Improving the ‘manager-clinician’ collaboration for effective healthcare ICT and telemedicine adoption processes – a cohered emergent perspective

Existing research shows that the adoption of information and communication technologies (ICTs) for healthcare development in developing countries is largely dominated by donor and international agencies, but the actual organizational-level decisions are often driven by corporate healthcare managers. The consequences of the strategic-driven healthcare ICT adoption practices are that they fail to match clinician users’ requirements and cause them to disuse ICTs for clinical practices and healthcare development. Prior attempts to bring local and globally-distributed actors together to implement ICTs innovatively for healthcare development have emphasized less on synthesizing the diverse information system approaches that inform our understanding of how to narrow the ‘manager-clinician’ tensions in ICT adoption for development in emergent situations. To fill this gap, this article explains the process of shifting healthcare ICT adoption from top-down planning to collective user involvement to enhance clinicians’ acceptance of ICTs for clinical practices and development in a Ghanaian teaching hospital, using the cohered emergent transformation model. Action research was used to engage the hospital’s corporate managers, clinician managers and clinicians, and elicit their views and experiences of the hospital’s ICT adoption for healthcare delivery improvement. Together with observations and document analysis, the data was analyzed to understand the hospital’s information and communication technologies for development (ICT4D) adoption issues and identify ways of managing them. The outcomes provide alternative theoretical and practical ways of adopting healthcare technology systems that shift the excessive use of managers’ powers in ICT adoption towards clinicians’ involvement, to enable technology acceptance for clinical practices and healthcare development.