Technological Change at Work: The Impact of Employee Involvement on the Effectiveness of Health Information Technology

The link between employee involvement (EI) and organizational performance is not clear-cut, and the diffusion of information technology (IT) in the workplace complicates this relationship. The author argues that new technologies offer an important avenue by which EI can improve firm performance. He also contends that those studies that do consider EI in the context of technological change may be focusing exclusively on workplace-level features of the employment relationship, ignoring variation in functional- and strategic-level aspects of employment relations. To test this hypothesis, he uses Kaiser Permanente Northwest Region's patient scheduling module as an exemplar to investigate the extent to which this particular technology interacts with EI to affect clinic-level improvements in patient satisfaction. He studies the impact of the technology over the period October 2004 to August 2007 across 16 clinics to identify variation across sites. Measuring outcomes from a dataset that includes employee and patient surveys, interviews, archival data, and clinic observations, he finds that the use of IT is associated with performance increases and that these effects are greater in those clinics achieving higher mean levels of EI. This study presents the first empirical evidence of the potential of EI to enhance the effectiveness of health IT.