The information systems (IS) literature has focused considerable research on IS resistance, particularly in the health-care industry. Most of this attention has focused on the impact of IS resistance on systems' initial implementation, but little research has investigated whether and how post-adoption resistance affects performance. We focus on a particular type of post-adoption resistance, which we call IS avoidance, to identify situations in which individuals avoid working with adopted IS despite the need and opportunity to do so. We examine the effects of IS avoidance on patient care delivered by health-care groups across three levels of analysis: the individual level, the shared group level, and the configural group level. We find that IS avoidance is significantly and negatively related to patient care only at the configural group level, which suggests that patient care is not degraded by the number of doctors and/or nurses in a group avoiding a system, but rather by their locations in the group's workflow network configuration. We use qualitative data collected over 16 months at the research site to help explain these results. Implications for theory and practice are discussed.
We examined the relationship between information technology (IT) and organizational performance in the U.S. life/health insurance industry by applying and testing Galbraith's information processing theory and strategic contingency theory. Rather than focusing on resource allocations in IT, we instead examined the manner in which IT is deployed in organizations through information processing design choices. Our results suggest that while some information processing design choices are generally related to organizational performance, others should be matched to a specific strategic posture. For example, we found that all organizations benefit from using IT to increase cost-effectiveness. However, other uses of IT should be more closely aligned with an organization's strategy. In particular, domain offensive organizations should align their IT systems to focus on the front end of their operations and understanding customer needs, which will spur further innovation.