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Using Structuration Theory to Assist in Understanding the Implementation and Adoption of Health Information Systems

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Theories to Inform Superior Health Informatics Research and Practice

Part of the book series: Healthcare Delivery in the Information Age ((Healthcare Delivery Inform. Age))

Abstract

Successful adoption and implementation of health information systems (HIS) has been the subject of extensive research as can be evidenced by the large body of recent research literature on this topic. Most scholars agree that these solutions are complex to understand and should be analysed under the lens of theoretically informed analytical tools. One approach identified in the literature used to facilitate correct and accurate capturing of the complexities and levels of interactions in healthcare operations and technologies is to use structuration theory (ST). To demonstrate the benefits and strengths of using ST, this chapter evaluates the merits of an ST analysis for the implementation and adoption of health information systems (HIS).

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References

  • Aaronson, J. W., Murphy-Cullen, C. L., Chop, W. M., & Frey, R. D. (2001). Electronic medical records: The family practice resident perspective. Family Medicine, 33(2), 128–132.

    PubMed  CAS  Google Scholar 

  • Aarts, J., Doorewaard, H., & Berg, M. (2004). Understanding implementation: The case of a computerized physician order entry system in a large Dutch University Medical Center. Journal of the American Medical Informatics Association, 11, 207–216.

    Article  PubMed  PubMed Central  Google Scholar 

  • Aarts, J., & Koppel, R. (2009). Implementation of computerized physician order entry in seven countries. Health Affairs (Project Hope), 28(2), 404–414.

    Article  Google Scholar 

  • Abbott, T. (2005). The adoption of eHealth in Australia. In The Health Informatics Conference Melbourne 2005. Melbourne.

    Google Scholar 

  • Agarwal, R., & Prasad, J. (1997). The role of innovation characteristics and perceived voluntariness in the acceptance of information technologies. Decision Sciences, 28(3), 557–582.

    Article  Google Scholar 

  • Altman, R. B. (1997). Informatics in the care of patients: Ten notable challenges. The Western Journal of Medicine, 166(2), 118–122.

    Google Scholar 

  • Al-Azmi, S., Al-Enezi, N., & Chowdhury, R. (2009). Users’ attitudes to an electronic medical record system and its correlates: A multivariate analysis. Health Information Management Journal, 38(2), 33–40.

    Article  PubMed  Google Scholar 

  • Ammenwerth, E., Iller, C., & Mahler, C. (2006). IT-adoption and the interaction of task, technology and individuals: A fit framework and a case study. BMC Medical Informatics and Decision Making, 6, 3.

    Article  PubMed  PubMed Central  Google Scholar 

  • André, B., Ringdal, G. I., Loge, J. H., Rannestad, T., Laerum, H., & Kaasa, S. (2008). Experiences with the implementation of computerized tools in health care units: A review article. International Journal of Human–Computer Interaction, 24(8), 753–775.

    Article  Google Scholar 

  • Ash, J. S., Sittig, D. F., Campbell, E., Guappone, K., & Dykstra, R. (2006). An unintended consequence of CPOE implementation: Shifts in power, control, and autonomy. In AMIA Annual Symposium Proceedings (Vol. 2006, p. 11).

    Google Scholar 

  • Ashish, K. (2009). Use of electronic health records in U. S Hospitals Medical Benefits. https://doi.org/101056NEJMsa0900592, 25(10 SRC–GoogleScholar), 4–9.

  • Atkinson, C., Eldabi, T., Paul, R., & Pouloudi, A. (2001). Investigating integrated socio-technical approaches to health informatics (p. 10–pp SRC–GoogleScholar)

    Google Scholar 

  • Avgerou, C. (2008). Information systems in developing countries: A critical research review. Journal of Information Technology, 23, 133–146.

    Article  Google Scholar 

  • Bahensky, J. A., Jaana, M., & Ward, M. M. (2008). Health care information technology in rural America: Electronic medical record adoption status in meeting the national agenda. The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association, 24(2), 101–105.

    Article  Google Scholar 

  • Barker, C. (2011). Cultural Studies: Theory and Practice (Fourth Edition edition). London: SAGE Publications Ltd.

