MIDAS Implementation: The Importance of Organisational Readiness for Change

Guest blog post by Justin Connolly, Dublin City University

The concept of organizational readiness has received increasing attention from the research community in recent years.  It refers to ‘the extent to which organizational members are psychologically and behaviourally prepared to implement organizational change’ (Weiner 2009) The increased attention that has been directed towards this concept results from a growing recognition that many efforts to implement new programs, practices, or policies in organizations fail, not because of the innovation, but because sufficient organizational readiness for change was not evaluated or addressed. Research has shown that when such evaluations and preparations have been made, i.e. when organizational readiness is high, members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behaviour, all of which has been shown to result in more effective implementation of the innovation (Pare et al., 2011; Zheng et al., 2009) On the other hand, when organizational readiness is low, members of the organisation are more likely to resist its adoption, thereby contributing to its failure. 

The organizational complexities that are associated with innovation implementation can often result in unpredictable project outcomes (Wyatt, 2003), including resistance or failure (Timmings et al. 2016). This is why many researchers advocate focusing on organisational readiness at early stages such as during the formative evaluation of a new information system or technology based innovation, in order to augment the possibility of successful adoption and implementation (Wyatt, 2003).  This has been the case with the MIDAS impact evaluation process.  For example, the formative and iterative evaluation and impact assessment process provides an opportunity for health organisations to identify potential barriers to successful implementation of the platform (Khoja et al. 2007; Li et al. 2012). The insights obtained also enable the organisation to take corrective and preventive measures to facilitate innovation or information system implementation successfully and avoid unrealistic expectations or inappropriate implementation strategies (Zheng et al. 2009).

Organizational readiness for change is a multilevel construct.  It can be assessed at the individual or supra-individual levels (e.g., team, department, or organization). In the case of the MIDAS project, this assessment applies at the supra-individual level.  This is the case, because the successful implementation of the MIDAS platform will require collective, coordinated actions by many organizational members in order to ensure its success.

It is also a multi-faceted concept and is frequently conceptualized along two distinct lines of enquiry, namely psychological and structural (Shahrasbi & Paré 2014).  As the impact assessment leaders for the MIDAS project, Weiner’s (2009) theory of organizational readiness for change provided a valuable guiding framework to ensure a multidimensional evaluation.  This comprehensive framework indicates that a number of issues must be considered when evaluating organisational readiness for change as part of impact assessment.   The first facet of readiness, change commitment, reflects organizational members’ shared resolve to implement a change. 

This is consistent with those researchers who evaluate organisational readiness in terms of its psychological and behavioural dimensions (Jennett et al. 2003; Shea, Jacobs et al. 2014; Weiner 2009).  For such researchers, organisational readiness reflects the commitment of organisational members and their views on organisational capability to implement the innovation or in this case health technology platform.  For example, the organisational readiness theory for change (Weiner 2009) conceptualises organisational readiness as a common psychological condition among organisational members who are committed to implement changes and who are optimistic about the organisation’s capability to implement changes (in this case introduction and implementation of the MIDAS platform).  That change commitment is defined as a mutual determination by various influential members of the organization to implement change and that change commitment is influenced by the extent to which they appreciate those resulting changes or outcomes.  This mutual appreciation, which is described as change valence, is the main determinant of the commitment to change.

The second facet of readiness is change efficacy.  It reflects organizational members’ shared belief in their collective capability to implement the required change (Weiner, 2009).  The determinants of change efficacy typically include task knowledge, resource availability, and situational factors.  This facet therefore encompasses several structural or contextual factors, which exert an indirect effect on organizational readiness by focusing on components that are generally classified as human, organisational and technological (Paré et al. 2011; Zheng et al. 2009).  For example, when organizational members know what the innovation can achieve and how to use it, when they perceive they have the resources they need to implement the change, and when they perceive situational factors such as timing to be positive, then their organisational readiness levels will be high and their commitment to the successful implementation of the innovation will be strong.

In the case of the MIDAS programme, a systematic impact assessment evaluation at the supra level is being iteratively employed in line with best practice in line with the research literature.  This novel and iterative approach, which encompasses measures of the core facets of organisational readiness, enables the project participants to proactively identify and address issues that might otherwise escalate into obstacles that could impede successful implementation of the system. In doing so, the impact evaluation work contributes significantly to the successful outcome for the MIDAS project.


Jennett, P., Jackson, A., Healy, T., Ho, K., Kazanjian, A., Woollard, R., Haydt, S. & Bates, J. 2003. A study of a rural community’s readiness for telehealth. Journal of Telemedicine and Telecare 9(5): 259-263. doi:10.1258/135763303769211265

Khoja, S., Scott, R.E., Casebeer, A.L., Mohsin, M., Ishaq, A.F.M. & Gilani, S. 2007. e-Health Readiness assessment tools for healthcare institutions in developing countries. Telemedicine and e-Health 13(4): 425-432. doi:10.1089/ tmj.2006.0064

Li, J., Ray, P., Seale, H. & MacIntyre, R. 2012. An E-Health readiness assessment framework for public health services- -Pandemic perspective. 2012 45th Hawaii International Conference on System Sciences 2800-2809. doi:10.1109/ HICSS.2012.95

Paré, G., Sicotte, C., Poba-Nzaou, P. & Balouzakis, G. 2011. Clinicians’ perceptions of organizational readiness for change in the context of clinical information system projects: Insights from two cross-sectional surveys. Implementation Science 6(1): 15. doi:10.1186/1748-5908-6-15

Shahrasbi, N. & Paré, G. 2014. Rethinking the concept of organizational readiness : What can IS researchers learn from the change management field? 20th Americas Conference on Information Systems, AMCIS 2014, 1-16.

Shea, C.M., Jacobs, S.R., Esserman, D.A., Bruce, K. & Weiner, B.J. 2014. Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science: IS 9(1): 7. doi:10.1186/1748- 5908-9-7

Timmings, C., Khan, S., Moore, J.E., Marquez, C., Pyka, K. & Straus, S.E. 2016. Ready, set, change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations. BMC medical informatics and decision making 16(1): 24. doi:10.1186/ s12911-016-0262-y

Weiner, B.J. 2009. A theory of organizational readiness for change. Implementation Science 4(1): 67. doi:10.1186/1748- 5908-4-67

Wyatt, J. 2003. When and how to evaluate health information systems? International Journal of Medical Informatics 69(2-3): 251-259. doi:10.1016/S1386-5056(02)00108-9

Zheng, K., McGrath, D., Hamilton, A., Tanner, C., White, M. & Pohl, J.M. 2009. Assessing organisational readiness for adopting an electronic health record systems: A case study in ambulatory practices. Journal of Decision Systems.Special Issue: Organisational Self-Assessment For IT Innovation Adoption 18(1): 117-140. doi:10.3166/jds.18.117-140