Investigating The Role Of HRM Strategies And Information Systems In Enhancing Performance In The Health Sector

Importance of HR practices and employees

Background to the research 

Human Resource Management and its related practices and strategies are construct elements that establish the outcomes of an organization. Such outcomes, however, are dependent on both individual and organizational levels (Beijer, 2021). Therefore, it can be argued that HRM practices need to be quantified to meet with the demands that today business organizations and health care are facing, especially with the challenges that the pandemic of COVID-19 has brought globally. To quantify the individual and organizational levels with such challenges beyond such pandemic, thus, it can be deducted that to reach out and determine the extent, HR (Human Resource) need to keep in mind the developments and talents of the employees, incorporating the core competencies and information systems within (Alomari, 2019).  To add, nowadays, with the up running of modern technology and with the concept to improve the efficiency, many firms are looking towards process and decision support systems (DSS) to enhance their product using data (Gupta, 2013). 

Looking at past research of HR practices and employees, it can be argued the importance research gave to the use of managerial reports on employees in relation to HR perceptions and practices. (Huselid, 1995) , whereas, much modern research studies, on the other hand, emphasize the need to allow employees give their perceptions regards the HR practices and strategies, and this is a very important shift for HRM in being more strategic and the focus would be always the employee (Purcell, 2007).Looking at a modern study, held in Malta back in 2021 and presented in an HR conference, employees argued that in a post pandemic HR function, they visualize more change management, more digitalization on HR processes and even to be more digitally savvy (Pulse, 2021). 

While the perception and recommendations of the employees are important as per Pulse (2021), even business leaders refer to an  HR in being more at a hybrid scale culture, more support and collaboration , transparency in communication and information sharing , leading to a progression to have the right people in the right place (Kang, 2022). The following section will shed the research question for this study. The investigation will be done within the Primary Healthcare department in Malta.

Health services are provided mainly by the State and the Private sector in Malta. The Public Healthcare system delivers all-inclusive set of services to all persons residing in Malta including as well non-Maltese residents. The private sector acts as a compliment to health coverage and service delivery, particularly in Primary health care (PHC). Having ten health centers around Malta, and about 20 community clinics, PHC has also enlarged its infrastructure with the building of new hubs in the southern and norther region around Malta. These hubs will be the two pillars of the PHC in the community offering 24/7 service delivery. 

Moreover, the introduction of the Centers of Excellence concepts, each located in specific Health Centers, across the islands will mitigate the challenges of the economies of scale and maximize our HR more efficiently and effectively under one roof. It will result in improved health outcomes PHC, (2018).

Need to shift focus towards employee perceptions

The below will define the main framework of this study that will be following with the research objectives and variables. 

RQ 1: To what extent, do Human Resource Management (HRM) strategies are supporting the development and talent of the employees in the Health Care sector using HR Information systems to enhance performance in the Health Sector? 

RQ 2: What are the theories that can be applied in explaining the relevance of the HR Strategy in shaping the Human Capital within Health Care?

The variables that will be analyzed further in the next chapters, based on the research questions identified include the following:

1. Human Capital
2. Strategy Implementation
3. Talent Management
4. Human Resource Information Systems (HRIS)
5. Leader- Member Exchange Theory (LMX) 

Based on the research questions identified, the researcher has map out both the Alternate and Null hypothesis to sustain the study as indicated below. 

Alternate Hypothesis 

H1 (A) – Human Resource Strategies support the staff and will enhance the development and talent management within Health Care using HRIS.

H2 (A)- Human Resource Strategies support the HR staff and will enhance the overall performance within the HR Department using HRIS. 

H3(A) – Human Resource Strategies and information systems will enhance the business strategy implementation and long-term goals

H 4 (A) – Human Resource Strategies and information systems will allow job/organization to fit, worker -workplace equation through leadership

H5 (A) – Human Resource Strategies and information systems will allow to identify the inputs required to implement the strategy implementation and induce psychological safety 

Null Hypothesis 

H1 (O) – Human Resource Strategies and information systems (HRS) will not support the staff and will provide no alignment.

H2 (O) – Human Resource Strategies (HRS) and information systems will not support the HR staff and will provide no alignment.

H3 (O) – There is no alignment between the business strategy and thus there will be no connection between the work-worker, workplace equation.

H4 (0)- Any information system within the HR Department/unit, is not related to the identification of training and development, talent management, strategic decisions, and core competencies. 

The objective of the study is foreseen into overall, specific research objectives as below. 

General Research Objective

The overall objective of this study is to investigate if HRM strategies do take into consideration talent management and staff development, whilst seeing the relationship with Human Resources Information Systems (HRIS) as an aid to strategy and performance long term in Health care. The focus will be towards the Primary Healthcare in Malta. Literature points out that great projects don’t just work better, but they make the world better, thus if the organization wants to work on competencies to transform and thrive, even in planning strategies, can do so by change (Rodriguez- Nieto, 2021). Primary care, on the other hand, is best distributed by effective teams, with range of scope and skills and a level of ability that can address many of the health needs (Alonso, 2008). 

Specific Research Objectives 

For the purpose to give more specific research objectives, a breakdown of the above research objective is presented below. 

1. To identify if HR within the organizations conceive and implement strategies taking into consideration the talent philosophies of the staff.
2. To examine the context of Talent Management and Staff development associated with work- worker -work place equation and recruitment.
3. To examine Strategy planning in context with the SHRM and HRIS within health care.
4. To recognize the situations by which HRM can be improved post pandemic in relation to Health care strategies.
5. To evaluate if such practices within the HR and Organization gauge performance.
6. To examine a strategic HRM framework and its impact on the HR Strategy and Leadership. 

