The influence of peer beliefs on nurses' use of new health information technology: A social network analysis.

Implementation of health information technology fails at an alarming rate because intended users often choose not to use it. Implementation theory and frameworks suggest that social networks may influence individuals' use, but empirical study remains limited. Furthermore, neither theory nor research has identified whose beliefs within the network matter most for implementation. We examine the relationship between an individual's system use and the beliefs of his or her peers. We assess the relationship for two peer groups: the entire group of peers and the subset that shares the individual's beliefs about the system. We used data collected from an academic hospital in the United States that had recently implemented a bar code medication administration system, a technology meant to increase medication safety. We administered a survey to nurses (N = 207) in six clinical units approximately 3-5 months (April-June 2013) after the "go-live" of the system to identify peer groups and beliefs about system usefulness. We calculated mean peer belief for the entire peer group and sharedness of belief using a homophily measure. From the hospital's electronic health record system, we obtained nurses' system use during the 3-month data collection period. We used multivariable linear regression to examine relationships. We found no effect of mean peer beliefs on individual system use. However, sharedness of belief about usefulness was positively associated with individual system use. Individuals' own positive belief was only associated with greater system use when shared with peers. Our findings indicate a significant role of social networks in implementation, and specifically that shared beliefs between an individual and his or her peer network may be critical to implementation success, more so than the beliefs across the entire peer group. Reinforcement by the social network appears to dictate whether individuals' own beliefs translate into system use.

Community relations 2.0.

Before the Internet, organizations had far more time to monitor and respond to community activity, but that luxury is long gone, leaving them in dire need of a coherent outreach strategy, fresh skills, and adaptive tactics. Drawing on the authors' study of more than two dozen firms, this article describes the changes wrought by social media in particular and shows managers how to take advantage of them--lessons that Kaiser Permanente, Domino's, and others learned the hard way. Social media platforms enhance the power of communities by promoting deep relationships, facilitating rapid organization, improving the creation and synthesis of knowledge, and enabling robust filtering of information. The authors cite many examples from the health care industry, where social media participation is vigorous and influential. For instance, members of Sermo, an online network exclusively for doctors, used the site to call attention to and organize against insurers' proposed reimbursement cuts. And on PatientsLikeMe, where people share details about their chronic diseases and the treatments they've pursued, charts and progress curves help members visualize their own complex histories and allow comparisons and feedback among peers. As you modernize your company's approach to community outreach, you'll need to assemble a social media team equipped to identify new opportunities for engagement and prevent brand damage. In the most successful firms the authors studied, community management was a dedicated function, combining marketing, public relations, and information technology skills.