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Managing the Internet of Things in Health Care Organizations

Issel, L. Michele, PhD, RN

doi: 10.1097/HMR.0000000000000256
Department: Editorial


The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.



The “smart” health care organizations of the near future will fully utilize both the internet of medical things and artificial intelligence in their various forms and applications. That including robotics, big data analytics, sensors, machine learning, precision medicine, and so much more. These technologies are touted as ways to improve care outcomes, reduce risks to clinicians and patients, increase profit margins, and decrease workloads across various health care workers. These advantages tend to be more speculation than fact, with little research that documents these advantages in the usual work flow and settings of health care organizations.

Last semester I taught health services doctoral students. The proportion of students who were interested in computer generated algorithms, predictive analytics, and robotics out numbered the proportion who were interested in quality of care, working conditions, or organizational processes. This shift toward a broad interest in internet technology and computational aspects of health care will continue and likely accelerate. Over the semester, I became better at articulating my uneasiness with their chosen topics. Specifically, their fascination with the technology distracted them from or blinded them to the context in which that technology was being used. They rarely acknowledged the people involved other than the technology developers.

The introduction of new technologies, whether messaging systems or diagnostic tools, still requires that someone use the technology and use it appropriately. The students seemed to take as a given that the implementation, uptake, and maintenance of the new behavior would just happen. Managers, those most directly responsible for fostering and encouraging new behaviors, know otherwise.

Several years ago Health Care Management Review (HCMR) had a themed issue related to the adoption of the electronic health record. The flurry of research in that area stemmed from the federal legislation, the Hi Tech Act as it became known, requiring the use of electronic records. Since then, HCMR has received very little new research in this area, which is understandable. But, we are now experiencing the next wave of technology related to health care delivery and services. HCMR has received virtually no research related to the implementation, uptake or maintenance of these new internet and artificial intelligence technologies.

These technologies, nonetheless, collectively are reshaping our concepts of care, services, and quality. At the same time, health care managers and administrators must stay abreast of and navigate this new landscape of technology, but with precious little evidenced based management or administrative best practices.

Health care management scholars could collaborate with scholars in the technology related disciplines to better understand and frame the interaction between technology systems and personnel caveats. The prior research on resistance to chance needs to be updated to account for the substantively different type of change related to the infusion of virtual technology into the health care organization and care delivery. We know little about how health care organizations manage displaced workers or have modified human resource procedures. Our knowledge gap includes the long-term employee consequences, both positive and detrimental. HCRM looks forward to having sufficient research to again have a themed issue on the intersection of technology and managing health care organizations.

L. Michele Issel, PhD, RN


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