The conduct of this research is justified taking into consideration the presence of existing research gaps as will be seen on the literature review. Moreover, from this study, stakeholders in HR and within the Nursing administration will be benefiting. As already mentioned, this study will benefit the Primary Healthcare Malta given that it is a very productive department providing community services and with the strategies taking place and the long term planned projects across the Maltese island, certainly will have an impact. Recommendations for practice and implementation plan of the results will be shown in this study. 

Employees’ perception of HR function in post-pandemic scenario

Secondly, this impact will also concern the HR Managers, Directors and even the Administration who need to involve employees in the ongoing strategies, especially with the increase of services and even with the changes and challenges in terms of human capital the pandemic of COVID-19 brought.  Research, adds that Health Care Workers (HCW`s), during the COVID-19 marathon wave, were psychologically crashing (Feinstein, 2020), and this was due to overwhelming workload, and shortage of staff to the distributed of staff in hospitals and clinics. Thirdly, this study will investigate the role of the Leadership and strategy, as how the HR will shape strategy and not ignoring the needs and wellbeing of the staff, such as incorporating talent management and training needs and stive for sustainability (Hoch, 2022) 

Fourthly, these concerns, therefore, justify even the evaluation of Human Resource Information Systems (HRIS) within the HRM and Health care, as a modern concept when compared to the traditional HRM (Rabiul Adam Golam, 2016). According to Wright, (2016), when an HR have a well implemented system of HRIS, which can be in any form or model, is a strategic tool of organizational performance, but as a weakness, this research adds that 70% of technology can fail to meet the prime objectives. Therefore, this study, will be a useful tool gauge how performance management is more transparent thought fairness and through digital data using KPI`s and criteria, while putting the HR Hybrid. 

The current study will be best traversed using a Quantitative Approach (Positivist paradigm) to measure the What and Why. It will employ the primary data through a distributed Questionnaire within the Primary HealthCare, and then the data that is number based will be through statistical analysis. 

This research will be assembled into six chapters, to reach out the forecast and visibility of the ideas and outcomes.  

· Chapter 1	· Introduction gives the background of the study, the research question and variables and research objectives and hypothesis, respectively
· Chapter 2	· Is about the literature review, which gives a full picture of the existing literature while noticing the past scholars’ achievements in their areas of study. This will shed light to the theoretical and conceptual framework as well.
· Chapter 3	· Will shadow many details with the methodological assumptions as indicated in the methodology outline.
· Chapter 4	· Provides the findings researched as by the findings outline order
· Chapter 5 & Chapter 6	· Will provide the analysis and conclusions of the study as envisaged in the chapter outline.

Figure 1: Outline of Chapters -As adapted by the Author: 

HealthCare system 

A Healthcare system is a terminology meaning an organization of institutions, resources and people providing health care services aiming at focusing on the needs of the people and society (Smith, 2013)  

Primary HealthCare (PHC) 

The Primary HealthCare has been recognized as the foundation of a Healthcare system. It has an important means of tackling health inequalities and meeting the health needs of a population through services that are delivered closer to communities and workplaces (WHO, 2021) 

Strategic Human Resource Management (SHRM) 

It is the organization push leading to competitive gain towards macro-focused practices integrated together towards the establishment strategic enterprise plan including employee’s knowledge, skills and abilities and integrates the strategy with HR leading in relation to objectives   (Huselid M. A., 1997) . 

Strategic Management Process 

It is the process which strides to the managers to generate a comprehensive strategy and how this is done, including the formulation, implementation, and monitoring  (David, 2009) 

Human Resource Information System (HRIS) 

It blends Human Resource Management (HRM) and in specific basic HR activities with the information technology (Jahan, 2014) 

Talent Management 

Talent Management is a strategic concept that considers human capital, while encompasses factors affecting personnel competence for sustaining talent, while is an essential element for sequence planning (Zaheeer, 2016) 

Business leaders’ perspective on a hybrid culture for HR

Leader- Member Exchange Theory (LMX) 

This theory is about the progression that concentrates on leader-member relations, which focuses on the relationship a leader has with any of the members or subordinates, taking the emotion regulation and follower duty performance (FarrukH, 2021) 

This chapter has provided an overview of the importance Human resources have within the organization, especially when related to healthcare strategy. The Healthcare strategy, including the employees core competencies, including the identification of variables that will be used in the next chapter are essential tools for HR and the organization long term objective, such as the PHC.   All terms that will be used throughout this work are defined and supported by scholars.

This Chapter is a critical advance in the use of research studies related to the topic being investigated. The purpose of this review is therefore to investigate scholarly work in relation to the recent findings using published conference reports, books, and journals. In recent years, there have been many studies within HR (Human Resource) concerning the strategy and the importance that such a topic contributes within the HealthCare care setting and business .In view, concepts that are important to consider within the HR strategy, focusing on the mission and vision concept, while recognizing the employees core competencies for such HR and organizational objectives, will be linked to conceptual studies even with new research in HR post COVID-19 pandemic and theories. All this would be the purpose of the investigation in linking such with Human Resources Information System (HRIS) and how data driven HR aid in strategy planning and leadership while gauging performance. The Chapter summary will also show an overview of the chapter. 

The Human Resources and Health care 

Today with the combined knowledge through research findings and even through the way global healthcare, business and strategy are developing, it is important that the HR takes care of employees strategically and considers the knowledge and skills in its coordination.  In supporting such statement, studies, show that, HR leaders need to understand that the organizations, are no longer a key to give one holder value, but to involve all, including even the employees, customers, and so on. (Hassler, 2020). In this statement Hassler, (2020) specifies a general observation, making it as a strong massage towards an HR with a vision. Based on the individualism vs collectivism as per (Hofstede, 2010),  studies within the concept of organizational culture add up, that in practice, both society and the company need to make wisdom that neither makes logic without the other. (Schein, 2017).  

