From cacophony to harmony: A case study about the IS implementation process as an opportunity for organizational transformation at Sentara Healthcare Chon Abraham a,⇑ , Iris Junglas b,1 a College of William and Mary, Williamsburg, VA 23187, United States b Accenture Research Institute for High Performance, Boston, MA 02199, United States article info Article history: Available online 6 May 2011 Keywords: Case study IS implementation Organizational transformation Business process change model (BPCM) Healthcare abstract The cacophony of criticisms emanating from an organization facing an information tech- nology-enabled transformation can be deafening and deleterious. This is especially true in healthcare in the US, where information systems investments are typically huge and often perceived by change resistant stakeholders as disruptive or even potentially life threatening. We describe how the IS implementation process itself contributed to organi- zational transformation in terms of changes in coordination, culture, and learning at a suc- cessful organization, Sentara Healthcare, which transformed the discordant cacophony of the change process into a harmonious implementation. Ó 2011 Elsevier B.V. All rights reserved. 1. Introduction Organizational transformation in any industry involves fundamentally reshaping behaviors within the organization and, now more than ever, instituting technology-enabled processes – something desperately needed in US healthcare (Bohmer, 2010; Blumenthal, 2009; Moreton, 1995). The aim of this research is to describe how the information systems (IS) imple- mentation process aids in organizational transformation, a business context that is rapidly moving to the center stage of societal importance. We exhibit this transformation via a case study of a healthcare organization, Sentara Healthcare, which has been nationally recognized for its superlative efforts in instituting technology-enabled processes. 2 We use the business process change model (BPCM) (Kettinger and Teng, 2000), one of the most comprehensive frames steeply couched in the orga- nizational transformation literature, as a framework to describe the steps Sentara followed in implementation of eCare, a com- prehensive healthcare information system. We also use BPCM as a framework for structuring our analysis and insights that are applicable in resolving the cacophony associated with how to manage the technology-enabled transformation. The cacophony of critics emanating from organizational transformation efforts enabled by well-intentioned information systems has long been a perplexing topic, especially in healthcare (Devadoss and Pan, 2007; Crowston and Myers, 2004; Kohli and Devaraj, 2004; Brynjolfsson and Hitt, 2000, 1998; Brynjolfsson, 1993). The reengineering of business processes 0963-8687/$ - see front matter Ó 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.jsis.2011.03.005 ⇑ Corresponding author. Tel.: +1 757 221 2803; fax: +1 757 221 2884. E-mail addresses: Chon.Abraham@business.wm.edu (C. Abraham), iris.a.junglas@accenture.com (I. Junglas). 1 Tel.: +1 617 488 7304; fax: +1 617 488 4001. 2 The Healthcare Information Management Systems Society (HIMSS) maintains diffusion statistics for healthcare IS and nationally recognizes healthcare organizations for reaching the highest level (i.e., HIMSS level 7) of demonstrated technology embeddedness (HIMSS, 2010). Sentara Healthcare is an HIMSS Level 7 designee and has won the coveted 2010 Davies Award for Excellence recipient for superlative implementation and demonstration of value from health information technology (Sentara Healthcare, 2010). Journal of Strategic Information Systems 20 (2011) 177–197 Contents lists available at ScienceDirect Journal of Strategic Information Systems journal homepage: www.elsevier.com/locate/jsis