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Introduction
As one of the largest consumers of public spending, the healthcare sector is increasingly recognized amongst most countries as an important economic sector with rapidly growing expenditure. The healthcare sector demonstrates, that compared with other sectors, it still has a relatively underdeveloped information system (IS) structure ([30] O'Riain and Helfert, 2005). The inadequate IS along with the general challenges within the healthcare sector, highlights the need for improvements. Challenges the healthcare sector faces are for instance, the declining resources, increasing patient complexity with an increasing need for high-quality healthcare services. Most governments recognize the importance of reducing healthcare costs, streamlining workflows, and care pathways, enhancing patient care and thus improving effectiveness and efficiency in the healthcare sector. Consequently, a high pressure for healthcare providers exist to increase productivity and to reduce costs.
Recent efforts to improve the effectiveness and efficiency of the healthcare sector have been made, for example concepts to integrate healthcare systems ([28] Mori, 2004). Many countries and healthcare providers have attempted to reduce costs and increase productivity by implementing enterprise resource planning systems or process management systems. Despite these efforts in many countries, concepts for the implementation of adequate healthcare IS, such as integrated electronic health record systems are often far away from realization.
A prominent example in Ireland is the implementation of Personnel Payroll Attendance and Recruitment System (PPARS). This scenario will be used in this paper as a background case study. The PPARS system aims to be a standardized healthcare human resource (HR) and payroll system for the Irish healthcare sector. The system was seen as crucial by the government in order to reduce HR expenditure. It is estimated that HR expenditure account for approximately 70 percent of the overall expenditure on health ([14] Department of Health and Children, 2004). The system was intended to be used by all health agencies and providers within Ireland. It should facilitate and address any deficits within the HR management function that includes workforce planning, time management, staff retention, recruitment, benchmarking, and management information ([14] Department of Health and Children, 2004).
The implementation of the PPARS project can be divided into two broad phases: the first phase from 1998 to 2002, when the initial concept was proposed and its first implementation attempted. Following...