The above research highlights the importance HR has, especially within a health care perspective, that all is a connected including the employees. Contrastingly, studies back to 2014, indicate an absence of studies concerning the subject of HRM on the value of healthcare that could affect the development of strategy and may lead to diminished performance in hospitals (Elarabi, 2014) However to sustain such argument,  there should be means that  can be stimulating, while be  better, to exploit expertise in the health sector and creating excellence through an environment that is willing to change current health care environments  (Cana, 2009). While change and innovative strategies in health care are important, in terms of services, literature implies that HR has a lead on the expansion and quality of the health care service (Keating, 2011). To question up such research, however, one must recognize how actually HR is achieving the excellence needed for the health care organizations. 

 In understanding the perception of innovation as a breakthrough, research leaps through the concept of science, technology, design, and other recent paradigms to change the expected and the possible (Pisano, 2021). As opposing to Pisano, (2021), it can be argued that not all breakthroughs both scientific or technological, give an element of value in creating new sources such as information systems within the HR, and to investigate new ways to do things while understand them. Similarly, it is advocated that all WHO member states, should invest for opportunities for greater technological advances and approaches in the drawing of systems data to collect, gather and use (Benton, 2014) . In a world with constant drive for the innovation, better decision making, and competition, the use of technologies together with the Human Capital and the organization creativity produce effective operational process, much more within the health sector (Farrahat, 2018).  On the other hand, literature, taking a contrasting note, states that when companies are just in the preliminary to test, too many conclusions are made incompetently leading to narrow perspectives (Balsamini, 2021). 

Being innovative, would mean that to meet all demands with, HRM, being the organizational system, together with the management and the employees, is mainly responsible for the handling of all aspects including the human capital essentials, such as the payroll, recruitment, training and much more. This allows the demand for more tools to have the correct and precise data needed to get along with the organization policies, while allowing transparency. Furthermore, in terms of HRM, technology has produced many computerized information systems, such as the HRIS, as a system attributed to the HRM in the health care setting.

While there are many definitions within the HRIS concept, in an employee perspective, however, helps to maintain data, while providing systemic information about the personnel (Jahan., 2014). On the other hand, more specific, it can be defined as an incorporated structure that conveys information about the organization `s HR, adding support to the management structure with planning, decision making, and report returns (Hendrickson, 2003).  Lots of studies, foresee the benefits of this HRIS in the management of an HR within an organization. As adapted by the author below, HRIS and for the purpose of this study would consist of:

 

As adapted by the Author: (Sah, 2013)

While, as stated by Sah, ( 2013), an HRIS is essential in order to enhance the strategy within the organization in terms of HRM , it can be seen as a cost burden while , it can be complex and difficult to sustain it and upgrade accordingly according to operators assent and after all cannot be a supernumerary to human beings  (Jahan., 2014). While it is widely acknowledged that an HRM strategy is critical from both a clinical and financial standpoint in health care, possessing an accurate HRIS assistance, which can take many forms including such payroll or rather resource planning system, will undoubtedly help with recruitment, training, and performance management (empxtrack, 2017). However, research considers this to be non-life threatening, and their consequences in health care, when contrasted to patient electronic systems in clinical areas, indicate a decline in attention to health informatics as well as were still developing (Tursunbayeva, 2017). These are not blatant system failures, but given the expenditures spent on HRIS installation, there is a clear opportunity to examine the variables and situations that facilitate HRIS strategic integration (Kovach, 2002).

In SHRM, there are lots of studies that focus on innovation while highlight the importance that the employees and the HR strategies are a common objective, even in terms of decision making. In fact, research implies that HRM to be strategic involves prearranged social resource placements and actions intended to enhance the firm to attain its aims (Wright, 1992) . To elaborate further, and on strategy, Wright, (1992) adds, that HRM, needs elements of decisions about HR practices, the configuration of human capital pool, behaviors and decision effectiveness given to strategic conditions. While all such requisites are very important especially concerning the health care setting, it is triggered that for national, regional, and global strategy, human resources should fortify their data (WHO 2020). An organization, usually there are systems in a striding way to aid the strategic management and HRM, and this can be related to the Anthony`s triangle model (Anthony, 1988). More studies, however, add that this framework, is part of Management Information Systems (MIS), in parts being the operational control, management control and strategic planning (Gorry, 1989), whereas, it is also a value adding to an HRIS adding the below as Adapted by the Author: 

 

As adapted by the Author: (Ko Keung, 2016) 

Evenly, due to the pandemic demand and the post covid-19 new projects, it is given much more importance the role of the employees in the organization, as ultimately the employees move the company ahead according to research,  (Tome, 2021). While the author agrees with such statement by Tome, (2021), sometimes staff turnover and engagement can make a turning on the organization in terms of costs, training and so on, while Hassles, (2020) implies this factor as a big challenge the organizations face. Within the PHC, being a community reachable setting, policies and strategies that direct the community to the right service, place, and time respectively (Levesque, 2012) are points to consider. 

Thus, emphasis therefore follow on the Profession proficiency, Research expertise, Change project workings, Innovations and budgets, and Ideas launch initiatives, and all these compromises the Human capital importance within health care, as in  (K827, 2011). While all these elements are important in terms of the value the employer can contribute within and which HRM need to recognize, on a general perspective, the PHC assembly, as stated in literature ,  consists of a group made up of logistics, financial, human and infrastructure resources the enhance the projection of health care conveyance (Donabedian, 1988). Pulse (2021) indicated that although corporations perceived positives as a result of the pandemic, such as greater investment in technology and improved wellness activities, this cannot be applied to particular levels of health care employees, such as the Medical and Nursing Professions. 