    Google Scholar 

  • Basch, P. (2005). Electronic health records and the national health information network: Affordable, adoptable, and ready for prime time? Annals of Internal Medicine, 143(3), 227–228.

    Article  PubMed  Google Scholar 

  • Bates, D. W. (2005). Physicians and ambulatory electronic health records. Health Affairs, 24, 1180–1189.

    Article  PubMed  Google Scholar 

  • Bath, P. (2008). Health informatics: Current issues and challenges. Journal of Information Science, 34(4), 501.

    Article  Google Scholar 

  • Bernstein, M. L., McCreless, T., & Côté, M. J. (2007). Five constants of information technology adoption in healthcare. Hospital Topics, 85(1), 17–25.

    Article  PubMed  Google Scholar 

  • Boonstra, A., & Broekhuis, M. (2010). Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Services Research, 10(1), 231.

    Article  PubMed  PubMed Central  Google Scholar 

  • Car, J., Anandan, C., Black, A., Cresswell, K., Pagliari, C., McKinstry, B., et al. (2008). The impact of eHealth on the quality & safety of healthcare: A systematic overview and synthesis of the literature, report, NHS Connecting for Health Evaluation Programme.

    Google Scholar 

  • Cash, J. (2008). Technology can make or break the hospital-physician relationship. Healthcare Financial Management : Journal of the Healthcare Financial Management Association, 62(12), 104–109.

    Google Scholar 

  • Catwell, L., & Sheikh, A. (2009). Evaluating eHealth interventions: The need for continuous systemic evaluation. PLoS Medicine, 6(8), e1000126. https://doi.org/10.1371/journal.pmed.1000126

  • Cohn, K., Berman, J., Chaiken, B., Green, D., Green, M., Morrison, D., et al. (2009). Engaging physicians to adopt healthcare information technology. Journal of Healthcare Management/American College of Healthcare Executives, 54(5), 291.

    PubMed  Google Scholar 

  • Coiera, E. (2004). Four rules for the reinvention of health care. British Medical Journal, 328(7449), 1197–1199.

    Article  PubMed  Google Scholar 

  • Coiera, E. (2011). Do we need a national electronic summary care record? The Medical Journal of Australia, 194(2), 90–92.

    Google Scholar 

  • Cresswell, K., Worth, A., & Sheikh, A. (2011). Implementing and adopting electronic health record systems: How actor-network theory can support evaluation. Clinical Governance: An International Journal, 16(4), 320–336.

    Article  Google Scholar 

  • Cresswell, K. M., Worth, A., & Sheikh, A. (2010). Actor-network theory and its role in understanding the implementation of information technology developments in healthcare. BMC Medical Informatics and Decision Making, 10, 67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Culnan, M., & Armstrong, P. K. (1997). Information privacy concerns, procedural fairness and impersonal trust: An empirical investigation. Available at: http://citeseer.ist.psu.edu/viewdoc/summary?doi=10.1.1.40.5243

  • Dansky, K. H., Gamm, L. D., Vasey, J. J., & Barsukiewicz, C. K. (1999). Electronic medical records: are physicians ready? J Healthc Manag, 44(6), 440–454.

    Google Scholar 

  • Davidson, E., & Heslinga, D. (2007). Bridging the IT – Adoption Gap for Small Physician Practices: An Action Research Study on Electronic Health Records. Information Systems Management, 24(1), 15.

    Google Scholar 

  • DePhillips, H. A. (2007). Initiatives and barriers to adopting health information technology: A US perspective. Disease Management and Health Outcomes, 15(1), 1–6. Available at: http://ideas.repec.org/a/wkh/dmhout/v15y2007i1p1-6.html. Accessed September 27, 2011.

  • DesRoches, C. M., Campbell, E. G., Rao, S. R., Donelan, K., Ferris, T. G., Jha, A., et al. (2008). Electronic health records in ambulatory care – A national survey of physicians. New England Journal of Medicine, 359(1), 50–60. https://doi.org/10.1056/NEJMsa0802005

  • Elrod, J., & Androwich, I. M. (2009). Applying human factors analysis to the design of the electronic health record. Studies in Health Technology and Informatics, 146, 132–136.

