in North America.
Keywords: information technology, healthcare industry, competitive advantage, Data Science research.
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Table of Contents
Abstract........................................................................................................................................................................2
Introduction.................................................................................................................................................................5
Problem Statement.....................................................................................................................................................5
Objectives....................................................................................................................................................................6
General objective........................................................................................................................6
Specific Objectives......................................................................................................................6
Theoretical Framework................................................................................................................6
Hypotheses...................................................................................................................................7
Significance of Study...................................................................................................................7
Definition of Terms.....................................................................................................................7
Ethical Considerations.................................................................................................................8
Delimitation.................................................................................................................................8
Limitation....................................................................................................................................8
Literature Review.......................................................................................................................................................8
Information Technology..............................................................................................................9
Information Technology and Healthcare Industry.......................................................................9
Competitive Advantage.............................................................................................................10
Factors Facilitating use of IT as Competitive Advantage for Healthcare.................................10
Review of Methodologies..........................................................................................................11
Review of Theories....................................................................................................................11
Theoretical Framework..............................................................................................................12
Research Design and Methodology.........................................................................................................................12
Research Worldwide..................................................................................................................12
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USE OF IT IN HEALTHCARE INDUSTRY
Research Design........................................................................................................................12
Research Strategy......................................................................................................................13
Method of Data Collection........................................................................................................13
Method of Data Analysis...........................................................................................................14
Sample.......................................................................................................................................14
Results........................................................................................................................................................................16
Descriptive analyses..................................................................................................................16
Inferential Statistics...................................................................................................................18
Discussion of results..................................................................................................................................................22
Recommendations.....................................................................................................................................................23
Conclusions................................................................................................................................................................23
References..................................................................................................................................................................24
Appendix A................................................................................................................................................................27
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Introduction
Healthcare industry is always under pressure to improve the healthcare standards, patient safety, and reduce
medical errors. If an organization can integrate its healthcare system with information technology, it can reduce the
medical errors and improve its service which will in return help it in gaining competitive advantage over its
competitors (Bates, 2000).While medical staff and patients have always been, and will continue to be at the heart
of healthcare, the value of the use of IT in a patient-centric approach to care is starting to reveal itself and for
everyone concerned, the improvements are there to see (Strategyand.pwc.com, 2017).
Problem Statement
In just 30 years, information technology (IT) has profoundly changed healthcare. Electronic medical
records, online second opinions, real-time virtual visits, eHospital critical care monitoring is just but the
beginnings of how IT systems are enhancing healthcare delivery in the 21st century (Harris, 2017).
IT has positive effect on healthcare system resulting in gaining the competitive advantage but on the other
hand, there are few factors like cost of implementation and reluctant to use IT due to cultures/beliefs which has
negative effect on gaining competitive advantage. This research therefore, will evaluate how the two factors affect
the gain of competitive advantage in healthcare system.
Purpose Statement
Proper use and integration of IT has resulted in enhancement of any field. (Reid, Compton, Grossman, and
Fanjiang, 2005). Healthcare industry has always been a topic of interest. Advancements in healthcare procedures
and healthcare delivery has attracted many other industries. Information Technology is one sector which has
successfully integrated with healthcare industry and resulted in benefit of millions of patients.
Although there are many benefits of IT integration with healthcare but still there is some ignorance in
handling the technology in healthcare. Few companies are reluctant in making full use of Information Technology.
Some people do not want their work to go digital. Bates (2000) suggests that several information systems
interventions like computerized physician order entry, computerized physician decision support, robots for filling
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prescriptions, bar coding, automated dispensing devices, and computerization of the medication administration
record have been shown to reduce medication errors considerably.
For this research, quantitative research methodology will be followed. Literature review was done by
studying different articles, books, and journals. Objectives and research questions were prepared, hypothesis was
done.