Taking a step towards the healthcare facility  HR objectives and strategies needed  , especially when employees are affected, Hassler, (2020),  adds that change and the creation of excellence in healthcare, require a needful HR administrator incorporating positive alteration towards a transforming vision and mission within, and making consideration and evaluation on the impact employees have on the company’s such as Costs ,Culture and Talent ,Data, Leadership, Employee surveys and Metrics , including Quantified objectives (K827, 2011) , On a global health care perspective, however,  it is stated that health system outputs are mainly the HR, Physical Capital and Consumables which all direct to the production of health interventions   (WHO., 2000).   Health interventions, therefore, while aiming towards sustainable development goals, as stated by the WHO (2020), should optimize with the wellbeing, resilience, policies on the human resources for health, and ensure digitalization is at a high level  (Zuazola, 2021). 

Being critical area, HRM is also responsible to develop the capabilities and talents of the employees especially in the PHC and this is also supported by Alomar, (2019). As already analyzed, HRM needs to contribute towards all requisites to ensure that services and employee needs within the PHC are never compromised. Evidence shows while PHC in general requires the involvement of all workforce skills and expertise, few countries provide nursing training specifically focused on the delivery of primary care

Through more efficient recruiting techniques, corporate communication, employee participation, and better HR management abilities, information systems have boosted the efficiency of HRM (Alcázar & Fernández, 2013). Human resource management departments must then link human capital plans to the most relevant technical solutions (Carberry & Cross, 2015). It entails establishing an eHR organization focused on linking people with business strategy in order to accomplish quick adaptability to changing demands shared by people and businesses. These same requirements begin to necessitate the use of eHR.          

In the case of HR professionals, HRIS enables them to do even the most basic job activities, like as accounting and conformance, payroll including salary analysis, benefits administrative, application tracking, as well as skills inventory (Clevenger & Singh, 2013). Functional managers, on the other side, want HRIS to deliver data to help them reach their goals and objectives. They anticipate that the system will give data for performance evaluation and administration, team as well as project management application processing, recruiting and retention, orientation and training testing, including organization development (Daly, Speedy, & Jackson, 2015). Individual workers also become end users of a variety of HRIS tools, including as self-service, benefit choices, career planning, and training and development (Narayanan, Rajithakumar, & Menon, Talent Management and Employee Retention: An Integrative Research Framework, 2018). Boateng emphasizes the significance of web-based access as well as self-service portals in making system usage easier for workers.

In this environment, information systems have improved HRM efficiency via more efficient recruiting techniques, corporate communication, employee participation, and greater HR managers’ abilities (Dries, 2013). Human resource management departments must then link human capital plans to the most relevant technical solutions. It entails establishing an eHR organization centered on linking people with business strategy in order to accomplish quick adaptability to changing demands shared by people and businesses (He & Morrison, 2020). These same requirements begin to necessitate the use of eHR. However, not all human resource professionals work within strategic human resource management. Many people are still under strain and regard their time as being consumed by day-to-day problems (Jones & Martain, 2013). It is vital to eliminate or at least reduce the administrative load in order to maximize your time and commitment to the business.

Human resource management is crucial to delivering high-quality health care. More study and a concentrate on human resource management in health care are required to design new policies. Effective human resource management methods are critical to improving health-care outcomes and access across the globe (Krishnan & Scullion, 2017). Nurses having long been acknowledged as the go-betweens in between patient as well as the health system. In most care settings, they act as a coordinator for all services required by patients. They must be able to handle and process nursing data, information, and expertise in a variety of care-delivery situations (Kuhn, 2014). Nurses appreciate workplace elements such as autonomy and independence over the workplace environment, the opportunity to begin and maintain a therapeutic connection with patients, as well as a shared decision – making with doctors at the unit level.

There has been very little published research on the usage and effect of information and communication technologies (ICTs) aimed to assist business tasks inside health organizations when compared to the overall eHealth literature (Maier, Tavanti, Bombard, & Gentile, 2015). HRISs have the potential to increase performance of the organisation through easing personnel planning, financial and management accounting, staff training, and management intelligence. However, the data base for HRIS in health care is dispersed across academic boundaries, and prior assessments were fairly restricted in breadth (Mello, 2015). This robust prospective study will identify, evaluates, and synthesize key trade research on the deployment and effects of HRIS in health organizations, in depth insights and guidelines to future costumers, trustees, implementers, evaluators, but instead users of such processes.

Efficient communication, as per the results of Quantum Workplace’s 2016 Employee Engagement Trends Report, is a crucial predictor of whether workers are content with their positions and may assist decide retention trends. An HRIS allows management and staff to communicate about policies and procedures (Moloney, Gorman, Parsons, & Cheung, 2018). It can transmit precise orders, gather input from diverse staff and departments, and prevent disinformation by acting as a consolidated platform. A unified platform facilitates top-down and bottom-up communication and gathers relevant, real-time data to help businesses make better choices (Narayanan, Talent Management and Employee Retention: Implications of Job Embeddedness – A Research Agenda, 2016). With the rise of cloud and mobile technologies, as well as other apps, businesses and their workers now have unprecedented flexibility in handling a wide range of HR operations and responsibilities.

Employees are embracing the flexibility to manage their requirements via self-service choices, according to a new LIMRA poll, and are ditching conventional paper-based benefits enrolment in favor of electronic ways (Sekiguchi, Froese, & Iguchi, 2016). Indeed, more than two-thirds of workers said they prefer to administer their own benefits online. An HRIS provides workers with a centralized platform from which they may manage various elements of their rewards without requiring HR interaction. Employees have accessibility to benefit and retirement enrollment documents, allowing them to discuss possibilities with their families at home (Turner & Morris, 2019). They, too, may enlist using the same website. Employees may also make direct deposits and make updates to their personal information using self-service abilities.

