Evolving Work Routines: Adaptive Routinization of Information Technology in Healthcare

Abstract

D espite the significant potential for performance gains from health IT (HIT), there has been limited study of the mechanisms underlying successful HIT implementations. We conducted an extensive longitudinal field study to gain an understanding of the interplay between technology and patterns of clinical work embodied in routines. We use the analytical device of narrative networks to identify where and how HIT influences patterns of work. We further draw upon adaptive structuration theory to conceptualize HIT as an intervention that alters the flow of events in a narrative network. Our findings suggest that the key to successful implementation is to manage the co-evolution process between routines and HIT and to actively orchestrate a virtuous cycle through agentic action. We propose a dynamic process model of adaptive routinization of HIT that delineates the major channels through which HIT and routines interact, identifies the different stages in the dynamic co-evolution process, and isolates the pivotal role of two forms of agency in enabling the virtuous cycle of co-evolution. This is one of the first studies to offer a processual, microlevel analysis of HIT implementation in a clinical setting.

Social Media in Healthcare

“…This in turn engenders agency in the form of personal innovativeness, which inspires others and helps to further propagate positive attitudes about the technology artifact. The researchers claim that an iterative cycle that continually recognizes and addresses system and routine glitches leads to high compliance and realization of initially anticipated performance gains [58]. Introduction of social media in the healthcare space will cause some degree of organizational change, therefore, healthcare organizations can draw on the suggested implementation constructs and ongoing, iterative sustainment approaches of AST to better inform design and implementation of both social media platforms technology artifacts and work practices to engender high levels of adoption.…”

Innovation Of, In, On Infrastructures: Articulating the Role of Architecture in Information Infrastructure Evolution

“…A system that may work well in one setting may fail in another, or result in different reorganizations (Barley, 1986). In addition, the shift from paperbased to system-based documents disrupts the effectiveness of daily routines of document handling (Goh, Gao, & Agarwal, 2011). These alterations are difficult to predict and manage because documents, along with other artefacts in general that are used for organizational coordination, do not work in isolation but are part of a multiplicity of artefacts and technologies that defy easy standardization and integration (Ellingsen & Monteiro, 2003, 2006Hartswood, Procter, Rouncefield, & Slack, 2003).…”

“…For instance, research shows how IS compatibility with existing workflow tends to have direct impact on the success of adoption and the performance that results (Goh et al, 2011), how technologies affecting providers' decision making tend to have a bigger impact on performance (DesRoches et al, 2010), and how organizational factors, each facilitating and hindering IS implementation at various points, have complex roles (Scott, Rundall, Vogt, & Hsu, 2005). In this paper, we contribute to this research by analyzing a case of information infrastructure (II) innovation in a hospital where a new patient portal is introduced.…”

A Review of Application of Affordance Theory in Information Systems

“…Affordances evolve through actors' behavior [25]. Studying the socialized affordances of social media and adopting the perspective of affordances-for-practice based on the theory of collective action [9].…”