Sundfloen hengebru : en statisk analyse og forslag til forsterkning av brua

Bacheloroppgave - Universitetet i Stavanger, Det teknisk naturvitenskapelige fakultet, 201

Socio-technical integration in health care : a case study from a hospital-based laboratory context.

This thesis deals with socio-technical approaches to the work of implementing ICT systems in health care. In the thesis, I address and reflect on challenges related to design and implementation as well as integration of ICT systems with hospital laboratories. Based upon empirical examples gathered from a longitudinal case study using interpretive methods, the results suggest how health care practices can shape the implementation of integrated systems and what role users may have in these projects. The thesis concerns not only the practical challenges of integration, but also how large-scale integration challenges may be handled. In recent decades, several projects and national strategies aimed at enabling electronic interactions within the health care system have failed. Despite heavy investment of resources, the results of many projects are still far from the initial goals. Major delays and budget overruns are common. One important reason for such outcomes is that designers and project managers do not manage to grasp the complexities in the existing practices when they draw up strategies for more efficient health care. My objective is to spell out this complexity in detail. By reflecting on previous research, I emphasize that ICT systems, when designed, do not adequately address existing practices and existing portfolios in health care organizations. In the light of the diversity and variations across different health care practices, a broader approach and understanding is necessary to understand the impact of these differences. In this thesis, integration is seen from a broader socio-technical perspective, which offers an important foundation for increased cooperation between designers of ICT systems and members of organizations. I illustrate the importance of such cooperation by showing that users may be an unexploited resource in large-scale ICT projects. In some cases, users should be regarded as co-designers of ICT systems

Simplifying Technology. Complex Work Practice

Information Technology (IT) has for several decades been seen to be a key enabler to achieve improved efficiency and quality in work processes, and so also within health care. Thus, even though many parts within the health care sector have high expectations, the desired benefits are not seen to large extent in practice, at least not until present. A lot of the work flows within health care are still paper based. Several authors claim that the mismatch between the goals and the real situations as today might be caused by the fact that social aspects are not included in design to large extent. Implementation processes has had a tendency to be far more technology oriented than social and communication oriented, thus indicating that technological processes rely on technological deterministic views. This thesis applies an implementation process of a new technology called Well Interactor, a system which is developed to let general practitioners choose laboratory services electronically and additionally enables interactive possibilities. The thesis is aimed to show to which extent existing work practices influence on the outcome of the technology. The findings documented are based upon an interpretive case study, including field observations and interviews. A study of 21 interviewed subjects has been carried out. The thesis concludes that existing work practices and existing infrastructures are quite complex. Such complexity makes it difficult to plan the outcome of the technology. It should therefore be seen implicit to map complex work practices before vision of drastic improvements caused by the use of Information Technology is created. The goals must be realistic based on the current situation. Then, both, social and technological aspects should play a role in how technology will and can be used