Patient care information systems and health care work: a sociotechnical approach

Understanding barriers and facilitators to the use of Clinical Information Systems for intensive care units and Anesthesia Record Keeping: A rapid ethnography

“…We framed our study with sociotechnical systems theory, which has been used and discussed prominently in the medical informatics literature [4][5][6][7][8][9][10][11][12][13][14]. Although there is no one "sociotechnical approach" [4], studies that rely on a sociotechnical perspective all have a high-level recognition that organizational and health systems at large have a substantial influence in shaping HIT and that the technology and context are intertwined [5].…”

“…For example, two studies examined the interrelation of the organizational environment and technical subsystems for the implementation of computerized provider order entry (CPOE) systems [6,13], resulting in unintended consequences [6] and implementation failure [13]. Berg and others note that "neutral" HIT applications in work practices evolve within the specific socio-political contexts of these practices [7,8]. One example is the "forgotten" power of paper as EHRs began to take shape; that is, how the paper record evolved within the sociotechnical work practices and how many of these nuances were lost with the introduction of the EHR [9].…”

Benefit or burden? A sociotechnical analysis of diagnostic computer kiosks in four California hospital emergency departments

“…An over-reliance on experimental design can thereby lead to disjuncture between predicted and actual uses of new technologies. In contrast, a "sociotechnical" approach, informed by ANT, draws on qualitative methods to study technologies in the midst of the complex social and material networks that constitute e and are re-shaped e by them (Berg, 1999;Berg, Aarts, & van der Lei, 2003;Latour, 1988;Timmermans & Berg, 2003). Ethnographic methods can be particularly helpful in explaining implementation difficulties, non-use or unintended outcomes of technology projects (Cresswell, Worth, & Sheikh, 2010;Greenhalgh & Russell, 2010), and are increasingly recognized as a valuable approach to evaluating and building health IT projects and health care more broadly (Forsythe, 1992;Greenhalgh & Swinglehurst, 2011;Kaplan, 2001).…”

Web-based telemedicine systems for home-care: technical issues and experiences

“…On this topic, there is a growing consensus in interpreting the design and assessment phases as an iterative process, in which the classical distinctions between analysis, design, implementation and assessment is no more valid [2,9]. The overall picture may be reached only by means of considering the complete ''social'' network in which the service customers and providers are located [2]. In particular, it is important to assess the implications of the change determined by the introduction of the new system in the environment where it will be used [10].…”

“…In telecare applications the role of the patient become central, since he/she is actively involved in the process of managing care and treatments, and since he/she (or his/her families) is responsible for collecting some measurements and related information. The management of a chronic patient is therefore a collective and cooperative enterprise that may exploit Information Technology (IT) to improve the overall quality of care [2]. The complex network of human and machine relations involved in this process should have strong implications in the design of the Web service.…”