ABSTRACT
As we already mentioned in Chapter 2, the implementation of PCISs in health care practices has proven to be a path ridden with risks and dangers. It has become evident that there are many more failure stories to tell than there are success stories —and the more comprehensive the technology, or the wider the span of the implementation, the more difficult it appears to achieve success. In addition, the preceding chapters have made it clear that organizational issues are just as important in successful PCIS development and use as technical issues. Of course, inadequate design of an information system (e.g. an inadequate userinterface) or its poor performance (e.g. slow response times) will reduce its chances of being successfully implemented. Yet even in cases of clear-cut technical difficulties, the question whether the implementation is seen as a success or a failure is ultimately not a mere technical matter. In the end, this final decision is about the attachment of the label ‘success’ or ‘failure’ (or anything inbetween) to a particular situation. Some health care organizations might decide to muddle through with a given system, or to invest more resources so as to improve the problems perceived to be most problematic; other organizations might, in similar situations, decide to abort the project, and accept their losses. In the end, then, the question whether an implementation has been successful or not is socially negotiated (Woolgar 1988; Kaplan 2001).
