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Cited by 15Information Systems Theories and ImplementationTelemedicine and Telehealth ImplementationICT in Developing Communities

The Map and the Territory: An Ethnographic Study of the Low Utilisation of a Global eHealth Network

Duclos, Vincent·2016·Journal of Information Technology
DOI 10.1057/jit.2016.3
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Abstract

Recent years were marked by the implementation of many eHealth projects using information and communication technologies to provide health services in developing countries. While generating great expectations, these projects remain poorly documented and available data suggest high failure rates. This raises a practical question: How are such eHealth networks to be effectively designed and implemented? This paper addresses this question. Specifically, it presents an ethnographic study of the Pan-African e-Network, a project which connects many hospitals all across India and Africa, providing medical teleconsultations and distance learning services. The study investigates the low utilisation of the network, an issue undermining its potential and efficiency. Factors contributing to this situation include communication barriers, the presumed ego of doctors, poor awareness of the project, and a lack of flexibility to work with the specificities of the connected sites. Above all, these factors point towards a dichotomous approach across the project's design and implementation, and taking two distinct yet related forms: (a) an ontological divide between technical and ‘non-technical’ domains; (b) a political sorting out of what is and what is not the project, aimed at neutralising and accounting for heterogeneous processes and practices. In both cases, low utilisation reveals tensions between processes of closure and control, and the openness of a life that will not be contained. Ultimately, this paper intends to destabilise binary modes of thinking as they crystallise oppositions between design and implementation, project and context, technical and social worlds, efficacy and improvisation, mastery and unruliness, map and territory.

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Authors
Duclos, V.
Affiliations
McGill University (CA)
Corresponding author
Duclos, Vincent
ORCID
Duclos, Vincent
Venue
Journal of Information Technology
Publisher
SAGE Publications
Published
2016-12
Volume
31
Issue
4
Pages
334-346
ISSN
  • 0268-3962 (ISSN-L)
  • 1466-4437
DOI
10.1057/jit.2016.3
OpenAlex
W2334933345
Cited by
15
References
90
Citations by year
2025: 1 · 2024: 1 · 2023: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2017: 4
FWCI
6.67
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Information Technology (publishedVersion)
  • Journal of the Association for Information Systems (submittedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
e-health, teleconsultation, distance education, network utilization, communication barriers, design and implementation, binary oppositions, developing countries, India, Africa

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