Information system (IS) implementation is a key element of digital transformation in public sector organisations, particularly in healthcare and social services. These systems promise improvements in efficiency, transparency and service quality. However, IS projects also entail considerable challenges and risks, including high failure rates and financial losses. A recent scoping review using Lewin’s change theory provides an in-depth understanding of the driving and restraining forces that shape the success of IS implementation in the public sector. By analysing 25 peer-reviewed articles published between 2018 and 2024, the study offers valuable insights into how these factors interact during the planning and deployment of digital systems.
Forces Supporting Implementation
The driving forces behind successful IS implementation fall into six categories: organisational, technological, managerial, project-related, end-user and institutional factors. Organisational readiness plays a pivotal role, with openness to change, proactive issue resolution and integration of new workflows emerging as significant facilitators. Training and active participation from personnel, especially those on the front line, support a sense of ownership and smooth transition. A culture that embraces innovation, coupled with strong internal coordination and a commitment to continuous learning, lays a strong foundation for transformation.
Technological factors also drive implementation forward. Well-designed systems that support existing workflows, offer ease of use and integrate smoothly with other technologies are more likely to be accepted. Features such as interoperability, usability and observable benefits further enhance user acceptance. Moreover, management practices, including clear communication, stakeholder engagement and leadership commitment, ensure alignment between strategic goals and operational activities. Effective leadership not only motivates personnel but also facilitates conflict resolution and change acceptance.
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Project planning contributes significantly to the implementation process. Early stakeholder involvement, defined roles, resource allocation and relationships with vendors all affect the pace and quality of deployment. End users' competence and motivation, along with supportive national strategies and regulatory frameworks, complete the picture of the positive forces propelling digital change in public service organisations.
Barriers Hindering Progress
Despite the presence of supportive elements, many IS projects face resistance and obstacles. Organisational challenges, such as fear of job displacement, stress and poor communication, frequently stall transformation. Personnel may resist change due to concerns about patient safety, professional autonomy and a lack of incentive systems. Negative organisational cultures, including covert resistance and indifference, further complicate reform efforts.
Technical difficulties remain persistent hindrances. Complex or poorly designed systems, limited user involvement in development and slow or unreliable performance contribute to underutilisation and dissatisfaction. When the systems are not user-centric, users may adopt workarounds, increasing the risk of errors and inefficiencies. Data migration issues, inflexible platforms and security concerns also exacerbate implementation problems.
Management-related barriers often stem from vague communication of strategic objectives, insufficient transparency and limited accountability. When leaders fail to convey purpose or address uncertainties, trust in the process erodes. Inadequate collaboration between IT teams and clinical or operational leaders and poor estimation of project scope and budget, contribute to implementation failure.
On the project level, delayed timelines, vague roles and inadequate planning undermine execution. Budget overruns and strained supplier relationships further restrain progress. Among end users, older age, technological reluctance and privacy concerns add to the resistance. Institutional barriers such as regulatory constraints and slow policy adaptation can also delay or prevent the desired changes.
A Complex Change Narrative
The overall narrative emerging from the scoping review paints a picture of IS implementation as a high-stakes, complex endeavour. In many cases, public sector organisations initiate these projects with the expectation of improving services, but they often face delays, underperformance or outright failure. Health care, in particular, has struggled with integrating new technologies despite recognising their potential.
Technological advancement, however, remains a double-edged sword. On one hand, it facilitates better service delivery, improved patient safety and enhanced efficiency. On the other, it brings uncertainty and stress for professionals, who must adapt to new routines and expectations. Large-scale reforms frequently disrupt workflows and may exacerbate workforce issues. The transformation process requires strong leadership and a clear, shared vision to mitigate these risks.
Nevertheless, ISs hold substantial promise when carefully aligned with organisational processes. They can reduce errors, improve communication and ultimately raise satisfaction for patients, customers and professionals. The most successful implementations are those that combine technical excellence with human-centred planning and execution. Despite the high incidence of failure, the review underscores that IS implementation is not inherently flawed—it is the quality of the implementation process that determines success or failure.
The implementation of information systems in the public sector is shaped by a dynamic interplay of forces that either facilitate or impede change. While organisational readiness, system usability, leadership and stakeholder involvement are critical enablers, challenges related to resistance, technical barriers and poor management can derail even well-funded projects. Successful IS adoption depends on addressing these restraining forces while reinforcing the driving ones. The study highlighted the importance of a comprehensive, context-sensitive approach to managing change, offering valuable guidance for future digital transformation efforts in public organisations. By understanding and balancing these forces, public sector institutions can realise the full potential of digital technologies to enhance services and outcomes.
Source: JMIR Human Factors
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