Enterprise architecture, IT effectiveness and the mediating role of IT alignment in US hospitals

Despite the possible benefits of implementing healthcare information technologies, successful implementation of effective healthcare information technology is constrained by cultural and regulatory concerns and technical obstacles encountered when establishing or upgrading an organisation's enterprise infrastructure. In this paper, we advance Ross' four‐stage model of enterprise architecture maturity as a valuable IT resource for helping healthcare organisations sustain a competitive advantage. We use partial least squares (PLS) structural equation modelling to analyse survey data from 164 US hospitals at different stages of EA maturity. Our results provide evidence that enterprise architecture maturity directly influences the effectiveness of hospitals' IT resources for achieving strategic goals. Further, enterprise architecture maturity indirectly influences the effectiveness of IT resources when IT alignment is incorporated as a mediating variable. We discuss the implications of our findings for research and practice and suggest opportunities for future research.

[1]  Ephraim R. McLean,et al.  The DeLone and McLean Model of Information Systems Success: A Ten-Year Update , 2003, J. Manag. Inf. Syst..

[2]  E. Vance Wilson,et al.  Interdisciplinary Research and Publication Opportunites in Information Systems and Health Care , 2004, Commun. Assoc. Inf. Syst..

[3]  Farhad Arbab,et al.  Enterprise architecture: Management tool and blueprint for the organisation , 2006, Inf. Syst. Frontiers.

[4]  Hsin Hsin Chang,et al.  Technical and management perceptions of enterprise information system importance, implementation and benefits , 2006, Inf. Syst. J..

[5]  Rick Gibson,et al.  Global Information Technology Architectures , 1994 .

[6]  Jeanne W. Ross,et al.  IT Savvy: What Top Executives Must Know to Go from Pain to Gain , 2009 .

[7]  M. R. Blaha,et al.  The case for reverse engineering , 1999 .

[8]  Paul A. Pavlou,et al.  Understanding and Mitigating Uncertainty in Online Exchange Relationships: A Principal-Agent Perspective , 2007, MIS Q..

[9]  John Hulland,et al.  Use of partial least squares (PLS) in strategic management research: a review of four recent studies , 1999 .

[10]  Leslie P. Willcocks,et al.  Shaping the Future. Business Design Through Information Technology , 1991, J. Inf. Technol..

[11]  H. Winklhofer,et al.  Index Construction with Formative Indicators: An Alternative to Scale Development , 2001 .

[12]  Eric K. Clemons,et al.  Sustaining IT Advantage: The Role of Structural Differences , 1991, MIS Q..

[13]  Arun Rai,et al.  Refocusing where and how IT value is realized: An empirical investigation , 1996 .

[14]  R. Lennox,et al.  Conventional wisdom on measurement: A structural equation perspective. , 1991 .

[15]  Rudolf R. Sinkovics,et al.  The Use of Partial Least Squares Path Modeling in International Marketing , 2009 .

[16]  Walter Baets,et al.  Aligning information systems with business strategy , 1992, J. Strateg. Inf. Syst..

[17]  Walter Buhr,et al.  What is infrastructure , 2003 .

[18]  Wilhelm Hasselbring,et al.  The SI challenge in health care , 2000, CACM.

[19]  Eric Overby,et al.  Enterprise agility and the enabling role of information technology , 2006, Eur. J. Inf. Syst..

[20]  Eli Segev,et al.  Strategy, strategy making, and performance—an empirical investigation , 1987 .

[21]  Wynne W. Chin.  The partial least squares approach for structural equation modeling. , 1998 .

[22]  Stuart Macdonald,et al.  From efficiency to flexibility: the strategic use of information in the airline industry , 1996, J. Strateg. Inf. Syst..

[23]  Randy V. Bradley,et al.  Information technology architecture as a competitive advantage-yielding resource: a theoretical perspective , 2007, Int. J. Netw. Virtual Organisations.

[24]  Yi-Shun Wang.  Assessing e‐commerce systems success: a respecification and validation of the DeLone and McLean model of IS success , 2008, Inf. Syst. J..

[25]  C. Fornell,et al.  Structural Equation Models with Unobservable Variables and Measurement Error: Algebra and Statistics , 1981 .

[26]  D. Teece,et al.  DYNAMIC CAPABILITIES AND STRATEGIC MANAGEMENT , 1997 .

[27]  A. Roth,et al.  Strategic Determinants of Service Quality and Performance: Evidence from the Banking Industry , 1995 .

[28]  Michael R. Vitale,et al.  Creating Competitive Advantage with Interorganizational Information Systems , 1988, MIS Q..

