Pilot Implementation of Health Information Systems: Issues and Challenges

Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare information system. Based on the findings from this study, we identify three main challenges: (1) defining an appropriate scope for pilot implementation, (2) managing the implementation process, and (3) ensuring commitment to the pilot. Finally, recommendations for future research and implications for practice are provided

When Systems Lose Their Identity

This paper reports a longitudinal study of the design and implementation of a Web-based groupware application. We studied the development of three versions of the application, and the preliminary discussions of the forth. We adopt a sensemaking perspective to analyze the dynamics of this process and show that improvisational action and bricolage (make do with the materials at hand) played a vital role in the development process, successfully within a small group of people, but less so when more, distributed people became involved. The paper introduces the problem of distributed sensemaking in IS development

Technology-Use Mediation:Making Sense of Electronic Communication in an Organizational Context

Abstract. Implementation of new computer-mediated communication (CMC) systems in organizations is a complex socio-technical endeavour, involving the mutual adaptation of technology and organization over time. Drawing on the analytic concept of sensemaking, this paper provides a theoretical perspective that deepens our understanding of how organizations appropriate new electronic communication media. The paper analyzes how a group of mediators in a large, multinational company adapted a new web-based CMC technology (a virtual workspace) to the local organizational context (and vice versa) by modifying features of the technology, providing ongoing support for users, and promoting appropriate conventions of use. We found that these mediators exerted considerable influence on how the technology was established and used in the organization. The mediators were not neutral facilitators of a well-defined technology that presented itself to them as given and fixed. On the contrary, the new technology was from the onset highly equivocal and open-ended, and the mediators were actively involved in creating the technology-in-practice—by making sense of it, defining it, and regulating its use. Implications for further research and for practice are considered