Successful IT systems
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# 5.6 Power and system success

In any process of system implementation, some groups will be better placed to influence the inputs, outputs and outcomes of the process than others. Furthermore, as you have seen, system implementation is a dynamic process, and the groups and individuals that are involved, and their relative power, are in constant flux.

What does this mean in terms of planning for successful IT systems? In order to begin to answer this question, we need to review the different criteria for determining what counts as system success. These were listed earlier as:

- meets client’s requirements
- completed within schedule
- completed within budget
- meets quality and/or safety standards.

All such criteria can and should be looked at from a power perspective. This is because the very notion of ‘the system’ implies a consensual understanding of a situation, yet this consensus – assuming it even exists – may only reflect the view of a small number of stakeholders who are able to exert their influence on others. The same can be said for determination of the system’s objectives and performance measures: who gets to decide these, when, where and how? In this connection, consider the following assertion of Markus and Robey (1983, p. 210):

> While an information system might validly fit the organization task and users’ needs and cognitive styles, it might be resisted because it causes a redistribution of power unacceptable to those losing power. Thus, organizational validity can also be defined in terms of the distribution of power within an organization; a system can be said to be invalid to the extent that it embodies a power distribution at odds with that existing in the organizational context of use.

Whether a particular IT system is classified as a failure or a success will often be contested, and it is here that power-relations and dominant/subordinate perspectives on evaluation criteria come into play. Disputes between stakeholders, if and when they arise, can involve the internal politics of an organisation and at times may be legal, contractual or even academic.

## Activity 12

20 minutes

In Activity 9, you were asked to read a short description of Riverside House, an NHS general practice transitioning from a paper-based patient records system to a computerised one. Read through the description again to refresh your memory.

1. For each of the five groups of stakeholders that you identified in that activity, try to come up with a criterion that it might use to determine system success.
2. For those stakeholders that interact, take a pair of stakeholders and try to identify the power relations between them in terms of which stakeholder is in a dominant position and which is in a subordinate position.

## Discussion

1. The following six stakeholder groups were listed in the answer to Activity 9 so we will list criteria for system success for each one.
   - Receptionists: A successful IT system would be one that enables them to do their job effectively and easily, but also to be able to keep their job.
   - Doctors and nurses: A successful IT system would allow these people to have easy access to patient records, without going through receptionists, both from work and home.
   - Patients: A successful IT system would be one that stores their information correctly and allows relevant staff to access it when needed, as well as enabling additional functionality such as repeat prescriptions.
   - Practice management: A successful IT system would enable practice management to produce aggregate statistics, and to allow them to run the practice more efficiently.
   - Computer system retailers/maintainers: A successful IT system for these people is one that uses their technology but also requires them to do minimal additional work.
   - Wider groups with some interest in the effect of the IT system at Riverside: Success criteria for these groups is multiple and somewhat conflicted – spending less money, but providing greater functionality in producing management statistics while maintaining patient privacy.
2. Brief comments on power relations between stakeholder groups.
   - Receptionists are in a subordinate position to doctors and nurses, to practice management, and somewhat to computer system retailers/maintainers; they interact with patients but it is not clear whether they are dominant or subordinate (in some ways both of these). They do not particularly relate to the wider groups.
   - Doctors and nurses are in a dominant position to receptionists and probably also to patients (in practice if not in theory). In some practices they will be dominant to management and in others they are subordinate to it. In power terms, they are somewhat subordinate to computer system retailers/manufacturers (as they are users rather than buyers). They will be subordinate to some wider groups and dominant to others.
   - Patients are in a subordinate position to doctors and nurses and to practice management; they have a complicated relationship to receptionists. They probably do not relate to computer retailers/manufacturers (as patients). They may well form part of the wider groups but, as a group, don’t have a power relation to them.
   - Practice management are in a dominant position to receptionists, patients (probably) and computer system retailers/manufacturers. They are sometimes dominant and sometimes subordinate to doctors and nurses, and likewise to the wider groups (though as the latter are often fund holders, they are more likely to be subordinate to them).
   - Computer system retailers/maintainers are in a subordinate position to practice management and in a de-facto dominant position to doctors and nurses, and to receptionists. They do not really relate to patients or the wider groups.
   - Wider groups are dominant to some of the above and subordinate to others, but it varies within each group of stakeholders.

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