[29]  Yoris A. Au.  Design Science I: The Role of Design Science in Electronic Commerce Research , 2001, Commun. Assoc. Inf. Syst..

[30]  Arun Rai,et al.  Intermediate Performance Impacts of Advanced Manufacturing Technology Systems: An Empirical Investigation* , 1999 .

[31]  Yolande E. Chan.  Why Haven't We Mastered Alignment? The Importance of the Informal Organization Structure , 2002, MIS Q. Executive.

[32]  Charles H. Kriebel,et al.  Information Technologies and Business Value: An Analytic and Empirical Investigation , 1995, Inf. Syst. Res..

[33]  Judy A. Siguaw,et al.  Formative versus Reflective Indicators in Organizational Measure Development: A Comparison and Empirical Illustration , 2006 .

[34]  Ram L. Kumar,et al.  A Framework for Assessing the Business Value of Information Technology Infrastructures , 2004, J. Manag. Inf. Syst..

[35]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[36]  Randy V. Bradley,et al.  Information Systems Success in the Context of Different Corporate Cultural Types: An Empirical Investigation , 2006, J. Manag. Inf. Syst..

[37]  Izak Benbasat,et al.  Factors That Influence the Social Dimension of Alignment Between Business and Information Technology Objectives , 2000, MIS Q..

[38]  H. Russell Johnston,et al.  Developing Capabilities to Use Information Strategically , 1988, MIS Q..

[39]  Scott Hamilton,et al.  Evaluating Information Systems Effectiveness - Part II: Comparing Evaluator Viewpoints , 1981, MIS Q..

[40]  C. Marano,et al.  To err is human. Building a safer health system , 2005 .

[41]  T. Hennig-Thurau,et al.  Consumer File Sharing of Motion Pictures , 2007 .

[42]  Detmar W. Straub,et al.  Specifying Formative Constructs in Information Systems Research , 2007, MIS Q..

[43]  Andrew C. Boynton,et al.  Information Architecture: In Search of Efficient Flexibility , 1991, MIS Q..

[44]  Jason Bennett Thatcher,et al.  The Emerging CIO Role of Business Technology Strategist , 2011, MIS Q. Executive.

[45]  Michael J. Earl,et al.  Management Strategies for Information Technology , 1989 .

[46]  Peter Weill,et al.  The Relationship Between Investment in Information Technology and Firm Performance: A Study of the Valve Manufacturing Sector , 1992, Inf. Syst. Res..

[47]  James C. Wetherbe,et al.  Key Issues in Information Systems Management: 1994-95 SIM Delphi Results , 1996, MIS Q..

[48]  Arun Rai,et al.  Technology investment and business performance , 1997, CACM.

[49]  L. Willcocks,et al.  The evolution of the organizational architect , 2002 .

[50]  James W. Kolari,et al.  Marketing Strategy Implications of the Miles and Snow Strategic Typology , 1987 .

[51]  Jeanne W. Ross,et al.  Enterprise Architecture As Strategy: Creating a Foundation for Business Execution , 2006 .

[52]  Randy V. Bradley,et al.  A Theoretical Investigation and Extension of a Model of Information Technology Architecture Maturity , 2009, J. Organ. End User Comput..

[53]  John F. Rockart,et al.  Managing the data resource: a contingency perspective , 1988 .

[54]  M. Sobel.  Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models , 1982 .

[55]  E. Vance Wilson.  Editorial Statement: Information Systems and Health Care Department , 2004, Commun. Assoc. Inf. Syst..

[56]  William J. Doll,et al.  Avenues for Top Management Involvement in Successful MIS Development , 1985, MIS Q..

[57]  Jan Pries-Heje,et al.  Business agility and diffusion of information technology , 2006, Eur. J. Inf. Syst..

[58]  Clare-Marie Karat,et al.  Affordances, motivation, and the design of user interfaces , 2000, CACM.

[59]  C. Fornell,et al.  Evaluating structural equation models with unobservable variables and measurement error. , 1981 .

[60]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[61]  Ephraim R. McLean,et al.  Information Systems Success: The Quest for the Dependent Variable , 1992, Inf. Syst. Res..

[62]  Terry Anthony Byrd,et al.  Measuring the Flexibility of Information Technology Infrastructure: Exploratory Analysis of a Construct , 2000, J. Manag. Inf. Syst..

[63]  Deborah Fitzsimmons,et al.  Intrusive Thoughts and Psychological Adjustment to Breast Cancer: Exploring the Moderating and Mediating Role of Global Meaning and Emotional Expressivity , 2010, Journal of clinical psychology in medical settings.

