Boundary factors and contextual contingencies: configuring electronic templates for healthcare professionals

Hybridity as a process of technology's ‘translation’: Customizing a national Electronic Patient Record

“…Our case suggests that configurability was not a technical barrier but a political in that changes in the software impacted the contractual relation suppliers had with CfH and were on this basis resisted. Ultimately the decision as to what is 'best' for a healthcare organisation to adopt and what is best to change is an outcome of negotiations (Bjørn et al, 2009;Oborn et al, 2011;Wagner & Newell, 2004).…”

“…Customization, one of these interventions, implies making extensive changes in the code of the system and redesigning some of its features so that it becomes contextualised to the implementer health organization (Bjørn et al, 2009;Davidson & Chiasson, 2005;Davidson & Chismar, 2007;Oborn et al, 2011;Williams & Pollock, 2008). Although necessary, customization is often limited as the software's embodied logic cannot be easily fine-tuned (Kallinikos, 2010) and because of the power IT suppliers exercise, through invocation of their technical expertise, to minimise changes in the provided software (Hislop, 2002).…”

“…Bjørn et al (2009) have shown that negotiations between stakeholders are necessary before deciding on the elements of a health technology that can be standardized and used across contexts and those that need to remain local. Negotiations between different groups of the same organization have also been reported as being essential to EPR adaptation (Boulus & Bjorn, 2010;Oborn et al, 2011).…”

Sociomateriality & Design

“…Comparing the technology-centred healthcare design research with the organizational-centred healthcare design research, we might say that the former has a tendency to privilege the IT artefact; whereas, the latter might have the opposite tendency, namely to privilege the social organization of work. The social organization of healthcare work includes topics on standardization and re-configuration (Hanseth et al 2006;Bjørn et al 2009), as well as professional sense-making (Jensen and Aanestad 2007).…”

“…Yet, given a preoccupation with the design, implementation, and use of coordinative artefacts, many scholars end up studying one system at a time (Xiao et al 2001;Chiasson and Davidson 2004;Xiao 2005;Hanseth et al 2006;Boulus and Bjørn 2008;Bjørn et al 2009). Although these studies are important, they tend to neglect how each of these systems and their materiality function not in isolation, but are part of larger and smaller entanglements.…”