Evaluation of Information Systems Development in the NHS Using NIMSAD Framework

Abstract

The principal focus of the research effort was the management of information systems development to support the increased information needs arising from the radical health reforms of 1989. This was undertaken in collaboration with a purchaser and a provider within the health service. An action research approach was adopted wherein the researcher was actively involved in the development and successful implementation of an information system. Initial findings revealed a variety of factors hindering the purchaser and the provider from successfully developing the intended information systems to support the contracting process required in the reforms. A disparity in relative strengths between the purchaser and provider was considered a major constraint hindering the purchaser from developing the intended information system and performing their designated role in the new internal market system of the NHS. Through the rapid development of a computer-based information system the immediate needs of the purchaser and the provider were satisfied, and development of the individuals and the organisation took place. Subsequent to
the development, a reflective post-intervention evaluation was carried out using a conceptual problem solving framework.

Three important findings emerged from the systems development effort:

[1] The employment of prototyping in the evolutionary development of the intended information system is considered to be particularly pertinent and responsive to the uncertain requirements of organisations undergoing change.
[2) The embracing of a flexible blend of expert intervention and facilitation is an important element in the information systems development process.
{3) The development of the individuals and the organisation is an intrinsic part of developing information systems.

Using the NIMSAD framework for post-intervention evaluation of the development effort, various additional findings were abstracted from the critical evaluation and reflection on the adopted approach. The systems development process was evaluated against three identified elements - the problem situation, the problem solving process and the problem solver. Results of the evaluation and reflection revealed deficiencies in the research, which indicate that:

[1] The appreciation of the context and content of the problem situation increases the level of understanding of the 'problems' leading to the adoption of appropriate methodologies for conducting the problem solving process.
[2] The effectiveness of the adopted problem solving process can be enhanced by the validation of the client's definition of the problem, the facilitation of involvement from participants, the innovative use of prototyping and the need for evaluation of the process.
[3] The personal characteristics of the problem solver significantly influence the possible solutions to the identified problems.

Contributions from the evaluation of the research effort can be seen in:

[1] The suggested reflexive model for action research, with emphasis on evaluation of the actions of the researcher as a problem solver.
[2] The need to maintain close links with the client and communicate disparate perceptions of the problem and problem situation.
[3] The employment of a flexible blend of expert intervention and facilitation (a hybrid approach enables the resolution of the problem from a multidisciplinary perspective).
[4] Suggestion for further research into the personal characteristics of an effective problem solver.