Objectives
General objective
Examination of how cultures/beliefs and cost of implementation affect the gain of competitive advantage in
the health sector
Specific Objectives
To describe the use of IT in the health care sector,types of ownership of healthcare units and integration of
IT into the heath care units departments
To find the relationship between IT integration into the health care system and type of ownership of
organization
To find the relationship between integration of IT into departments of health units and views on the cost of
implementation
To find the relationship between integration of IT into the health care system and views on cultures/beliefs
Theoretical Framework
There are different factors that contribute in gaining competitive advantage by using IT in healthcare
industry.. Error free patient care, electronic health records, and healthcare tools are the few outcomes of using IT in
healthcare industry. Use of IT is not always welcomed. There is always constant resistance from the users to use IT
in healthcare and, implementation cost of IT is also very high. The raise in healthcare standard and the constant
support for the introduction of IT in medical field has always been the positive variables for this research.
Although there are many positive factors but there are few weaknesses also that might affect that research results.
Figure 1. (Appendix A) of theoretical framework gives the overview of different theories and analysis done.
Different factors contribute towards the competitive advantage whereas there are certain factors which need to be
avoided or improved.
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Hypotheses
H0:There is no association between integration of IT and views on cost of implementation of IT
H1: There is an association between integration of IT and views on cost of implementation of IT
H0: There is no association between integration of IT into the health system and cultures/beliefs
H1: There is no association between integration of IT into the health system and cultures/beliefs
Significance of Study
By doing research on this topic, I would like to find out how information technology can be used as a
blessing for healthcare industry and how it can be used to gain competitive advantage in healthcare industry.
“The future of healthcare is on your computer, your phone, your tablet, your network and the World Wide
Web,” says Dr. Harris (2017). “By connecting patients with caregivers ― and caregivers with each other ― we
will be better equipped to diagnose conditions, recommend treatments and monitor patients in ways that weren’t
possible 10 years ago.”
Information Technology will make healthcare more affordable for everyone and chances of mistakes will
reduce. It will revolutionize the healthcare industry in next few years. So, scholarly community must continue
doing research on this topic to understand the relationship between IT and healthcare.
Definition of Terms
Information Technology. the technology involving the development, maintenance, and use of computer
systems, software, and networks for the processing and distribution of data (Merriam-Webster's dictionary, 2017)
Competitive Advantage. A superiority gained by an organization when it can provide the same value as its
competitors but at a lower price, or can charge higher prices by providing greater value through differentiation.
Competitive advantage results from matching core competencies to the opportunities (Business Dictionary, 2017).
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Ethical Considerations
It will be make sure that all the ethical principles will be met while conducting the research. The main
ethical principles are informed consent, beneficence, respect for anonymity, and respect for privacy. Other than
that, there are few more considerations while doing the research like data sharing, data protection, copyright
guidelines, confidentiality etc. No personal information will be used without consent, nobody will be harmed
during this research, references will be made and co-authorship will be mentioned wherever necessary.
Delimitation
Delimitation is defined as the scope of research. While conducting a research area of research or boundary
line of research should be considered. This research focuses on use of information technology to gain competitive
advantage in healthcare industry. The demographic boundary of this research will be restricted to North America
and as per techniques are considered, different research papers, studies, and books will be followed to support the
hypothesis. .
Limitation
The main limitation in conducting this type of research is that accurate data is not available. Around 90
percent of research today shows positive effect of information technology on healthcare industry whereas there are
few factors like user acceptance and cost of implementation which can result in negative effect (Buntin, Burke,
Hoaglin, and Bluementhal, 2011). In deductive approach, one will rely on the research that has already been done
but nobody can say anything about the authenticity of the research.
Literature Review
Healthcare industry is always under pressure to improve the healthcare standards, patient safety, and reduce
medical errors. If an organization can integrate its healthcare system with information technology, it can reduce the
medical errors and improve its service which will in return helps it in gaining competitive advantage over its
competitors. While medical staff and patients have always been, and will continue to be at the heart of healthcare,
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the value of the use of IT in a patient-centric approach to care is starting to reveal itself and for everyone concerned
the improvements are there to see (Strategyand.pwc.com, 2017).
Information Technology
Even though information technology (I/T) has evolved from its traditional orientation of administrative
support toward a more strategic role within an organization, there is still a glaring lack of fundamental frameworks
within which to understand the potential of I/T for tomorrow's organizations (Henderson and Venkatraman, 1999).
