What Teams Need to Be Clear about - an Activity Theoretical Perspective on Shared Understanding in Health IS Implementation

Shared understanding facilitates the implementation of IS and can help to prevent unintended consequences. However, research is hitherto not precise on the kind of knowledge such understanding needs to capture. Taking an activity theory perspective, this paper theorizes that shared understanding needs to cover knowledge, experiences and perspectives on the contested activity systems the HIS is implemented in. Analyzing the data of an in-depth case study, it is found that issues emerging during the rollout can be traced back to a lack of shared understanding about the affected activity systems, particularly to insufficient shared understanding about the instrument-mediated relationships between contradictory motives, rules and the evolved division of labor. These findings are synthesized in a framework on critical aspects of shared understanding. This framework offers a coherent explanation for the rise of unintended consequences and enhances our learning of shared understanding in IS implementation

Conflicting Roles of CIOs and their Negative Effects on the Workplace of the Future

Demographic change is forcing companies to find new ways to attract skilled knowledge-workers to safeguard strong economic performance. In particular, in the case of younger generations, companies have the opportunity to increase their attractiveness apart from usual incentives like a high salary by addressing these generations’ altered expectations towards their professional life and their work-life balance. Recent studies show, however, that companies often struggle to implement the necessary information technology. Drawing on role theory and existing literature, we developed a role framework to identify intra-role conflicts perceived by the chief information officers and inter-role conflicts between the IT and other departments. Through qualitative interviews with representatives from five companies, we identify numerous role conflicts, particularly common in smaller companies and companies managed by their owners. Implications for theory and practice are discussed

Exploring the Nuances of 'Wickedness' in Information Systems Development

Information Systems Development (ISD) practice is an inherently challenging undertaking, as exemplified by the high rate of ISD project failures. The scale of the challenge is often heightened in distributed environments where ISD practitioners can face considerable complexity, uncertainty, and contention. The concept of -˜wickedness’ epitomizes such challenges. However, ISD literature has yet to fully explore the nuances of wickedness found in ISD practices within distributed environments. To address this gap, we use a theoretical framework to analyze case study findings from an interdisciplinary connected health project. In particular, we break open the social aspects of wickedness and explore their impact on shared understanding and shared commitment in ISD projects. The paper highlights the implications that these nuances have for group decision-making in distributed ISD project teams

Exploring the Nuances of \u27Wickedness\u27 in Information Systems Development

Information Systems Development (ISD) practice is an inherently challenging undertaking, as exemplified by the high rate of ISD project failures. The scale of the challenge is often heightened in distributed environments where ISD practitioners can face considerable complexity, uncertainty, and contention. The concept of -˜wickedness’ epitomizes such challenges. However, ISD literature has yet to fully explore the nuances of wickedness found in ISD practices within distributed environments. To address this gap, we use a theoretical framework to analyze case study findings from an interdisciplinary connected health project. In particular, we break open the social aspects of wickedness and explore their impact on shared understanding and shared commitment in ISD projects. The paper highlights the implications that these nuances have for group decision-making in distributed ISD project teams

Operational Business-IT Alignment in Healthcare: Theoretical Foundation and Empirical Evidence

This thesis examines IT-related change in healthcare. Building on and extending prior research on operational business-IT alignment, new insights are derived that enable practitioners to align IT and medical reality to realize expected potentials of health IT. The results posit that strong social capital mitigates the challenges that come with structurally decoupled organizations and facilitates identification and implementation of necessary IT-related change in hospitals. Likewise, shared understanding about how health IT will affect and is affected by socio-organizational complementarities is found to be a critical requirement for effective change processes. Strong linkages between IT and medical professionals as well as sufficient shared understanding enables effective change processes. These processes are characterized by reciprocal adaptations to HIS and other elements of interrelated organizational activity systems, in which IT is embedded in. The empirical results demonstrate that iterative resolution of contradictions and mitigation of tensions within and between activity systems increases the efficiency of IT and leads to sustained alignment. Overall, this dissertation extends prior theories on alignment, helps scholars understand and account for the unique and complex characteristics of the healthcare domain and offers actionable guidance for practice.Diese Dissertation untersucht IT-bezogene Veränderungsprozesse in Krankenhäusern. Aufbauend auf dem Stand der Forschung zum operativen Business-IT Alignment erarbeitet diese Dissertation neue Erkenntnisse, die es Praktikern ermöglichen, IT und medizinische Realität bestmöglich aufeinander abzustimmen und damit den Wertbeitrag der IT in dieser Domäne zu steigern. Die empirischen Ergebnisse zeigen, dass starkes Sozialkapital die Herausforderungen strukturell entkoppelter Organisationen ausgleicht und die Identifikation und Realisierung notwendiger IT-bezogener Veränderungen in Krankenhäusern erleichtert. Ebenso ist ein gemeinsames Verständnis der Beteiligten darüber, wie sich die Gesundheits-IT auf die komplementären sozio-organisatorischen Charakteristika auswirkt und von diesen beeinflusst wird, eine entscheidende Voraussetzung für effektive Veränderungsprozesse. Enge Verbindungen zwischen IT- und Medizinern sowie ein ausreichendes gemeinsames Verständnis begünstigen effektive IT-bezogene Veränderungsprozesse. Diese Prozesse sind gekennzeichnet durch wechselseitige Anpassungen an der IT und anderer Elemente zusammenhängender organisatorischer Tätigkeitssysteme, in welche die IT eingebettet ist. Die empirischen Ergebnisse zeigen, dass die iterative Lösung von Widersprüchen und der Abbau von Spannungen innerhalb und zwischen Aktivitätssystemen die Effizienz der IT steigert und zu einer nachhaltigen Business-IT Alignment führt. Insgesamt erweitert diese Dissertation das theoretische Wissen zu operativem Business-IT Alignment und verbessert das Verständnis über die Charakteristika und Komplexitäten der Domäne Krankenhaus und bietet praktische Hilfestellungen zur Gestaltung IT-bezogener Veränderungsprozesse