For the last three decades, research on Information Technology Business Value (ITBV) has highlighted how organizations can create greater value from IT investments in different industries, including the healthcare sector. There has been some research investigating the business value of Health Information Systems (HIS). However, the current body of knowledge regarding the challenges in front of proper business value realization of these systems is limited. This study investigates the challenges of HIS business value creation using a combination of the Fuzzy Analytic Hierarchy Process (FAHP) and fuzzy Decision-making Trial and Evaluation Laboratory (DEMATEL). First, this study reviews the literature to identify the main challenges in the field. The outcome of this step revealed three main categories and 22 challenges, including technological (ten challenges), organizational (eight challenges), and environmental (four challenges). Then, this study first uses FAHP to evaluate the weighting for each criterion and then adopts the fuzzy DEMATEL method to establish contextual relationships among those criteria. We find out that technological challenges are the most crucial dimension. Moreover, we observed that “infrastructure costs” has the highest priority. Under the technological dimension, “maintenance costs” and “systems compatibility” challenges are the most critical since they are in the cause area and directly influence the HIS outcomes. Under the organizational dimension, “Change in strategic objectives” is the most important challenge. Moreover, “inter-departmental coordination”, “training costs”, “proficiency”, and “users’ knowledge” are affected by each other as well as influenced by the net causes. The outcome of this study shows that to handle HIS business value creation challenges, healthcare executives should start with infrastructure costs, maintenance costs, and systems compatibility challenges.