User acceptance of and implementation cost of IT are road blocks in facilitation of IT in an organization. If these
two roadblocks are overcome, IT can be used to gain competitive advantage for an organization. In the 3 decades
since the term “medical informatics” was first used, individuals working at the intersection of information
technology (IT) and medicine have developed and evaluated computer applications aiming to improve health and
health care (Hersh, 2004). The process of information technology adoption and use is critical to deriving the
benefits of information technology. Yet from a conceptual stand-point, few empirical studies have made a
distinction between individuals' pre-adoption and post-adoption (continued use) beliefs and attitudes. This
distinction is crucial in understanding and managing this process over time (Karahanna, Straub, and Chervany,
1999).
conceptual stand-point, few empirical studies have made a distinction between individuals' pre-adoption and post-
adoption (continued use) beliefs and attitudes. This distinction is crucial in understanding and managing this
process over time.
Information Technology and Healthcare Industry
In last few decades, evolution of information technology and its use in healthcare industry has totally
changed the healthcare field (Thompson and Brailer, 2004). Online appointments, electronic billing, electronic
billing records etc. are few examples of how integration of information technology with healthcare has changed the
healthcare delivery. The effect of information technology on healthcare industry is even more profound when it
comes to diagnosis and treatment. Different cancer diagnosis and treatment techniques like image reconstruction,
image data storage, image transfer, DICOM and PACS etc. are benefitted hugely with involvement of IT.
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Implementation of HIPPA regulations has improved the security standards and protecting the patient’s healthcare
information.
According to Dr. Harris, Chief Information Officer at Cleveland Clinic, in just 30 years, information
technology (IT) has profoundly changed healthcare. Electronic medical records, online second opinions, real-time
virtual visits, eHospital critical care monitoring — it’s just the beginning of how IT systems are enhancing
healthcare delivery in the 21st century (Harris, 2017).
Competitive Advantage
Competitive advantage refers to the set of conditions which helps a business in getting favorable position as
compared to its rivals. A competitive advantage is an advantage gained over competitors by offering customers
greater value, either through lower prices or by providing additional benefits and service that justify similar, or
possibly higher, prices (Ehmke, 2008).
Competitive advantage can be gained by offering the customers something at lower cost or at higher value which
its competitors cannot. A sustainable competitive advantage means upholding the favorable conditions which
makes the company successful. A firm that can discover a better technology for performing an activity than its
competitors thus gains competitive advantage (Porter, 1985).
Factors Facilitating use of IT as Competitive Advantage for Healthcare
There are several factors which can be used to gain favorable position over competitors in healthcare industry.
1.) Cost reduction. Cost reduction is the main factor when it comes to gaining competitive advantage. Online
appointments, billing records, online billing can reduce the both time and money cost (Bates and Gawande,
2003).
2.) Maintaining Database entries. Entering the patient’s information in hospital database can make it easy for
doctors to understand patient’s history even if patient is not present physically at that time. It will help in
maintaining uniformity of patient’s information and thus result in effective treatment plans (Bates and
Gawande, 2003)
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3.) User friendly website. A user-friendly website can attract many people. If a hospital’s website has features
like live chat and 24X7 helpline which can answer preliminary questions about health, it can be a huge
factor to gain competitive advantage (Bates and Gawande, 2003).
4.) Tracking tool. Having a tracking tool which will track patient’s progress and send out alarm to hospital
staff if progress is dropping will be additional factor for competitive advantage (Bates and Gawande, 2003).
5.) Patient’s knowledge. With the integration of IT with healthcare, patients can get visual representation of
their health. For example, ultrasounds, X-rays, radiography has made it possible to get better idea of health
for patients and doctors both (Bates and Gawande, 2003).
Review of Methodologies
Use of Information Technology in Healthcare Industry is a very vast field. This topic has become so
important to the healthcare industry that different schools have started offering Masters in Healthcare Informatics.
