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The importance of Interaction in the implementation of information technology in health care: A symbolic interactionism study on the meaning of accessibility
Blekinge Institute of Technology.
Blekinge Institute of Technology.
Blekinge Institute of Technology.
Blekinge Institute of Technology.
2012 (English)In: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 37, no 4, p. 277-290Article in journal (Refereed) Published
Abstract [en]

A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.

Place, publisher, year, edition, pages
Informa Healthcare, 2012. Vol. 37, no 4, p. 277-290
Keywords [en]
Co-constructed meaning of words, everyday work practice, health information technology, institutional ethnography, symbolic interactionism
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-44605DOI: 10.3109/17538157.2012.710683OAI: oai:DiVA.org:lnu-44605DiVA, id: diva2:822362
Available from: 2015-06-16 Created: 2015-06-16 Last updated: 2018-04-23Bibliographically approved
In thesis
1. Social challenges when implementing Information Systems in a Swedish healthcare organization
Open this publication in new window or tab >>Social challenges when implementing Information Systems in a Swedish healthcare organization
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

When the Swedish National IT Strategy for Health and Social Care was introduced in 2006, intensive work started in implementing Information Systems (IS) in Swedish healthcare organizations. To follow up on the requests for more research with a combined socio-technical focus on challenges, the overall aim of this thesis was to identify social challenges when implementing IS in a Swedish healthcare organization. Furthermore, the aim was to understand the impact of identified social challenges when implementing IS in this context by putting them in an interdisciplinary Applied Health Technology theoretical framework. Institutional ethnography and phenomenological hermeneutics influenced the study design. Study 1 aimed to investigate different meanings of accessibility when implementing Health Information Technology in everyday work practice. The results indicate that accessibility depends on working routines, social structures and patient relationship. When an IT strategy and interaction in everyday work use the same word in different ways there will be consequences. Study 2 sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. It was found that there is a need for improvement in communication and understanding between nursing staff at the hospital and in primary healthcare. The aim of study 3 was to explore social challenges when implementing IS in everyday work in a nursing context. Power (changing the existing hierarchy, alienation), Professional identity (calling on hold, expert becomes novice, changed routines), and Encounter (ignorant introductions, preconceived notions) were categories presented in the findings. The aim of study 4 was to explore and obtain a deeper understanding of how identified social challenges have an influence on the implementation process of IS, based on healthcare staff’s experiences on micro, meso and macro levels of Swedish Healthcare organizations. It was found that the challenges were related to the steps of putting into practice, making IS a part of everyday work routine and establishing an identity in the implementation process. In the thesis’s discussion, social challenges when implementing IS in Swedish healthcare organizations and how they might be met and dealt with constructively are further reflected upon in relation to the interdisciplinary theoretical framework and as possible consequences of the modernity-era. This thesis contributes to the starting up of a discussion of how ingrained professional characteristics are important to feel secure of being part of an established profession. If the characteristics are questioned, the whole professional performance is threatened. One consequence of this insight is the reinforcement of the realization that a basic understanding of IS and IS implementation processes in healthcare organizations needs to be integrated in to the construction of professional identity of nurses already from the start in nursing education.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2014. p. 96
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 14
National Category
Other Engineering and Technologies not elsewhere specified
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-73281 (URN)978-91-7295-293-5 (ISBN)
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-04-23Bibliographically approved

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Nilsson, LinaBorg, Christel

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