HRM is critical to any national healthcare system’s success. So a nation needs precise HRH statistics to guarantee the appropriate right people on the right places with the correct abilities. But HRH-specific information is hard to get from in poor nations (Balsamini, 2021). A comprehensive HRIS can assist administrators and policymakers promptly address HR-related issues influencing healthcare delivery. Despite their many benefits, information systems are not widely used in underdeveloped nations. Such systems may not always be well-liked by hospital staff. Many significant aspects impact the implementation of ISs and their acceptability in healthcare organizations. Several studies have examined these aspects in deciding to use HRIS in an organization. Researchers examined critical elements affecting technology adoption. A review of IS/IT innovation literature reveals certain variables for adopting HRIS. Technology adoption study uses both qualitative and quantitative methods. But the qualitative is a notable approach (Yahiaoui, Chebbi, & Weber, 2016). Reviewing prior research shows that relevant aspects fall into four categories: person, organization, technology, and environment.

Human variables include hospital top executives and IS-competent workers. The Chief Information Officer (CIO), Chief Executive Officer (CEO), and other top leaders are said to have a crucial role in IS utilization at the organizational level (Anthony, 1988). Prestige is enhanced by senior executives directly involved in IS operations, ensuring their support and collaboration for the overall success of the organisation’s IS projects. A recent Al-Qirim research found that CEO innovation influences electronic commerce uptake in New Zealand. In line with previous research, a study on SMEs found that owner IT skills and creativity were important determinants in implementing electronic commerce systems in Indonesia (Cana, 2009). Researchers propose that while deploying critical IS applications in hospitals, staff IT skills should be addressed. According to Hung et al., staff information intensity and IS knowledge are major determinants of hospital IS application uptake. Ettlie also argues that workers need some IS expertise to effectively use modern IT. Hospitals will surely have greater trust in the adoption process if workers have proper knowledge and skills on newly deployed IT systems (Daly, Speedy, & Jackson, 2015). Following are assumptions for HRIS adoption in hospitals based on the preceding literature study.

The technological component pertains to HRIS technology adoption concerns. Perceived IT infrastructure, complexity, and compatibility are major aspects in this dimension. A solid IT infrastructure is the most important aspect in adopting a new IS application (Hendrickson, 2003). Most organizations in underdeveloped nations lack modern IT infrastructure, according to Zhu et al. For example, a lack of adequate IT equipment in Pakistan prevents most organizations from implementing proper software and hardware. The apparent complexity of innovation adoption also contributes to reluctance, according to the study (Ko Keung, 2016). Generally, reported system complexity and compatibility are major adoption determinants. Hospitals utilize cutting-edge information systems that are unique. RIS, HIS, and PACS are examples of state-of-the-art information systems. Moreover, prior study indicated that perceived complication and compatibility strongly affect management choice to embrace modern information systems. Organisations should think about how these systems can function together (Kuhn, 2014). Thus, system complexity as well as compatibility are significant factors to consider while adopting HRIS. 

Organisational variables, such as structure and procedure, may either hinder or accelerate the adoption of technological advancements. The elements of organizational dimension were the most generally assessed qualities in IT adoption (Pisano, 2021). According to prior research, a company’s inclination to use contemporary information technology is influenced by relative benefit, centralisation, standardization, top management commitment, and purchase intention. Less time and effort is believed to boost performance by saving time and effort. According to Teo, Lim et al., the perceived benefits of HRIS for HR departments are closely linked to the choice to implement the system in Singaporean firms (Sah, 2013). Al-Dmour investigated the role of perceived facilitating conditions in HRIS adoption in Jordanian enterprises. Again, senior manager’s support refers to the readiness of intention of the organization to make availability the necessary resources and expertise or power for the achievement of IT/IS projects.

A hospital’s senior manager’s endorsement influences new technology uptake, according to a research. Similarly, Teo, Lim et al. identified top management support to be an important organizational element for HRIS adoption and dissemination in Singapore (empxtrack, 2017). Centralisation is also vital (Alcázar & Fernández, 2013). Centralised organisations rely on key stakeholders to make choices and steer the organization. Many studies show that a company’s centralised design encourages strategic IS, which improves end-user computation. So, according to Zmud, centralisation promotes the commencement, acceptance and deployment of incompatible technological advancements (Benton, 2014). Formalisation refers to an organisation’s belief in formal processes, rules, and task boards for efficient administration of activities and associated flows. They found formalisation to be an essential component in technological innovation. England and Stewart observe that Australia’s health and banking industries are highly formalized. To be successful in Australia, every technology breakthrough must be formalised (Daly, Speedy, & Jackson, 2015). Finally, pricing is a crucial issue in the acceptance and usage of any modern innovation. When deciding whether to implement a new technology, an organization does a cost benefit analysis. Premkumar and Roberts concurred that the lower the cost of an invention, the more likely it would be adopted in organizations. Also, pricing is predicted to hinder innovation uptake. It also covers possible administrative and implementation expenses. Moreover, IS adoption expenses include operational, setup, and training costs (Ko Keung, 2016).

Compelling pressure, technology user support, and government rules and support are all part of the environmental factor Among the factors, competitive pressure refers to the level of competition a firm encounters (Gorry, 1989). To obtain a competitive advantage over rivals and to offer excellent services, organizations must employ cutting-edge IS applications. Hsiao, Li, et al. found that competitive pressure strongly impacts hospital management to implement mobile nursing systems in Taiwan. A technology vendor provides IT-related items and services to other businesses. Furthermore, Costa, de Oliveira et al. and Sulaiman and Wickramasinghe found that technology vendor support influences IS innovation uptake. Finally, government regulation and assistance is critical in the environmental setting. Numerous studies have shown that government rules and assistance impact the uptake of IT innovation in emerging nations (Clevenger & Singh, 2013). Similarly, research in emerging nations demonstrates that government restrictions and policies influence the choice to utilize IT in healthcare.