To study the benefits of health information technology, Buntin, Burke, Hoaglin, and Blumenthal (2011)
used previous articles based on the peer-reviewed literature for the period of 1994-2007. Basit Chaudhry and
colleagues covered articles from 1995 to January 2004, and Caroline Goldzweig and colleagues examined articles
from June 2004 to June 2007. They used the methods and selection criteria of these two studies to update their
findings on the effects of health IT for the period July 2007 up to February 2010. Online database MEDLINE was
used for search purposes from 2007-2010 and total 4,193 articles were searched. Comprehensive approach was
followed for conducting this study. Inductive research approach was followed very successfully. Articles for this
research was successfully narrowed down from 4.193 to 100 in the end based on the research criteria. Previous
study results were used but new topics like use of IT in clinical practice and measure of quantitative and qualitative
results of use of IT in clinical practice. Few topics were dropped from the previous studies.
Inductive research approach is the best approach to follow for this topic as the topic is very vast and
reviewing the literature with new perspective will give good results.
Review of Theories
SWOT Analysis of Information Industry and Healthcare Industry (Helms, Moore and Ahmadi, 2008) focus
on internal strengths and weaknesses, and external opportunities and threats in to analyze medical error reduction,
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patient safety, timely information to health records and patient privacy. Patient safety, investment in IT in
healthcare industry, and improvement in patient safety emerged out as main internal strengths whereas lack of
System integration, resistance to use IT in healthcare industry emerged out as weaknesses. Use of internet, support
for IT in healthcare, and raise in standards after introduction of IT in healthcare are main opportunities whereas
HIPPA compliance, loss of trust, and cost of IT implementation are main external threats.
Use of information technology as weapon on healthcare system is of great interest for medical and
academic research scholars. Different scholars follow different approaches. Implementing IT in healthcare can be
done by taking care reviewing literature and reapplying integrating concepts, field experience examination id
another approach, and re-examining several successful IST applications could be one approach too.
Theoretical Framework
Figure 1. (Appendix A) of theoretical framework gives the overview of different theories and analysis done.
Different factors contribute towards the competitive advantage whereas there are certain factors which need to be
avoided or improved. This framework will help me crating hypothesis and answering my research questions.
Research Design and Methodology
Research Worldwide
Different philosophers have explained different research worldviews but there are four that are widely
discussed: Postpositivism, constructivism, Advocacy, and Pragmatism (Cresswell, 2014). Post-positivism research
approach accepts the critique of traditional positivism that has been presented by the subjectivists, without going so
far as to reject any notion of realism. In post-positivism approach one tries to represent the reality (Sukamolson,
2007). For this research, post-positivism research worldview has been selected because this study requires
statistical analysis and scientific approach which are both parts of post-positivism. Hypothesis, research questions
will be answered better if post-positivism research worldview is followed.
Research Design
There are three different types of research designs, qualitative, quantitative, and mixed methods. Different
worldviews follow different research designs.There are different laws and theories that need to be testified and
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verified so that we can use these again and again(Creswell,2013). A post positivist’s observation is based on the
theories that already exist and follow the quantitative design. The purpose of quantitative design is to compare the
variables, precise measurement, establish relationship between variables, and then expand from a sample to
population (Morse, 2003). So, quantitative design will be followed for this research. A non-experimental approach
will be taken for quantitative design. Relationship between the already existing variables will be studied and the
research questions/hypothesis will be formulated. Research questions in quantitative study means variance or the
questions related to process. After data collection, and data analysis, validity of data will be checked.
Research Strategy
Blaxter, Hughes, and Tight (1996) argue that quantitative research is concerned with the collection of data
and analysis of data in numeric form. It focuses on relatively large scale and sets of data (Blaxter, Hughes, & Tight,
1996). Quantitative research approach is basically deductive and tests an existing theory. The research strategies
used in quantitative research are experiment, surveys, and predetermined instruments in data collection to produce
statistical data. Bryman (2015) asserts quantitative research usually emphasizes quantification in the collection and
analysis of data.
The strategy followed for this research is survey. The research topic “Use of IT to gain competitive
advantage in Healthcare Industry” is a very wide topic. It requires large sets of data to be studied and find out the
gaps.
Method of Data Collection
Abbas and Charles (2003) defined “method” as a design component that includes (a) the relationship that
the researcher establishes with individuals and groups being studied, (b) the selection of sites, participants, settings,
and times of data collection, (c) the methods used for data collection, and (d) the strategies used for data analysis
(Abbas & Charles, 2003).