[64]  John C. Henderson,et al.  Strategic Alignment: Leveraging Information Technology for Transforming Organizations , 1999, IBM Syst. J..

[65]  Terry Anthony Byrd,et al.  Electronic data interchange usage in China's healthcare organizations: the case of Beijing's hospitals , 2004, International Journal of Information Management.

[66]  Gary W. Dickson,et al.  A Principles-Based Enterprise Architecture: Lessons from Texaco and Star Enterprise , 1990, MIS Q..

[67]  L. Willcocks,et al.  Core IS Capabilities for Exploiting Information Technology , 1998 .

[68]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[69]  Anna Demming,et al.  The best of both worlds , 2010, Nanotechnology.

[70]  T. S. Ragu-Nathan,et al.  Research Report - Adaptation of a Planning System Success Model to Information Systems Planning , 1994, Inf. Syst. Res..

[71]  U. Reinhardt,et al.  Health care spending and use of information technology in OECD countries. , 2006, Health affairs.

[72]  Terry Anthony Byrd,et al.  Examining possible antecedents of IT impact on the supply chain and its effect on firm performance , 2003, Inf. Manag..

[73]  E. Brynjolfsson,et al.  Paradox Lost? Firm-Level Evidence on the Returns to Information Systems Spending , 1996 .

[74]  C. Prahalad,et al.  The Core Competence of the Corporation , 1990 .

[75]  A. Gunasekaran,et al.  Agile manufacturing: The drivers, concepts and attributes , 1999 .

[76]  Sameer Kumar,et al.  Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study , 2010, Health Informatics J..

[77]  Robert J. Kauffman,et al.  Measuring Gains in Operational Efficiency from Information Technology: A Study of the Positran Deployment at Hardee'S Inc. , 1990, J. Manag. Inf. Syst..

[78]  Jerry N. Luftman,et al.  Transforming the Enterprise: The Alignment of Business and Information Technology Strategies , 1993, IBM Syst. J..

[79]  Xianggui Qu,et al.  Multivariate Data Analysis , 2007, Technometrics.

[80]  T. Little,et al.  On selecting indicators for multivariate measurement and modeling with latent variables: When "good" indicators are bad and "bad" indicators are good. , 1999 .

[81]  Laurie J. Kirsch,et al.  Strategic Data Planning: Lessons From the Field , 2011, MIS Q..

[82]  Jason Bennett Thatcher,et al.  Conceptualizing and testing formative constructs: tutorial and annotated example , 2009, DATB.

[83]  Randy V. Bradley.  Strategic Valuation of Enterprise Information Technology Architecture in Healthcare Organizations , 2006 .

[84]  F. J. Armour,et al.  A big-picture look at enterprise architectures , 1999 .

[85]  Jeanne W. Ross,et al.  Creating a Strategic IT Architecture Competency: Learning in Stages , 2003, MIS Q. Executive.

[86]  K ClemonsEric,et al.  Sustaining IT advantage , 1991 .

[87]  Cynthia Mathis Beath,et al.  Sustainable IT Outsourcing Success: Let Enterprise Architecture Be Your Guide , 2006, MIS Q. Executive.

[88]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[89]  Varun Grover,et al.  Shaping Agility through Digital Options: Reconceptualizing the Role of Information Technology in Contemporary Firms , 2003, MIS Q..

[90]  Scott Hamilton,et al.  Evaluating Information Systems Effectiveness - Part I: Comparing Evaluation Approaches , 1981, MIS Q..

[91]  R E Miles,et al.  Organizational strategy, structure, and process. , 1978, Academy of management review. Academy of Management.

[92]  David Gefen,et al.  Structural Equation Modeling Techniques and Regression: Guidelines for Research Practice , 2000 .

[93]  Robert D. Galliers,et al.  Coping with information technology? How British executives perceive the key information systems management issues in the mid-1990s , 1994, J. Inf. Technol..

[94]  Detmar W. Straub,et al.  Examining Trust in Information Technology Artifacts: The Effects of System Quality and Culture , 2008, J. Manag. Inf. Syst..

[95]  K Burton.  Measuring flexibility. , 1991, Applied ergonomics.

[96]  Nagesh N. Murthy,et al.  The antecedents of supply chain agility of a firm: Scale development and model testing , 2006 .

[97]  Anandhi S. Bharadwaj,et al.  A Resource-Based Perspective on Information Technology Capability and Firm Performance: An Empirical Investigation , 2000, MIS Q..