Bangladesh’s medical system is a mix of public and private. The central government runs public hospitals. These hospitals serve low-income people in rural and urban regions at reduced or no cost. These hospitals are unfamiliar with IS. Private hospitals include specialized, corporate, and minor facilities. And they are costly for healthcare. In some private hospitals, administrative, medical, customer service, and information staff utilize IS software everyday, affecting employee happiness and performance (Schein, 2017). As a result, the company’s performance suffers. Bangladesh has a severe scarcity of medical personnel. Moreover, neither the informal nor official health sectors have a clear picture of HRH in Bangladesh. Those statistics are vital in building an effective HRH strategy for citizens’ healthcare requirements. So, adopting HRIS will assist the health industry handle the personnel deficit efficiently (Yahiaoui, Chebbi, & Weber, 2016). The research covers private hospitals in Bangladesh since most state organizations have not embraced HRIS.

This research was driven by two theories: “the diffusion of innovation theory” and “the Adaptive Structuration Theory”. Anthony Giddens developed the Adaptive Structuration Theory in 1984. DeSanctis and Poole (1984) applied Giddens’ theory to the relationship of institutions and people with digital technologies (He & Morrison, 2020). The idea is important in understanding how group structures impact communication and decision-making. It is also valuable in evaluating the role that strength plays throughout the growth of organizations and the achievement of their aims. Scholars who have researched group and organizational structuration have underlined the necessity of understanding the link between the inputs into groups (resources and regulations) as well as the outputs (Maznevski & Chudoba, 2000). However, it is critical not only to comprehend the presence of resources, but also to investigate how these resources develop and alter as a consequence of the communicative activity that occurs inside the group while making choices (DeSanctis & Poole, 1994) Adaptive Structuration Theory (AST) is important to today’s businesses because of the growing effect that evolving technologies have had on human interface part of AST and its repercussions on socio-biologically inspired construction in cybersecurity application software (Anthony, 1988). 

The Diffusion of Innovation (DOI) Theory, proposed by E.M. Rogers around 1962, has been one of the earliest social science ideas. It originates in communication to describe how an idea or product develops traction and disperses (or spreads) within a certain population as well as social structure across time. According to Rogers (1982), diffusion is defined as the acceptance of an invention over time by a specific social system; therefore, diffusion actions resulted in the acceptability or infiltration of a new concept, behavior, or physical innovation (Alcázar & Fernández, 2013). As a result, the decision to adopt an innovation is influenced by, among other things, the perceived of the members of society involved with five particular features of the advancement in question, which have been perceived benefits; that is, the severity whereby the effective change agent to be better compared to what it precedes (Katz, 1989).

Relative advantage leads to increased efficiency, economic gains, and social position. compatibility; this is the degree to which the innovation is superficial in order to be trustworthy with current beliefs, prior experiences, and wants; compatibility is also an essential quality of innovation since compliance with consumer lifestyle may enhance a quick rate of adoption; complexity; this is the amount to which the invention is regarded to be difficult to grasp and use (Donabedian, 1988). Technology readiness seems to be the extent whereby the advancement can be tested before adoption; if clients are given the opportunity to try the innovation, it will reduce certain unidentified fears and lead to implementation and testability is the significant degree with which one can see and comprehend of adopting the advancement prior to actually full adoption (Hassler, 2020). In the context of online banking, reliability is the way to access banking institutions at any place and any time even without wait or queue.

According to Mintzberg, for an organizational to be productive and profitable at completing a specific goal, its design should be consistent, logical, and fit (He & Morrison, 2020). According to Mintzberg, coherent and logical organizational design arises in “one of five natural arrangements, each a mixture of particular structural and situational factors.” To apply Five Organizational Configurations, a management will compare the design from their own organisation to even the most suited one of the five organizational setups. They may then discover where their organization’s component elements do not align in order to make adjustments (Levesque, 2012).

A manager, according to Mintzberg, is “a person in command of an institution or subdivision.” As a consequence, the title is relevant to a wide number of persons with official power and rank. He claims that these people have 10 integrated management functions that may be divided into three categories (Sekiguchi, Froese, & Iguchi, 2016). The position of leader consists of both direct leadership, such as recruiting and training, and indirect leadership, such as staff encouragement. “Leadership decides in major measure how much of an owner’s potential power is achieved,” in other words.

HRIS systems benefit both corporations and their employees. They may assist management in providing clear guidelines, automating procedures, and streamlining the employee lifecycle experience. A unified platform offers a gateway where employees can locate relevant information, understand work duties and processes, get online training, and use self-service tools to handle time-off requests, payroll adjustments, and benefit choices, to mention a few (Alcázar & Fernández, 2013). According to a Gallup research, one of the most significant markers of employee satisfaction and productivity is their understanding of what their employer and immediate managers expect of them. Simply said, people want to do a good job and develop in their professions. However, how well a person knows their function within the business is a key indication of work success; in fact, a lack of clarity may lead to decreased engagement and productivity (Daly, Speedy, & Jackson, 2015). A single platform HRIS system offers workers with a repository of tools they need to excel in their positions and the business as a whole.

Indeed, according to a 2016 Glassdoor user poll, one of the most important barriers to recruiting fresh talent is a long hiring process.An automated application tracking system (ATS) managed by an HRIS may assist to simplify and speed the recruiting process for prospective workers. Through a centralized job board, an ATS makes it easy to see and apply for available positions (Balsamini, 2021). It also serves as a conduit of communication for workers to arrange interviews and send and receive communications. Once a candidate is chosen, a number of activities that range from payroll and benefits administration to delivering equipment such as a computer and other IT services may be initiated to expedite the on boarding experience (Clevenger & Singh, 2013). Welcoming new talent into your business with a seamless and straightforward recruiting process can assist to inspire contentment and increase productivity right away.

