Contextual dynamics during health information systems implementation: an event-based actor-network approach
Abstract
Despite its information-intensive nature and considerable investments, healthcare continues to lag behind other industries in effectively exploiting information technology (IT). This paradox suggests that the healthcare industry presents particular challenges for successful implementation of information systems. As a result, there is an increasing interest in research into how information systems implementation efforts are shaped in interaction with the healthcare context. This paper contributes to this emerging body of knowledge by applying Actor-Network Theory (ANT) to explore the implementation of a radiology network system in a Swedish hospital. The analysis of the process reveals how complex contextual dynamics had disruptive effects. First, we identified important dynamics related to implementation content; these were mainly expressed as tensions between the radiology network system and medical work practices. Second, we found important dynamics related to implementation context; these were mainly expressed as tensions between shifting networks of actors within the implementation project and the broader institutional setting. Seeking to understand contextual dynamics during healthcare information systems implementation, we use events to focus, structure, and present the ANT analysis. This event-based approach furthers our understanding of how researchers can apply ANT to study IT-based change in general.
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National EHR endeavors should not be seen as programs composed of discrete ICT projects dissociated from policy, technology, service delivery and clinical work; rather, these elements are inextricable parts of EHR programs.
“Thus we see national EHR endeavors not as programs composed of essentially discrete ICT ‘projects’, dissociated from policy, technology, service delivery and clinical work. Rather, we see the need to incorporate these elements in evaluation as inextricable parts of EHR programs, including the constantly changing parallel policies and strategies, complex and evolving software ecologies and diverse”
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- Authors
- Cho, S., Mathiassen, L., & Nilsson, A.
- Affiliations
- Virginia State University (US)
- Georgia State University (US)
- University of Gothenburg (SE)
- Corresponding author
- Cho, Sunyoung
- ORCID
- Cho, Sunyoung
- Venue
- European Journal of Information Systems
- Publisher
- Informa UK Limited
- Published
- 2008-12
- Volume
- 17
- Issue
- 6
- Pages
- 614-630
- ISSN
- 0960-085X (ISSN-L)
- 1476-9344
- OpenAlex
- W1973058570
- Cited by
- 161
- References
- 99
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 19 · 2018: 6 · 2017: 10 · 2016: 6 · 2015: 9 · 2014: 20 · 2013: 12 · 2012: 21
- FWCI
- 33.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Information Systems (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Business, Management and Accounting › Management Information Systems › ERP Systems Implementation and Impact
- Keywords
- health information system implementation, actor-network theory, event-based analysis, contextual dynamics, institutional environment, hospital information technology, disruptive effects
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