    PubMed  Google Scholar 

  • Fichman, R. G., Kohli, R., & Krishnan, R. (2011). Editorial overview—the role of information systems in healthcare: Current research and future trends. Information Systems Research, 22(3), 419–428. https://doi.org/10.1287/isre.1110.0382

  • Frame, J., Watson, J., & Thomson, K. (2008). Deploying a culture change programme management approach in support of information and communication technology developments in Greater Glasgow NHS Board. Health Informatics Journal, 14(2), 125–139.

    Article  PubMed  Google Scholar 

  • Gaylin, D., Goldman, S., Ketchel, A., Moiduddin, A., & Chicago, I. (2005). Community Health Center Information Systems Assessment: Issues and Opportunities Final Report (p. 125). NORC at the University of Chicago. Retrieved from http://aspe.hhs.gov/sp/chc

  • Giddens, A. (2013). The Constitution of Society: Outline of the Theory of Structuration. John Wiley & Sons.

    Google Scholar 

  • Goldstein, M. M., & Blumenthal, D. (2008). Building an information technology infrastructure. The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics, 36(4), 709–715, 609.

    Google Scholar 

  • Greenhalgh, T., & Stones, R. (2010). Theorising big IT programmes in healthcare: Strong structuration theory meets actor-network theory. Social Science & Medicine (1982), 70(9), 1285–1294.

    Article  Google Scholar 

  • Hanseth, O., & Monteiro, E. (1998). Understanding information infrastructure. Unpublished Book, http://Heim.Ifi.Uio.No/∼Oleha/Publications/Bok. Html. Retrieved from http://heim.ifi.uio.no/oleha/Publications/bok.pdf

  • Hanseth, O., Aanestad, M., & Berg, M. (2004). Guest editors’ introduction: Actor-network theory and information systems. What’s so special? Information Technology & People, 17(2), 116–123.

    Google Scholar 

  • Hennington, A. H., & Janz, B., (2007). Information systems and healthcare XVI: Physician adoption of electronic medical records: Applying the UTAUT model in a healthcare context. Communications of the Association for Information Systems, 19(1), 5.

    Google Scholar 

  • HFMA. (2006). Overcoming barriers to electronic health record adoption: Results of survey and roundtable discussions conducted by the Healthcare Financial Management Association. Available at: http://mhcc.maryland.gov/electronichealth/mhitr/EHR%20Links/overcoming_barriers_to_ehr_adoption.pdf. Accessed October 4, 2011.

  • Hikmet, N., Bhattacherjee, A., Menachemi, N., Kayhan, V. O., & Brooks, R. G. (2008). The role of organizational factors in the adoption of healthcare information technology in Florida hospitals. Health Care Management Science, 11(1), 1–9.

    Google Scholar 

  • Hoffinan, L. (2009). Implementing electronic medical records. Communications of the ACM, 52(11), 18–20. https://doi.org/10.1145/1592761.1592770

  • Hoffinan, S., & Podguski, A. (2008). Finding a cure: The case for regulation and oversight of electronic health record systems. Harv. JL & Tech., 22, 103.

    Google Scholar 

  • Hovenga, E. J. S., Kidd, M. R., Garde, S., & Cossio, C. H. L. (2010). Health Informatics: An Overview (1 edition). Amsterdam; Washington, DC: IOS Press.

    Google Scholar 

  • Huang, Z., & Palvia, P. (2001). ERP implementation issues in advanced and developing countries. Business Process Management Journal, 7(3), 276–284. https://doi.org/10.1108/14637150110392773.

    Article  Google Scholar 

  • Kaplan, B., & Harris-Salamone, K. D. (2009). Health IT success and failure: Recommendations from literature and an AMIA workshop. Journal of the American Medical Informatics Association, 16(3), 291–299.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kennedy, B. L. (2011). Exploring the sustainment of health information technology: Successful practices for addressing human factors. Northcentral University.

    Google Scholar 

  • Kimaro, H., & Nhampossa, J. (2004). The challenges of sustainability of health information systems in developing countries: Comparative case studies of Mozambique and Tanzania 1(1), 1–10.

    Google Scholar 

  • Kralewski, J., Dowd, B. E., Zink, T., & Gans, D. N. (2010). Preparing your practice for the adoption and implementation of electronic health records. Physician Executive, 36(2), 30–33.

