This study investigates the factors contributing to the failure of Health Information Systems (HIS) in a public hospital in South Africa. While HIS have the potential to improve healthcare delivery by integrating services and enhancing effectiveness, failures can lead to service interruptions, revenue loss, data loss, administrative difficulties, and reputational damage. Using semi-structured interviews with key stakeholders, we employed a hybrid data analysis approach combining deductive analysis based on the Design- Reality Gap Model and inductive thematic analysis. Our findings highlight several factors contributing to HIS failures, including system capacity constraints, inadequate IT risk management, and critical skills gaps. Despite these challenges, end users perceive HIS positively and recommend its implementation for streamlining daily processes. This study underscores the importance of addressing design-reality gaps to improve HIS outcomes in public healthcare settings.

翻译：本研究调查了南非一家公立医院中导致卫生信息系统失败的因素。尽管卫生信息系统通过整合服务和提升效率具有改善医疗服务的潜力，但其失败可能导致服务中断、收入损失、数据丢失、管理困难及声誉损害。通过对关键利益相关者进行半结构化访谈，我们采用混合数据分析方法，结合基于设计-现实差距模型的演绎分析和归纳式主题分析。研究结果揭示了导致卫生信息系统失败的若干因素，包括系统容量限制、信息技术风险管理不足以及关键技能缺口。尽管存在这些挑战，终端用户对卫生信息系统持积极态度，并建议通过实施该系统来优化日常流程。本研究强调了解决设计-现实差距对于改善公立医疗机构中卫生信息系统实施效果的重要性。