[98]  Randy V. Bradley,et al.  The Role of Enterprise Architecture in the Quest for IT Value , 2011, MIS Q. Executive.

[99]  Peter B. Seddon.  A Respecification and Extension of the DeLone and McLean Model of IS Success , 1997, Inf. Syst. Res..

[100]  J. Alberto Espinosa,et al.  The Organizational Impact of Enterprise Architecture: A Research Framework , 2011, 2011 44th Hawaii International Conference on System Sciences.

[101]  Rajiv Sabherwal,et al.  The Relationship Between Information System Planning Sophistication and Information System Success: An Empirical Assessment* , 1999 .

[102]  Wynne W. Chin,et al.  A Partial Least Squares Latent Variable Modeling Approach for Measuring Interaction Effects: Results from a Monte Carlo Simulation Study and an Electronic - Mail Emotion/Adoption Study , 2003, Inf. Syst. Res..

[103]  John C. Henderson,et al.  Strategic Alignment: Leveraging Information Technology for Transforming Organizations , 1993, IBM Syst. J..

[104]  Rajiv Sabherwal,et al.  Strategic Alignment Between Business and Information Technology: A Knowledge-Based View of Behaviors, Outcome, and Consequences , 2006, J. Manag. Inf. Syst..

[105]  P. Varadarajan,et al.  Strategic types, distinctive marketing competencies and organizational performance: A multiple measures‐based study , 1990 .

[106]  Markus Buschle,et al.  Enterprise Architecture Management's Impact on Information Technology Success , 2011, 2011 44th Hawaii International Conference on System Sciences.

[107]  Rajiv Sabherwal,et al.  Alignment Between Business and IS Strategies: A Study of Prospectors, Analyzers, and Defenders , 2001, Inf. Syst. Res..

[108]  K. Jöreskog,et al.  Intraclass Reliability Estimates: Testing Structural Assumptions , 1974 .

[109]  Cheryl Burke Jarvis,et al.  A Critical Review of Construct Indicators and Measurement Model Misspecification in Marketing and Consumer Research , 2003 .

[110]  C. C. Snow,et al.  Strategy, Distinctive Competence, and Organizational Performance. , 1980 .

[111]  Fred Niederman,et al.  Information Systems Management Issues for the 1990s , 1991, MIS Q..

[112]  Grover S. Kearns,et al.  The effect of strategic alignment on the use of IS-based resources for competitive advantage , 2000, J. Strateg. Inf. Syst..

[113]  Qingyu Zhang,et al.  Manufacturing flexibility: Defining and analyzing relationships among competence, capability, and customer satisfaction , 2003 .

[114]  Nagesh N. Murthy,et al.  Achieving supply chain agility through IT integration and flexibility , 2008 .

[115]  Jeanne W. Ross,et al.  Preparing for utility computing: The role of IT architecture and relationship management , 2004, IBM Syst. J..

[116]  David E. Avison,et al.  Using and validating the strategic alignment model , 2004, J. Strateg. Inf. Syst..

[117]  Detmar W. Straub,et al.  A Practical Guide To Factorial Validity Using PLS-Graph: Tutorial And Annotated Example , 2005, Commun. Assoc. Inf. Syst..

[118]  Albert H. Segars,et al.  Strategic Information Systems Planning Success: An Investigation of the Construct and Its Measurement , 1998, MIS Q..

[119]  David J. Ketchen,et al.  Risk Uncertainty and Supply Chain Decisions: A Real Options Perspective , 2010, Decis. Sci..

[120]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[121]  Paul P. Tallon,et al.  Competing Perspectives on the Link Between Strategic Information Technology Alignment and Organizational Agility: Insights from a Mediation Model , 2011, MIS Q..

[122]  D. A. Kenny,et al.  Data analysis in social psychology. , 1998 .

[123]  Kristopher J Preacher,et al.  Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models , 2008, Behavior research methods.

[124]  M. Wade,et al.  Review: the resource-based view and information systems research: review, extension, and suggestions for future research , 2004 .

[125]  K Pelly Periasamy,et al.  Information architecture practice: research-based recommendations for the practitioner , 1997, J. Inf. Technol..

[126]  M. Lindell,et al.  Accounting for common method variance in cross-sectional research designs. , 2001, The Journal of applied psychology.

[127]  Deepinder S. Bajwa,et al.  An Empirical Investigation into Factors Relating to the Adoption of Executive Information Systems: An Analysis of EIS for Collaboration and Decision Support* , 1997 .

[128]  Kristopher J Preacher,et al.  SPSS and SAS procedures for estimating indirect effects in simple mediation models , 2004, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.