    PubMed  Google Scholar 

  • Kukafka, R., Johnson, S. B., Linfante, A., & Allegrante, J. P. (2003). Grounding a new information technology implementation framework in behavioral science: A systematic analysis of the literature on IT use. Journal of Biomedical Informatics, 36(3), 218–227.

    Google Scholar 

  • Latour, B. (2003). Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford: University Press.

    Google Scholar 

  • Latour, B. (2005). Reassembling the social: An introduction to actor-network theory. Oxford: Oxford University Press.

    Google Scholar 

  • Latour, B., Harbers, H., & Koenis, S. (1996). On actor-network theory: A few clarifications. London: Academic Press.

    Google Scholar 

  • Law, J., & Hassard, J. (1999). Actor network theory and after. Wiley-Blackwell.

    Google Scholar 

  • Law, J., & Hassard, J. (2004). Actor-network theory and after. Wiley-Blackwell.

    Google Scholar 

  • Leykum, L. K., Pugh, J. A., Lanham, H. J., Harmon, J., & McDaniel, R. R. (2009). Implementation research design: integrating participatory action research into randomized controlled trials. Implementation Science: IS, 4, 69–69. https://doi.org/10.1186/1748-5908-4-69

  • Liu, L. S., Shih, P. C., & Hayes, G. R. (2011). Barriers to the adoption and use of personal health record systems. In Proceedings of the 2011 iConference, pp. 363–370.

    Google Scholar 

  • Lorenzi, N., Kouroubali, A., Detmer, D. E., & Bloomrosen, M. (2009). How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings. BMC Medical Informatics and Decision Making, 9, 15.

    Article  PubMed  PubMed Central  Google Scholar 

  • McLean, C., & Hassard, J. (2004). Symmetrical absence/symmetrical absurdity: Critical notes on the production of actor-network accounts. Journal of Management Studies, 41(3), 493–519. https://doi.org/10.1111/j.1467-6486.2004.00442.x

  • McPhee, R. D., & Poole, M. S. (2001). Organizational structures and configurations. In The new handbook of organizational communication: Advances in theory, research and methods (pp. 503–543).

    Google Scholar 

  • McReavy, D., Toth, L., Tremonti, C., & Yoder, C. (2009). The CFO’s role in implementing EHR systems: The experiences of a Florida health system point to 10 actions that can help CFOs manage the revenue risks and opportunities of implementing an electronic health record. Retrieved December 16, 2011, from http://findarticles.com/p/articles/mi_m3257/is_6_63/ai_n35529545/

  • Mitchell, V., & Nault, B. (2008). The emergence of functional knowledge in sociotechnical systems. https://pdfs.semanticscholar.org/5c3a/a7d7d20309ce9dc9572aa41915436ad31219.pdf

  • Mort, M., Finch, T., & May, C. (2009). Making and unmaking telepatients: Identity and governance in new health technologies. Science, Technology & Human Values, 34(1), 9–33.

    Article  Google Scholar 

  • Muhammad, I., Teoh, S. Y., & Wickramasinghe, N. (2012). Why Using Actor-Network Theory (ANT) Can Help to Understand the Personally Controlled Electronic Health Record (PCEHR) in Australia. International Journal of Actor-Network Theory and Technological Innovation (IJANTTI), 4(2), 44–60.

    Google Scholar 

  • Parente, S., & McCullough (2009). Health information technology and patient safety: evidence from panel data. Health Affairs, 28(2). https://doi.org/10.1377/hlthaff.28.2.357, Accessed on Apr 10 2018.

  • Personally Controlled Electronic Health Record Act (2012).

