How can we develop contextualized theories of effective use? A demonstration in the context of community-care electronic health records

We contribute to the shifting discourse in the literature on information system use, towards context-specific (rather than general) theories and effective use (rather than just use). Organizations are under great pressure to use information systems effectively but they have few theories to turn to for insights. Motivated by this need, we propose an approach for developing context-specific theories of effective use. The approach suggests that effective use can be theorized by: (1) understanding how a network of affordances supports the achievement of organizational goals, (2) understanding how the affordances are actualized, and (3) using inductive theorizing to elaborate these principles in a given context. We demonstrate the approach in the context of a Canadian health authority’s use of a community-care electronic healthcare record (EHR). We discovered that effective use in this context can be viewed at a high level as the accuracy and consistency with which users work with the EHR, and how they engage in reflection-in-action across a network of nine affordances. The key, however, is understanding how those elements interact with the multiple levels of data needed to achieve the organization’s various goals. Overall, we contribute by offering an approach for developing context-specific theories of effective use, demonstrating its usefulness in an important context, and discovering the importance of understanding in a new way the multilevel nature of information systems

Transitioning from Use to Effective Use of Digital Innovation Platforms for Development: An Evergreen Discussion

The disruptions of different nature occurring since the onset of pandemics such as Ebola & Covid19 have exposed the imperative to re-imagine digital transformation, towards a more realistic goal-oriented perspective. Public sector organizations in many countries around the global south are at a crossroads, where the digital solutions at their disposal must be efficient, to address situations beyond technology adoption. Recent discussions have advocated for understanding what effective use of digital platforms is, as this would serve as a backbone between a system and the benefits it can deliver. In this research, we tackle the pressing imperative of using health information systems effectively for efficient organizational transformation. The insights discussed in this research will assist both scholars and professionals in reflecting on the digital transformation of public organizations in the global south, and the drivers behind the effective use of health information systems in fragmented economies

Examining Information Systems Infusion over the Routinization

Information systems (IS) infusion becomes important from the management perspective because organizations can leverage IS investment only at the IS infusion stage. The model for the stages of IS implementation explains that IS infusion can be achieved through IS routinization. This study examined how to achieve IS infusion through routinization based on application of the psychological empowerment theory and the unified theory of acceptance and use of technology (UTAUT), respectively. This study adds value to the IS literature by explaining how IS routinization leads to IS infusion and how their antecedents are different and related across the two stages. This study also provides guidance on how organizations can promote IS infusion beyond IS routinization, which then helps organizations leverage their IS investments

Is Facebook A Ride-Sharing Platform? Exploration Through Affordance Theory

Peer-to-peer ride-sharing is one of the most complex archetypes of the sharing economy. As a result, dedicated digital platforms, designed specifically to handle this complexity, have emerged. However, there are practices where Facebook is used to organise the ride-sharing, although it lacks features that can handle the complexity of ride-sharing. In this research-in-progress paper we demonstrate the importance for researching these practices. We justify the appropriateness for using the Affordance - actualisation lens for analysing the practices. We present the preliminary results from the first case study research

On the Complexity of Health Data Protection-in-Practice: Insights from a Longitudinal Qualitative Study

Digitalization of healthcare presents opportunities for improving the quality of healthcare services and promises economic benefits. However, the success of digital health and the benefits cannot be actualized without considering health data protection practices in the process of healthcare service delivery. Despite the criticality of protecting health data in the system use lifecycle (from recording to consuming and taking informed actions), there is a paucity of research to investigate this complex phenomenon. Using longitudinal qualitative data on a state-wide digital health transformation project, we contextually theorize the practices for protecting health data. Our study reveals five types of health data protectionin-practice, namely data minimization, informal encoding, accuracy, improving cyber-awareness, and appropriate access management. Our results provide new insights into information system use (especially, effective use), and highlight practices that can improve health data protection

An Affordance-based Approach for Assessing Effective Use of Health Management Information Systems in Low-Resources Context

Assessing effective use of health Management information systems (HMIS) in low-resource settings is critical to improving public health. However, mainstreaming information systems into daily practice can be challenging in dynamic, isolated settings where technology adoption is often not a priority. It is essential to design tools that address user needs and are deemed useful. In this paper, we propose a generic framework that applies effective use theory and affordance actualization theory to assess how HMIS are used efficiently in organizations and identify areas operational vulnerabilities. The proposed study uses a mixed-methods approach to data collection and analysis. This framework contributes to the information systems utilization literature by providing a method for contextualizing the assessment of effective utilization by giving relevance to specific information management tasks. From a practical perspective, it aims to guide information systems practitioners in low-resource environments in strengthening their digital organizational information systems

Testing the Links from Fit to Effective Use to Impact: A Digital Hospital Case

The global health sector is undergoing rapid digital transformation. Because such transformations often fail to meet expectations, researchers have begun studying the full chain from implementation to outcomes to learn what improvements are needed. Recent studies suggest that it is especially important to learn what ‘effective use’ of new systems involve, because effective use is the lynchpin between a system and its benefits. A key challenge, however, is operationalizing effective use. In this paper, we compare two approaches: theory-driven, operationalizing effective use using the ‘theory of effective use’, and context-driven, operationalizing it in terms of the workarounds users devise to achieve their goals. We compare these approaches using survey data from a multi-hospital digital transformation. The results support the theory-driven approach, while offering useful insights on workarounds

Understanding technology-enabled patient-provider working alliance in diabetes management.

Diabetes is a prevalent global health challenge and managing it requires ongoing collaboration between patients and healthcare providers. Notably, the quality of the patient-provider relationship is a critical factor that impacts the adherence to and effectiveness of collaborative diabetes management interventions. Digital health technologies have transformed the collaborative diabetes management process, but the effectiveness of these technologies depends on their ability to foster a strong patient-provider relationship. In this ongoing interpretive and exploratory research, we investigate how the use of technology and its features facilitates patient-provider working alliance in diabetes management, considering both the personal and collaborative dimensions. We will leverage the combined conceptual lens of working alliance model from psychology and information systems affordance theory to gain insights into this important topic

Towards Explaining Smart Service Innovation Events and Trajectories

How and why can smart technologies affect service innovation trajectories? We address this question via a multiple case study approach. First, we identify two dimensions for smart service innovation events: while performing and patterning characterize two distinct mechanisms of smart service innovation, flexible technologies and routines represent constituent elements of smart service systems. Building on these two dimensions, we delineate four ideal types of smart service innovation events and illustrate how these materialize in real-world contexts. Finally, we outline how our findings may serve as a starting point for future research and provide managerial guidelines for those aiming to shape innovation trajectories in smart service systems

Effective IT Use Among Residential Caregivers: The Role of Autonomy, Competence and Relatedness

Technological innovation in the healthcare sector is increasing, but integration of information technology (IT) in the care process is difficult. Healthcare workers are important agents in this IT integration. The purpose of this study is to explore factors that feed motivation to use IT. Self-determination theory (SDT) is applied to study how motivational factors impact effective IT use among frontline caregivers in residential care settings. As the team is very important to these caregivers, the team is our unit of analysis. In an embedded single case study design, interviews were conducted with all nine members of a team effectively using IT. All three basic psychological needs from SDT - autonomy, competence and relatedness - were found to have impact on effective IT use, though autonomy was primarily experienced at team level. Conversely, the effective use of an IT collaboration tool influences relatedness