The research data in quantitative research is typically gathered through surveys using close-ended questionnaires.
These surveys and questionnaires are designed and developed very carefully to provide the numerical data to yield
results from the data.
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Method of Data Analysis
Descriptive and inferential analysis are the two data analysis techniques for quantitative research. Donnely
and Trochim (2001) showed that Descriptive Statistics are used to describe the basic features of the data in a study.
They provide simple summaries about the sample and the measures. Together with simple graphics analysis, they
form the basis of virtually every quantitative analysis of data. With descriptive statistics, you are simply describing
what is, what the data shows where as inferential statistics investigate questions, models and hypotheses. In many
cases, the conclusions from inferential statistics extend beyond the immediate data alone. Thus, we use inferential
statistics to make inferences from our data to more general conditions; we use descriptive statistics simply to
describe what's going on in our data (Donnely & Trochim, 2001).
For this study,we will use the data gathered from questionnaires.The data will be cleaned,coded and entered
into SPSS for analysis. Descriptives statistics using frequency distribution tables,appropriate graphs and
measures of central tendencies will be done to describe our data and then, inferential statistics using chi-square
tests will be carried out to test our hypotheses.
Inferential statistics will be carried out at 5% level of significance and the decision to reject or not the null
hypothesis will be determined through comparison of the p-value and level of significance .The decision
rule ;reject null hypothesis if p-value is less than the level of significance otherwise,we do not reject the null
hypothesis.
Population
This research topic is wide and the population for this topic includes the organizations, organization staff,
and the patients.
The target population for this study are the health care units within North America that have integrated IT
into their system.This narrows down to specific demographic area.
Sample
As the research topic is wide and the population under the topic is large, a sample data was chosen.
According to Suresh, Suresh, and Thomas (2011), A major purpose of doing research is to infer or generalize
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research objectives from a sample to a larger population. The process of inference is accomplished by using
statistical methods based on probability theory. A sample is a subset of the population selected, which is an
unbiased representative of the larger population. Studies that use samples are less-expensive, and study of the
entire population is sometimes impossible (Suresh, Suresh, & Thomas, 2011).
For this research, Stratified Sampling method will be used. Based on the research, four stratas based on the
type of the organization;private,governmental,non-profit and profit.Then,a simple random sample will be drawn
from each stratum proportional to the sample size. Stratified random sampling is used because the health units are
heterogeneous.This reduces the cost per observation,produce a smaller error of estimation compared to simple
random sampling and also estimates of population parameters may be desired for subgroups of the population
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Results
Descriptive analyses
Use of IT
The bar chart below shows that 63.42% of the respondents are actively practising IT in their healthcare
system while 36.58% are not actively practising IT.
Type of organization
The bar chart shows that 74.5% of the health units sampled are privately owned,14.6% owned by the
government,5.9% are non-profit and 5% are profit organizations.
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Integration of IT into the health unit departments
Among the health units in our study,92.3% of them have managed to integrate IT in all departments within
their facility,4.5% partly integrated but not in all departments while 3.2% have not managed at all to integrate IT
into their system.
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Inferential Statistics
This research utilized chi-square tests to test for associations between variables.The variables under study
are categorical hence chi-square test is the appropriate test statistic.
Chi-square test is used to test for associations between two more categorical variables(Agresti and Kateri,2011)
IT integration and type of organization
The clustered bar chart below displays the association between the two variables
H0:There is independence between IT integration and the type of organization
H1:There is no independence between IT integration and type of organization
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Chi-Square Tests
Value df
Asymp. Sig. (2-
sided)
Pearson Chi-Square 58.754a 4 .000
Likelihood Ratio 46.653 4 .000
Linear-by-Linear Association 14.051 1 .000
N of Valid Cases 2732
a. 0 cells (.0%) have expected count less than 5. The minimum expected count
is 8.85.
