Rethinking the improvisation of digital health technology: A niche construction perspective

Paid open accessThe COVID-19 pandemic has sent shock waves through healthcare organisations and catalysed an impromptu digital shift, creating a demand for telemedicine and other digital health technologies. Under such conditions, improvisation, adaptation, and innovation emerge as core dimensions to an organisation’s capacity to generate a response to crisis. This paper integrates a process perspective on the radical improvisation of a digital health technology and investigates how the radical improvisation of a digital health technology emerges and develops during a health crisis. Through a combination of supporting case evidence and literature, a multi-phase conceptual process model anchored in the crisis management cycle and illustrating the radical improvisation of digital health technology is developed and proposed. We conclude with discussion on the long-term implications of radical improvisation and crisis learning, with possible theoretical explanation using niche construction theory, and providing suggestions for future information systems and crisis management research.publishedVersio

A Reappraisal of Resilience in Digital Infrastructure: A Study of Cyber-Physical-Social Systems in Ongoing Crises

Paper V has been extracted pending publication.Digital technologies are now entrenched in the core operations of organisations providing critical services (OCSs). This is due to ongoing innovations in work and practice. As new applications and services are developed, there is a convergence of traditional physical infrastructures and rapidly changing modern digital technologies. These technologies are complex and have been characterised as cyber-physical-social systems (CPSSs). CPSSs are tightly integrated, coordinated, sensor-based digital solutions with both human and cyber characteristics. They are notably embedded in and facilitate OCS operations. A salient instance of such a development is identifiable in the health sector. Service innovations (e.g., telemedicine) have been common in this sector for decades. There has, though, been a significant upturn in recent years, one that the COVID-19 pandemic has compounded. A priority for health OCSs is to bridge operational disruptions and secure care continuity. This is being increasingly achieved by leveraging digital assets like CPSSs. Health OCSs’ leveraging of CPSSs and other digital assets during the pandemic has been recognised as a resilient response in the information systems (IS) literature. However, early experiences during the pandemic revealed a stark fragility to unanticipated constraints. Indeed, health services nearly came to a standstill. COVID-19 was (and to some degree still is) a destabilising factor in OCSs. On the one hand, it posed unforeseen challenges and introduced sustained instability. On the other hand, it ignited widespread innovation and change. Limited research examines a crisis from this kind of dualistic perspective; a crisis is simultaneously a calamity and an opportunity. Unfortunate circumstances influence short-term innovation and digital assets’ selective expansion. This, in turn, triggers transformative learning and possible long-term evolution in OCSs. In this thesis, I follow an empirical case in which a CPSS solution was leveraged in an OCS supporting pandemic response efforts in Agder County, Norway. As part of the crisis response planning in Agder, a pre-existing remote patient monitoring tool was adapted and repurposed for monitoring COVID-19 patients. The pandemic presented unprecedented constraints and fast-paced mutations of new variants. This meant that OCSs only had a brief reprieve between waves of infection. …publishedVersio

Is this Digital Resilience? Insights from Adaptation and Exaptation of a Cyber-Physical-Social System

This paper is based on a qualitative case study that explores the adaptation and customisation of a Cyber Physical Social System (CPSS)-based patient monitoring solution for use during Covid19 in the Norwegian health sector. The study seeks to answer the following research questions: 1) what are the preconditions that enable the adaptive use of a CPSS in crisis response efforts? 2) what are the contributions of the adaptive use of technology in the building of digital resilience in a health organisation? The study identifies five main themes that emerge as enabling factors forming a basis for the preconditions to adaptive use of the CPSS. We conclude with a discussion on the practical and theoretical implications of this research and how it contributes to crisis management and digital resilience theory.publishedVersio

Is this Digital Resilience? Insights from Adaptation and Exaptation of a Cyber-Physical-Social System

This paper is based on a qualitative case study that explores the adaptation and customisation of a Cyber Physical Social System (CPSS)-based patient monitoring solution for use during Covid19 in the Norwegian health sector. The study seeks to answer the following research questions: 1) what are the preconditions that enable the adaptive use of a CPSS in crisis response efforts? 2) what are the contributions of the adaptive use of technology in the building of digital resilience in a health organisation? The study identifies five main themes emerge as enabling factors forming a basis for the preconditions to adaptive use of the CPSS. We conclude with a discussion on the practical and theoretical implications of this research and how it contributes to crisis management and digital resilience theory

BEYOND CRISIS RESPONSE: LEVERAGING SOCIOTECH-NICAL TRANSFORMABILITY

We investigate the organizational capacities required to leverage digital infrastructures both (1) in re-sponse to crisis and external threats, and (2) in realizing the transformative potential associated with the digital infrastructures. Thus, our research question is: What is required for organizations to be able to transform in the face of disruptions and breakdowns? We report from an empirical study of a digital infrastructure innovation process in the context of the COVID-19 pandemic, which involved extensions and novel development of both the technology and the former service model. While the literature on organizational resilience offers us a conceptual framework to identify organizational capabilities, we lean on literature that foregrounds transformability as a crucial aspect of resilience. We discuss organ-izational capacities which are considered vital in realizing the potential for transformative crisis learn-ing in sociotechnical systems that builds adaptive capacity and influences the enactment of future or-ganisational routines