Regardless of industry, the key to an organization’s success is in the hands of its employees. Creating a rewarding atmosphere in which employees can grow, broaden their skill sets, and be challenged with meaningful work is critical to guaranteeing engagement and longevity. Employees that are satisfied are more engaged, productive, innovative, and inclined to remain with a company (Alcázar & Fernández, 2013). According to a recent research conducted by the University of Warwick, happy workers are 12 percent more productive than their dissatisfied counterparts. Because workers are so important to any firm, big or small, keeping them happy and pleased should be a top concern for CEOs, front-line managers, and everyone in between. While assessing “happiness” from the viewpoint of employees might vary widely, most share a drive to succeed in their professions, to feel respected, and to connect with coworkers and bosses. Furthermore, people want to know that their demands and time are being honored (Hofstede, 2010).

In conclusion it can be said that an HRIS makes it easy for staff to keep up with their training and certifications. It also enables firms, particularly those in regulated sectors, to guarantee compliance and retain the necessary records and paperwork. An HRIS may greatly boost engagement, productivity, and, eventually, profitability by controlling organizational procedures and providing employee self-service options. Applying for a job is often a time-consuming procedure that involves the use of several and frequently divergent technologies, such as paper, software, and email. While this may seem to be typical procedure for job seekers, an organization’s recruiting methods may tell potential workers a lot about how the firm will function if they are employed. A difficult and drawn-out recruiting procedure may leave workers with lasting bad sentiments and even deter prospective talent from accepting an offer.

This chapter includes the methodologies used to collect and examine the data of this primary research and include several strides including the research used, or philosophy behind using this method, justification for research, methodology, design, procedure, and ethical concern. The previous chapters explained the topic under study and provided a framework. This chapter however elaborates further on how the study moved forward and how the research was conducted. According to Saunders et al. (2016), the research process for business students is much like an “onion”. As there are different layers of an onion, that needs to be peeled. Similarly, in business or Human Resource management research, there are different layers that required to be peeled to reach the end goal.

As seen in figure 2, the different layers of research start from understanding the philosophy of research (positivism, realism, interpretivism, or pragmatism). 

 

Figure 2: The Research Onion, Saunders, Lewis & Thornhill, (2016) 

The primary objective of undertaking out this research, is to know to what extent HR strategies can support the development and talent of the employees in healthcare using HRIS to enhance performance: therefore, this study focuses on the effectiveness of HRM strategies and HRIS in the health sector (Iwu, 2021). The rationale of undertaking this primary research is that the existing research studies do not answer the research questions properly, and some existing information cannot be applied in the current situation. Henceforth, a primary analysis has been conducted to obtain firsthand data. According to literature, in the primary research, scholars, do the analysis themselves to identify the results and answer related to the research questions identified (Flick, 2015). 

Primary Research is important to take over a position and support the accessible evidence. The Methodology section on the other hand is vital as defines the results and the perspective of the data analysis. To add, in primary research, there is control over the data as the research do different interviews and surveys, whilst, as opposing to secondary research, it is mostly dependent on the studies available and have a certain element of restriction on the subject specific (McCusker, 2015).   The methodology is the data collection process in research that can include different practices techniques; hence, to assemble the relevant data to support the hypothesis, it is necessary to have a wide-ranging research method that matches the subject and deliver essential evidence. 

The primary analysis includes quantitative and qualitative methods, qualitative method aims on the theory and individual data while quantitative analysis includes the depth and analysis of numeric values and numbers that can show the variations (Apuke, 2017). This study includes Quantitative analysis based on the survey questionnaires, where the participants are the Primary HealthCare Managers and HR staff using a positive theory. 

Research philosophy is an approach of thought that research has for the study including attained knowledge that can be trustworthy for research. In other words, research philosophy is the basic that includes the option of academics about the strategies of data collection, formulation, processing, and analysis of data. Hence, research methodology is motivated by the belief of the academics who assemble the information. There are two major philosophies been associated in the research methods such as positivist, and anti-positivist. These phrases focus on different paradigms such as what is known to be true, and what is believed to be true. 

The positivist paradigm deems that reality is stable and can be studied from an unbiased viewpoint; therefore, this research centers on the positivist paradigm without impeding with the events being studied. This approach follows that reflection can be repeatable while facts should be isolated. One of the remarkable aspects of this approach is that predictions of how to be made on established of the preceding observations that show up the link between realities and inter-relationships (Saunders, 2016). 

There has been much argue about the use of positive paradigm in research. This approach can manipulate reality with variation in a single variable; however, it has been widely used by different academics as it sees the positive approach. It is used to discover common reality, such as for this research, can be embraced to obtain better awareness of human conduct and observation. It is used to know the observation of managers for the use and effectiveness of HRIS, to how they agree with it that HRIS is one of the important aspects of HRM in healthcare that help to develop the talent (Tursunbayeva A. , 2019). This approach does not only have the focal point on the objectives; but it can see the details that can be significant for the purpose. Thus, the primary objective to use this approach in this study is to put together a meaningful pattern of hypothesis (McDermott, 2019).

Study tactics used as the research methods to assemble and analyze the data are various.  Based on the research paradigm and the purpose, these methods can be espoused in different contexts; for example, field research are for reviews, and surveys can be directed for action research. This research uses the survey as the method for data collection. The survey way permits the author to obtain the most relevant practical data. The information was obtained in the form of questions from the participants. Participants answer the questions based on the specific research question or scenario. The participants are predefined in the surveys to ask questions about the topics of interest (James, 2016) One of the important facts about this method is that it is necessary to know the social benefits of the study, and how this will improve the practice of the selected area; hence, researchers must ensure that the target population use the right survey tool. Furthermore, there are several methods to analyze the results of the surveys; this research follows the quantitative approach to analysis (Philips, 2017) 

 In this research, participants in the survey have been asked to answer the relevant questions focusing on the use of HRIS for the development of talent in healthcare. A survey in this study follows the quantitative analysis that has been used to draw the interference from the data regarding HRIS. The use of survey is cost-efficient compared to the other research methods and allow the researchers more time than the other methods such as laboratory experiments, and field experiments. The data in these methods can be collected in real-domain environment; however, this method has a few downsides, such as bias (Melliger, 220) . 

