Panos Constantinides & Michael Barrett The Judge Institute of Management, University of Cambridge20 July 2005 the case of a regional, health information.

Panos Constantinides & Michael Barrett The Judge Institute of Management, University of Cambridge 20 July 2005

the case of a regional, health information network in Crete

On the Innovation of New Infrastructure Technologies:

Overview

Introduction Conceptual Foundations Research Questions Background to the Case Study Analysis of Findings Implications for Research and Practice Conclusion

Introduction – why a focus on healthcare?

One of the key sectors where information and communication technologies (ICTs) have become extremely pervasive is healthcare with national strategies aimed at:

developing health-related infrastructure technologies developing integrated electronic patient records improving quality, access and management of health

services

Introduction – why a focus on infrastructure?

Research in Information Systems (IS) has traditionally focused on the organisational level seeking to understand:

the relation of IS to an organisation’s strategy and the ways for achieving competitive advantage (Chan et al, 1997; Henderson & Venkatraman, 1993)

the impact of IS in organisational change and development (Heracleous & Barrett, 2001; Markus & Robey, 1998)

Introduction – why a focus on infrastructure?

More recent IS research has focused on the importance of the Internet and other infrastructure technologies seeking to understand:

the dynamics of infrastructure technologies and the processes of negotiation entrenched in their development and implementation (Bowker & Star, 1999; Cibora et al., 2001)

Information infrastructure emerges through an interplay between heterogeneous and geographically distributed computer-based systems, organizations, communities and their work practices (e.g. the Internet)

> therefore an II is never built from scratch rather it evolves on the existing base of human and

technological resources

Introduction – a definition of II

Conceptual Foundations – II as a network of sociotechnical relations

Professional kit of Tools & Techniques

Communities

Large Technical Systems

Organizations/

Institutions

New Technological Developments

Individuals

PowerNetworks

skill development &practical know-how

interests & intentions

Power networks = the articulation of diverse interests and practices into commonly shared goals by embodying desired actions into organisational initiatives and technological artifacts.

What are the different types of sociotechnical relations at play in the construction and reconstruction of information infrastructure?

What are the implications of these sociotechnical relations for the innovation of new infrastructure technologies?

Research Questions

Background to the Case Study- the context

Analysis of Findings - power networks in the case study

Professional kit of Tools & Techniques

Communities

Large Technical Systems

Organisations/

Institutions

New Technological Developments

Individuals

PowerNetworks

skill development &practical know-how

interests &intentions

Pilot Regional Health II

ProfessionalCommunities(e.g. GPs)

MedTech-led Power

Network

-Regional IT Network- HL7 standards

Regional IT Network

1995 Presentation

- 4 GPs- 2 Cardiologists 1997 Working group

- IT applications (e.g. electronic patient records)

1998-2000 Major Implementation

Established 1984

MedTech- Ministry of Health

Analysis of Findings - power networks in the case study

Professional kit of Tools & Techniques

Communities

Large Technical Systems

Organizations/

Institutions

New Technological Developments

Individuals

PowerNetworks

skill development &practical know-how

interests & intentions

RHA-led Power

Network

National callfor regional ITcompetitions

2003

-MedTech receives European eHealth award

2003

ProfessionalCommunities

(e.g. GPs)

Established 2001

RegionalHealth Authorities

MedTech’sPilot Health

II

2002 IP Rights DisputeMedTech’s Electronicpatient records

- 3 GPs (-1)- 2 Cardiologists 1997 Working group

Ministry of Health

Implications for Research & Practice

Changes introduced through IT vs. existing practices (Ballantine & Cunningham, 1999; Jones, 2003)

Conflicts of interest between key stakeholders and access to resources at different points in time (Berg, 2001)

Consensus building processes in diverse communities (Bowker & Star, 1999)

The role of different artefacts (e.g. standards) in negotiation processes (Hanseth & Monteiro, 1997)

Following the project throughout with the same care Resolving conflicts through clearly defined agreements Building alliances vs. holding a rigid stance

Conclusion

This research addresses an epistemological gap in the literature: How do we study the innovation of new infrastructure

technologies?

It provides an integrated set of conceptual tools that are relevant to both researchers and practitioners zoom in & out levels of analysis identify key enablers & inhibitors of change develop context-specific management practices based on these

Future research needs to apply these conceptual developments in other sectors to assess their credibility

Ballantine, J., & Cunningham, N. (1999). Strategic information systems planning: applying private sector frameworks in UK public healthcare. In R.B. Heeks (ed.) Reinventing Government in the Information Age, London: Routledge, 293-311.

Berg, M. (2001). Implementing information systems in health care organisations: myths and challenges. International Journal of Medical Informatics 64, 143-156.

Bowker, G. & Star, S.L. (1999). Sorting Things Out – Classification and its Consequences. Cambridge, MA: MIT Press.

Chan, Y.E., Huff, S.E., Barclay, D.W., & Copeland, D.G. (1997) Business strategic orientation, information systems strategic orientation, and strategic alignment. Information Systems Research 8(2), 125-150.

Ciborra, C.U. (ed.) & Braa, K., Cordella, A., Dahlbom, B., Failla, A., Hanseth, O., Hepso, V., Ljungberg, J., Monteiro, E., & Simon, K.A. (2001). From Control to Drift: the Dynamics of Corporate Information Infrastructures. Oxford University Press.

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Heracleous, L., & Barrett, M. (2001) Organisational change as discourse: communicative actions and deep structures in the context of information technology implementation. Academy of Management Journal 44(4), 755-778.

Jones, M.R. (2003) “Computers can land people on Mars, why can’t they get them to work in a hospital?” Implementation of an electronic patient record system in a UK hospital. Methods of Information in Medicine 42, 410-415.

Latour, B. (1999) Pandora’s Hope: Essays on the Reality of Science Studies. Cambridge: Harvard University Press.

Markus, M.L. & Robey, D. (1998) Information technology and organizational change: casual structure in theory and research. Management Science 34(5), 583-598.

References