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The conventional wisdom is that information technology (IT) will "transform" the health care system, helping to contain costs and to make medical care significantly safer, of more consistently high quality, and more efficient. Yet the expected transformation has not yet occurred despite “a four-decade history of anticipation and investment.” We believe that the full impact of IT has not been realized because of the failure to recognize both that the path from availability of applications to anticipated benefits passes through a series of five discrete steps and that progress can be stopped at any one of those steps. In this paper, we present a comprehensive framework that can be used to review existing literature about the following question: What driving and restraining factors affect the spread, use, and effects of information technology in the health care sector in the U.S.? Understanding what those factors are and how they operate on individuals and organizations will make it possible to develop and implement a truly effective strategy to achieve the benefits of IT throughout the health care system.

Stream: Human Technologies and Usability

Paper: A paper has not yet been submitted.

Davidson, who has a Ph.D. from the University of Chicago, is an active researcher, concentrating on the organization and delivery of health care services, as well as related public policy issues. Prior to joining the faculty at Boston University, he was on the faculty at the University of Chicago (1971-1981) and the Kellogg Graduate School of Management at Northwestern University (1981-1985). Much of his recent research has focused on managed care, including relationships between managers and physicians in health care organizations, utilization and quality comparisons between managed care and indemnity insurance, the relationship between competition and quality in managed care organizations, the effects of managed care on physician practice, physician retention in community health centers, managed care in state Medicaid programs, and strategies of large employers in the purchase of health care benefits for their employees. He is co-author (with Janelle Heineke and Marion McCollom), of The Physician-Manager Alliance: Building the Healthy Health Care Organization (Jossey-Bass, 1996), as well as co-editor (with Stephen A. Somers) of Remaking Medicaid: Managed Care for the Public Good (Jossey-Bass, 1998), as well as the author or co-author of several other books and many journal articles and monographs. He has conducted a number of program evaluations, including a recently completed one of a program of subsidized health insurance for working people, and he designed and evaluated a prepaid managed care experiment operated by the Suffolk County (NY) Medicaid Program. Davidson, who is a political science graduate of Swarthmore College, is also Director of Research at John Snow, Inc. (JSI), Boston, MA.