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Change and resistance to change in health care: Inertia in sociotechnical systems
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.ORCID iD: 0000-0003-2534-4937
2014 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis explores change and resistance to change of IT systems in organisations from a sociotechnical perspective. The work is drawing on empirical data gathered during two Action Research projects in Swedish Health Care: one regarding the deployment of electronic patient record systems within health care organisations, and the other regarding the deployment of eHealth services geared towards patients and citizens. Resistance to change is classified as an indicator of social inertia, and the concept of counter-implementation, comprising three general strategies to obstruct change initiatives, is used to highlight the political aspects of social inertia. For the analysis, the concept of social inertia is used as a point of departure towards inertia in sociotechnical systems by applying values and principles from sociotechnical systems research, most prominently the interdependence-characteristic. This extended concept is used to show and discuss how IT systems can either enforce change or be a source of inertia preventing change in organisations, and such planned or inadvertent effects of implementing IT systems are discussed as a significant source of user resistance.

Place, publisher, year, edition, pages
Uppsala University, 2014.
Series
Information technology licentiate theses: Licentiate theses from the Department of Information Technology, ISSN 1404-5117 ; 2014-005
National Category
Human Computer Interaction
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
URN: urn:nbn:se:uu:diva-224862OAI: oai:DiVA.org:uu-224862DiVA: diva2:718762
Presentation
2014-06-13, Room 2446, Polacksbacken, Lägerhyddsvägen 2, Uppsala, 13:15 (English)
Supervisors
Funder
VINNOVA, 2012-02233
Available from: 2014-06-13 Created: 2014-05-22 Last updated: 2017-08-31Bibliographically approved
List of papers
1. Mind the gap: Towards a framework for analysing the deployment of IT systems from a sociotechnical perspective
Open this publication in new window or tab >>Mind the gap: Towards a framework for analysing the deployment of IT systems from a sociotechnical perspective
2013 (English)In: Past History and Future Challenges of Human Work Interaction Design: Generating Cross-domain Knowledge about Connecting Work Analysis and Interaction Design, South Africa: University of Cape Town , 2013, 28-33 p.Conference paper, Published paper (Refereed)
Abstract [en]

Deployment of IT is little discussed in research literature, despite the fact that a successful deployment encompasses complexities and difficulties well worth investigating. The deployment phase of IT systems can be a make-or-break moment for usefulness of the system due to sociotechnical factors. We argue that there is a gap between the technological artefact produced and the social requirements that govern how well the system will fit in the organisation. Hence, in this work in progress paper we present a framework (the SOT framework) for analysing deployment of IT from a sociotechnical perspective.

Place, publisher, year, edition, pages
South Africa: University of Cape Town, 2013
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-225885 (URN)978-0-620-58037-3 (ISBN)
Conference
INTERACT 2013 Workshop
Projects
DOME
Available from: 2013-09-02 Created: 2014-06-09 Last updated: 2017-07-29Bibliographically approved
2. Evaluation of User Adoption during Three Module Deployments of Region-wide Electronic Patient Record Systems
Open this publication in new window or tab >>Evaluation of User Adoption during Three Module Deployments of Region-wide Electronic Patient Record Systems
2014 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 83, no 6, 438-449 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

In Sweden there are modular region-wide EPR systems that are implemented at various health organisations in the region. The market is dominated by four IT systems that have been procured and deployed in 18 out of 21 regions.

METHODS:

In a 2.5-year research study, deployments of three region-wide EPR modules: a patient administration system, eReferral module and eMedication module were followed and evaluated. Health professionals, EPR maintenance organisation, IT and health care managers were observed, interviewed and responded to questionnaires.

RESULTS:

Although the same deployment process was used during the three deployments, large variations in the units' adoptions were observed. The variations were due to: (1) expectation and attitude, (2) management and steering, (3) end-user involvement, (4) EPR learning, and (5) usability and the possibility of changing and improving the EPR.

CONCLUSIONS:

If changes in work processes are not considered in development and deployment, the potential benefits will not be achieved. It is therefore crucial that EPR deployment is conceived as organisational development. Users must be supported not just before and during the go-live phase, but also in the post-period. A problem often encountered is that it is difficult to make late changes in a region-wide EPR, and it is an open question whether it is possible to talk about a successful deployment if the usability of the introduced system is low.

National Category
Human Computer Interaction
Research subject
Human-Computer Interaction; Medical Informatics
Identifiers
urn:nbn:se:uu:diva-196508 (URN)10.1016/j.ijmedinf.2014.02.003 (DOI)000335903400005 ()24630924 (PubMedID)
Available from: 2013-03-11 Created: 2013-03-11 Last updated: 2017-12-06Bibliographically approved
3. Development of novel eHealth services for citizen use: Current system engineering vs. best practice in HCI
Open this publication in new window or tab >>Development of novel eHealth services for citizen use: Current system engineering vs. best practice in HCI
2013 (English)In: Human-Computer Interaction – INTERACT 2013: Part II, Springer Berlin/Heidelberg, 2013, 372-379 p.Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2013
Series
Lecture Notes in Computer Science, 8118
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-210076 (URN)10.1007/978-3-642-40480-1_24 (DOI)000342898400024 ()978-3-642-40479-5 (ISBN)
Conference
INTERACT 2013, September 2–6, Cape Town, South Africa
Projects
DOME
Funder
Vinnova, 2012-02233
Available from: 2013-09-04 Created: 2013-10-30 Last updated: 2017-07-29Bibliographically approved
4. Development of patient access to electronic health records as a step towards ubiquitous public eHealth
Open this publication in new window or tab >>Development of patient access to electronic health records as a step towards ubiquitous public eHealth
2013 (English)In: European Journal of ePractice, ISSN 1988-625X, E-ISSN 1988-625X, Vol. 20, 21-36 p.Article in journal (Refereed) Published
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-212477 (URN)
Projects
DOME
Available from: 2013-11-21 Created: 2013-12-10 Last updated: 2017-12-06Bibliographically approved

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