There is a risk of bias as the researchers may have the option to self-select the participants of the survey. To remove the bias from this method, have followed a random survey method where questions have been asked randomly from the managers in primary healthcare. The survey questionnaire includes basic questions of age, gender, and work experience of managers followed their knowledge about the use of HRIS in the system (Ma et al., 2020). 

Research justification is the rationale for research and a justification for why the research is being conducted with these methods. The purpose of conducting this research is to identify the use of HRM strategies, and HRIS to improve the development of talent in the healthcare sector. The reason for using primary analysis is to know the impact of the HRM strategies in the present situation, and how strategies such as HRIS utilization can change the practices of HRM in the post-pandemic situation including the development and enhancement in key HR Activities as pointed out again by Tursunbayeva, et al (2019). Furthermore, it has been found that the existing research findings have gaps that cannot help to achieve the objective of this result; hence, a primary analysis has been conducted to obtain first-hand results. In addition, existing research has been used in the literature review section to support the research question. 

HRM strategies are important to support and manage the staff, that also improve the overall performance of HRM, while HRIS, can be used as one of the effective tools in HRM practices. Talent management and staff development are part of the job of HR which include various HR practices; hence this study evaluates the complex work of HR and recommends   how HR professionals can improve their practices in the healthcare sector according to Udekwe, et al, (2021). The random survey method has been used to reduce the bias and obtain answers from different people. Online survey though Google survey form can be used for quantitative analysis as it does not require interviewing the percipients, it is a more convenient, and possible method of research under the current circumstances. 

This research will help the management within the nursing administration, while support Primary healthcare which is very creative and provides community services. It will also support the HR Managers, Directors, and the Administration system, who need to improve employee engagement and development post COVID -19. This study includes the role of HR professionals, leadership, and how strategy shapes the needs, health, and wellbeing of staff (Park, 2016). 

Research design is the framework, or the technique used by the researchers to analyse the data; hence researchers choose the design that allows them to utilise the methods required for the study to achieve the primary objectives of their study. The research design can focus on quality or numbers; hence the approach of analysis can be qualitative or quantitative, while some research follows a mixed methodology focusing on both numbers and theoretical information; for example, a quantitative analysis of the survey can do to evaluate the time taken by a doctor to respond since the patients enter the hospital. These types of research would focus only on the numeric data, and numbers explaining the changes. Research design includes an important element of data collection, measurement of data with relevant tools, and analysing the data (Mohajan, 2018).

Quantitative analysis uses a statistical model to measure the numeric data and to understand the behaviour of research. It requires when researchers want to measure, evaluate, or predict real-world changes. QA is used in the financial world, social science, and other experiments that require the numeric analysis of data. To evaluate the use of HR strategies and how they can improve the HRM practice in healthcare this study uses the quantitative analysis focusing on talent management, HRIS, and human capital. It has been found that the results of quantitative analysis are unbiased and logical that can be used to analyse the study. There are some specific requirements and characteristics of the quantitative method; for example, it has structured tools, included close-ended questions, and focused on the generalization of results (Mukhopadhyay, and Gupta, 2014). 

The research produces influences how research methodology is used and how it applies the approach of data analysis including sampling and target population. In primary research analysis, there is a risk of bias; and it increases in quantitative methods when the target population is pre-defined. To remove the bias, this study follows the random sampling method (Phakiti, 2015). This study follows a positive paradigm and a quantitative analysis to measure what and why; for example, in terms of what is the use of HRIS, and why it is necessary for the HR professionals to implement different strategies to support the development of health professionals. Sampling is a process of analysing a part of the participants using the same method that has been used for the entire group; for example, quantitative method with random sampling can be used to identify the effectiveness for a specific person while random technique can be followed to avoid issues of bias in the research methodology. 

For the sampling method to work properly, it is necessary that samples must be taken randomly. There are several steps in the sampling method that have been followed in this study such as identification of population, sampling frame, method, size, and implement the plan. Research procedure refers to the processing of data collected through sampling method, in other words, it is the transformation of collected into the information that can be used to measure the outcome if the study (Disman, Ali, and Barliana, 2017). 

Ethical consideration is the set of principles in the research that needs to be adhered to ensure that they meet the standards and regulations while conducting research. The ethical consideration in research includes the protection of the rights of participants, research validity, and maintaining integrity; for example, in a clinical research trial, it is necessary for the researchers to ensure that participants have the right to withdraw from the study at any time. This research also follows the ethical principles and guidelines to ensure the protection of participants’ rights. There might have been issues related to human affairs while collecting the data from participants, and some challenges might arise due to the risk of a data breach (Johnson, Adkins, and Chauvin, 2020).

To elaborate more after data collection

As discussed above research methodology is the approach of the researcher used for the collection and analysis of data. The methodology is a crucial process that affects the result of the study based on the facts such as bias in the study, the method used for analysis, collection of data, and sampling. This research focuses on the effectiveness of HR strategies to develop employees and talent in healthcare using the HRIS; hence, to meet the requirement of study and achieve the goals, the researcher has used quantitative analysis of survey questionnaire based on the HRIS. Although there are similar researchers that show the effectiveness of HR strategies for employee development in the healthcare sector; however existing references do not address the research questions properly, and there is a need for new research to identify how HRIS and HRM strategies can change their practise after Covid-19 pandemic. Hence, a survey has been conducted to ask the selected following questions from the primary healthcare manager related to HRIS.

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