Nurses' Perception of an ERP Implementation Process - Based on a Means-End Chain Approach

No abstractElectronic Patient Record; Implementation Process; Means End Chain Approach; Danish Hospitals

Can We Rely on Electronic Medical Record Systems to Reduce Medication Errors?

Expectations to Electronic Medical Record (EMR) systems in healthcare are high when it comes to reducing medication errors and increasing security in the medication process. Studies show that certain types of medication errors are eliminated when introducing EMRs; however, such systems also entail new types of errors. Based on a study in an orthopedic surgical ward in a medium-sized Danish hospital, we investigate what previous types of errors can be reduced by using the EMRs but also what new types of errors may appear. We zoom in on the process of medicine prescription and focus on what new types of errors appear in the interaction between the doctors and the technology. Identifying and understanding the nature of errors that emerge when doctors use EMRs may enable system developers and implementers to better manage implementation and maintenance of future EMR projects and accordingly set up appropriate strategies to prevent medication errors

Making sense of enterprise systems in institutions: a case study of the re-implementation of an accounting system

Whereas previous research provides a number of accounts of failure prone enterprise system (ES) implementations, empirical evidence of the re-implementation of an accounting system in a Scandinavian high-tech company shows how the system became highly integrated, accepted by its users, and well-aligned to the work processes. To learn from this case study, we investigate the interactive and dynamic relationships among the enterprise system, people and institutional properties. We investigate the institutional structures and the sensemaking processes at play to identify how the idea of an efficient accounting system travelled from a national to a local level, how the system moved from being highly customized to becoming a standard package and how the users’ enactment of the system reinforced existing institutional practices. Based on the findings, we frame our contributions into five lessons learned: (1) An ES implementation entails mutual adaptations between the organization, human actors and enterprise system; (2) “small is beautiful” is almost a truism but may turn out to be an appropriate starting point; (3) a certain level of resilience is essential to cope with future upgrades and enhancements; (4) the recognition of professional identity and roles is vital for ES adaptation; and (5) first customizing and then un-customizing the ES may be a valuable approach towards integrating the system. We relate these lessons to ES adaptations in general in discussing the study’s contributions and implications

Appropriation of Information Systems: Using Cognitive Mapping for Eliciting Users\u27 Sensemaking

This paper explores the use of cognitive mapping for eliciting users\u27 sensemaking during information system (IS) appropriation. Despite the potential usefulness of sensemaking, few studies in IS research use it as a theoretical lens to address IS appropriation. A possible reason for this may be that sensemaking does not easily lend itself to be used in practice. We introduce cognitive mapping as a way to elicit users\u27 sensemaking and illustrate its value by reporting on findings from an empirical study of the introduction of an Electronic Patient Record (EPR) system. The contribution of the paper is threefold: first, our findings demonstrate cognitive mapping\u27s use for eliciting users\u27 sensemaking during IS appropriation. Second, our findings illustrate how cognitive mapping can be used as a dynamic approach facilitating collective negotiation of meaning. Third, we contribute with a thorough discussion of the epistemological and methodological assumptions underlying cognitive mapping to ensure its validity and trustworthiness

Using Existing Response Repertoires to Make Sense of Information System Implementation

The implementation of information systems (IS) in organizations often triggers new situations in which users experience a disruption of existing work patterns and routines. Sensemaking becomes central in making users’ meanings explicit, serving as a foundation for further actions and interactions with the new technology. The purpose of this paper is to study how users make sense of new technologies by building on existing response repertoires. Empirically, we present findings from a study of an Electronic Patient Record (EPR) system implementation in two Danish hospital wards. Our findings illustrate: (1) how doctors’ and nurses’ existing routines are disrupted by the new technology, (2) how identity construction plays an important part in the users’ meaning construction process, and (3) how self-fulfilling prophecies are formed as a natural part of their sensemaking. The study contributes to existing literature by providing a detailed account of how users’ early sensemaking of a technology influences their subsequent actions and reactions towards it. Our findings support managers in understanding users’ perceptions of a new technology, helping them in planning and executing the implementation process

Enterprise System Adaptation: a Combination of Institutional Structures and Sensemaking Processes

In this paper we set out to investigate how an Enterprise System (ES) adaptation in a Scandinavian high-tech organization, SCANDI, can be understood using a combination of institutional and sensemaking theory. Institutional theory is useful in providing an account for the role that the social and historical structures play in ES adaptations, and sensemaking can help us investigate how organizational members make sense of and enact ES in their local context. Based on an analytical framework, where we combine institutional theory and sensemaking theory to provide rich insights into ES adaptation, we show: 1) how changing institutional structures provide a shifting context for the way users make sense of and enact ES, 2) how users’ sensemaking processes of the ES are played out in practice, and 3) how sensemaking reinforces institutional structures

SOCIAL MEDIA IN PATIENTS’ SELF-MANAGEMENT OF CHRONIC DISEASE: THE ROLE OF NURSES AS BOUNDARY SPANNERS

This paper presents research-in-progress of the adoption and use of social media as part of patients’ self-management of their chronic disease. The purpose is to investigate the social and organizational challenges that social media bring to the healthcare setting. We focus on how nurses can act as mediators between the formal healthcare institution and the informal setting in which patients engage via social media. We discuss how the use of social media influences nurses’ professional identity, roles and responsibilities. Preliminary findings and existing literature point to two issues of interest: 1) The inclusion of the informal system of self-management and use of social media into the formal healthcare system and 2) The development of the role of nurses as boundary spanners. We wish to pursue these issues in a three-year research project, conducting in-depth case studies in 10 General Practices to investigate the collaborative partnership between patients and nurses

NATIONAL INITIATIVES TO BUILD HEALTHCARE INFORMATION INFRASTRUCTURES

Significant sums of money are invested in information systems (IS) initiatives in the healthcare sector all over the world. Most countries have implemented Electronic Patient Record (EPR) systems, which are clinical IS that support documentation of examination, treatment, and care of patients. EPR systems are expected to raise the quality of care, reduce medical errors, cut waiting time and render the operation of healthcare more effective. Many of the expected benefits from EPR systems hinge on their ability to facilitate information sharing between healthcare providers. Consequently, many governments and healthcare providers have formulated national strategies to achieve a fully integrated information infrastructure building on interoperable EPR systems. In this paper we describe how the health authorities in Denmark have attempted to achieve interoperability through standardization of EPR systems in the so-called B-EPR initiative (i.e. Basic Structure for EPR).The initiative eventually failed and we argue that the main reason for this was too high ambitions along three dimensions: the geographical reach, the functional scope, and the temporal span. We argue that a critical look at the ambition level and associated strategies may contribute to formulating more modest targets. It is worthwhile to focus on defining strategies that specify how small and manageable initiatives can be extended and built on

Debating Sociomateriality: Entanglements, imbrications, disentangling, and agential cuts

Sociomateriality is on everyone\u27s lips these days. Since Orlikowski (2006; 2007; 2009), together with Scott (Orlikowski and Scott 2008; Scott and Orlikowski 2009) first introduced this term in organisation studies and in information systems (IS) research, we count an impressive number of contributions on this topic along with calls for papers in renowned journals and conferences. Without going so far as to propose sociomateriality as the defining identity of the IS field, as suggested by Hassan and Hovorka (2011), we acknowledge that this new lens offers a way of challenging and expanding the prevailing modus operandi of the theoretical foundations of the relationships between artefacts and agency, technology and practice. This is well expressed by Cecez-Kecmanovic et al. (2010) who argue that sociomateriality can help us question and rethink \u27the supposed ontological separation among the social and the technological.\u2