{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:00:52Z","timestamp":1789891252739,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIM J"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study involved the across-distance implementation of a Patient Administration System (PAS) in rural Australia, led by three health information managers (HIMs). The setting was a vast, rural health district with 10 widely dispersed health collectives (\u2018agencies\u2019), each encompassing a hospital and up to five additional facilities that delivered acute, rehabilitation, residential aged care, bush nursing and\/or community health services to their rural and semi-rural populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The research aimed to examine, contemporaneously, the across-distance PAS implementation work of a team of HIMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>This qualitative research adopted a bounded case study approach utilising the ethnographic methods of unobtrusive observation of the project committees (Steering Committee, Project Managers\u2019 Committee, Team Leaders\u2019 Committee) and in-depth interviews with the HIM team and other key actors. Temporally, the research primarily centred on the lead-up to Go-Live, via point-in-time snapshots and shadowing of the HIM team\u2019s work at different junctures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The HIM team enacted alignment with typical, health system implementation stages. Problems encountered were: Go-Live timings; consultation on design of referral functions; poor or absent report, referral, and billing functionalities; and universal health IT implementation issues of insufficient staffing resources and too-tight timeframes. Constantly problem-solving to (re-)balance tensions between the agencies\u2019 desire for an effective PAS and the realities of a government-imposed, standardised system, the HIMs imagined the new PAS and its impacts on the agencies\u2019 data collection processes, day-to-day operations, and patient care. From a distance, they intensively and collectively imagined and (re-)ordered technology, systems, policies, procedures, work and documentation practices, patient and information flows, and adjunct services, to establish a PAS with integrity and address the requirements of the purchaser agencies\u2019 directors, management, clinicians, HIMs, and finance and administrative staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The HIM team applied knowledge of healthcare systems and processes, mitigated risk, and mediated the technology and the stakeholders\u2019 worlds. Their collaborative work to establish PAS-related order was congruent with our previous findings on the work of HIMs, Australia-wide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for health information management practice:<\/jats:title>\n                    <jats:p>This case study research highlights the significance of HIMs\u2019 deep professional knowledge of (a) health informatics and information systems, and (b) healthcare agencies\u2019 data requirements, practices, and artefacts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18333583261483160","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:46:52Z","timestamp":1789721212000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A health informatics in-depth evaluation study of the rural, across-distance implementation of a health information system: Implementing in the wild"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-6022","authenticated-orcid":false,"given":"Kerin","family":"Robinson","sequence":"first","affiliation":[{"name":"La Trobe University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1773-1478","authenticated-orcid":false,"given":"Simon","family":"Barraclough","sequence":"additional","affiliation":[{"name":"La Trobe University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_3_4_2_1","volume-title":"National Safety and Quality Health Service Standards","author":"Australian Commission on Safety and Quality in Health Care","year":"2021","unstructured":"Australian Commission on Safety and Quality in Health Care (ACSQHC) (2021) National Safety and Quality Health Service Standards, 2nd edn. 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