The chi-square tests revealed that there is a significant association between IT integration and the type of
organization.The analysis yielded(chi-square value with 4 d.f=58.754,p-value=.000) which led to rejection of null
hypothesis since .000<.05
Integration of IT in all departments and views on cost of implementation
H0:There is no association between integration of IT and views on cost of implementation of IT
H1: There is an association between integration of IT and views on cost of implementation of IT
The clustered bar chart below is a graphical representation of the two variables.
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The chi-square test revealed that there was no significant association between those health units that have
managed to integrate IT in all departments and their views on the cost of implementation of IT into the health
system.They all believe that the cost of implementation is high.
Chi-Square Tests
Value df
Asymp. Sig. (2-
sided)
Pearson Chi-Square 9.873a 8 .274
Likelihood Ratio 9.479 8 .304
Linear-by-Linear Association 2.900 1 .089
N of Valid Cases 1376
a. 4 cells (26.7%) have expected count less than 5. The minimum expected
count is 1.63.
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Integration of IT and views on culture/beliefs
The clustered bar chart below displays the distribution of these two variables
H0: There is no association between integration of IT into the health system and cultures/beliefs
H1: There is no association between integration of IT into the health system and cultures/beliefs
The chi-square test gave the results in the table (chi-square value with 8 d.f=1.173E2,p-value=.000).This
reveals that there is a significant association between integration of IT into the health system and cultures/beliefs.
The health facilities that feel there is rarely or no conflict between cultures/beliefs and adoption of
technology has integrated IT into all or most departments of their facility as compared to their counterparts who
belief otherwise.
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Chi-Square Tests
Value df
Asymp. Sig. (2-
sided)
Pearson Chi-Square 1.173E2a 8 .000
Likelihood Ratio 91.746 8 .000
Linear-by-Linear Association 104.618 1 .000
N of Valid Cases 2203
a. 4 cells (26.7%) have expected count less than 5. The minimum expected
count is .77.
Discussion of results
Our analysis gave results that solved the problem of our research,we were able to examine how
cultures/beliefs and cost of implementation affect integration of IT into the healthcare system.
We found that there was a significant association between IT integration and the type of organization since
the results led to rejection of null hypothesis of independence.Private organizations were seen to have integrated
technology into their systems more compared to any other.This can be attributed to the fact that,quality is their
value for most of them and reducing on labour costs while improving efficiency is their goal.
There was a significant association between those health units that have managed to integrate IT in all
departments and their views on the cost of implementation of IT into the health system since we rejected our null
hypothesis.They all believe that the cost of implementation is high.Purchase of modern instruments and tools for
use within the facility require huge amounts of capital.Installation costs are also included which makes it an all
expensive undertaking.
This study also revealed a significant association between integration of IT into the health system and
cultures/beliefs.The health facilities that feel there is rarely or no conflict between cultures/beliefs and adoption of
technology has integrated IT into all or most departments of their facility as compared to their counterparts who
belief otherwise.
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This research was able to fill the gap on giving a better understanding and relationships between
cultures,cost of implementations and integration of IT into the system.The results contribute to the existing
literature and the concerned can use this information to better their decision when adopting technologies.
Recommendations
Further research should be extended to other parts of America in order to cover a wider scope because this research
is limited to only health care units within North America.
Conclusions
IT has positive effect on healthcare system resulting in gaining the competitive advantage but on the other
hand, there are few factors like cost of implementation and reluctant to use IT due to cultures/beliefs, which, has
negative effect on gaining competitive advantage. This research therefore, evaluated how the two factors affect the
gain of competitive advantage in healthcare system.The research questions addressed the relationships between
these two factors and integration of the IT into health care system.
Quantitative research design was suitable for this research,the research strategy was a survey utilizing
closed -ended questionnaires to collect primary data for analysis.Quantitave method was used for analysis,where
descriptives were first carried out to describe the data and then inferential statistics was done to test
hypotheses.Chi-square tests were appropriate since the variables were categorical.
The results revealed that was a significant association between those health units that have managed to
integrate IT in all departments and their views on the cost of implementation of IT and there was a significant
association between integration of IT into the health system and cultures/beliefs.
It was recommended that further research be carried out in other parts of America as our study focused only
in North America.
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Appendix A
Figure 1. Theoretical Framework
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