    Google Scholar 

  • Protti, D., & Smit, C. (2006). The Netherlands: Another European country where GPs have been using EMRs for over twenty years. Healthcare Information Management & Communications, 30(3). Available at: http://www.healthcareimc.com/bcovers/PDFS/TheNetherlands.pdf

  • Protti, D., Johansen, I., & Perez-Torres, F. (2009). Comparing the application of Health Information Technology in primary care in Denmark and Andalucía, Spain. International Journal of Medical Informatics, 78(4), 270–283. https://doi.org/10.1016/j.ijmedinf.2008.08.002

  • Rosebaugh, D. (2004). Getting ready for the software in your future. Home Health Care Management Practice, 16(3), 228–234. https://doi.org/1011771084822303259877

  • Rosenbloom, S. T., Qi, X., Riddle, W. R., Russell, W. E., DonLevy, S. C., Giuse, D., et al. (2006). Implementing pediatric growth charts into an electronic health record system. Journal of the American Medical Informatics Association, 13, 302–308.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ross, S. E., Schilling, L. M., Fernald, D. H., Davidson, A. J., & West, D. R. (2010). Health information exchange in small-to-medium sized family medicine practices: Motivators, barriers, and potential facilitators of adoption. International Journal of Medical Informatics, 79(2), 123–129. https://doi.org/10.1016/j.ijmedinf.2009.12.001

  • Rydin, Y. (2010). Actor-network theory and planning theory: A response to Boelens. Planning Theory, 9, 265–268.

    Article  Google Scholar 

  • Scott, J. T., Rundall, T. G., Vogt, T. M., & Hsu, J. (2005). Kaiser Permanente’s experience of implementing an electronic medical record: a qualitative study. BMJ (Clinical Research Ed.), 331(7528), 1313–1316.

    Google Scholar 

  • Shaban, R. (2005). Theories of clinical judgment and decision-making: A review of the theoretical literature. Australasian Journal of Paramedicine, 3(1). Retrieved from https://ajp.paramedics.org/index.php/ajp/article/view/308

  • Sharma, R., Southon, G., & Yetton, P. (1999). Successful IS innovation: the contingent contributions of innovation characteristics and implementation process. Journal of Information Technology, 14(1), 53–68. https://doi.org/10.1080/026839699344746

  • Showell, C. M. (2011). Citizens, patients and policy: A challenge for Australia’s national electronic health record. Health Information Management Journal OnLine, 40(2), 39–43.

    Article  Google Scholar 

  • Staples, W. G. (2007). Encyclopedia of Privacy: A-M. Greenwood Publishing Group.

    Google Scholar 

  • Tang, P. C., Ash, J. S., Bates, D. W., Overhage, J. M., & Sands, D. Z. (2006). Personal health records: Definitions, benefits, and strategies for overcoming barriers to adoption. Journal of the American Medical Informatics Association: JAMIA, 13(2), 121–126. https://doi.org/10.1197/jamia.M2025

  • Thompson, R., Compeau, D., Higgins, C., & Lupton, N. (2008). Intentions to use information technologies: An integrative model.

    Google Scholar 

  • Thweatt, E. G., & Kleiner, B. H. (2007). New developments in health care organisational management. Journal of Health Management, 9(3), 433–441.

    Article  Google Scholar 

  • Timpka, T., BÃ¥ng, M., Delbanco, T., & Walker, J. (2007). Information infrastructure for inter-organizational mental health services: An actor network theory analysis of psychiatric rehabilitation. Journal of Biomedical Informatics, 40(4), 429–437.

    Article  PubMed  Google Scholar 

  • Tobler, N. (2008). Technology, organizational change, and the nonhuman agent: Exploratory analysis of electronic health record implementation in a small practice ambulatory care. Utah: The University of Utah.

    Google Scholar 

  • Torda, P., Han, E. S., & Scholle, S. H. (2010). Easing the adoption and use of electronic health records in small practices. Health Affairs (Project Hope), 29(4), 668–675.

    Article  Google Scholar 

  • Trudel, M. C. (2010). Challenges to personal information sharing in interorganizational settings: Learning from the Quebec Health Smart Card project. London: The University of Western Ontario.

    Google Scholar 

  • Vitacca, M., Mazzù, M., & Scalvini, S. (2009). Socio-technical and organizational challenges to wider e-Health implementation. Chronic Respiratory Disease, 6(2), 91–97.

    Article  CAS  PubMed  Google Scholar 

  • Walsham, G. (1997). Actor-network theory and IS research: Current status and future prospects. In Information Systems and Qualitative Research: Proceedings of the IFIP TC8 WG 8.2 International Conference on Information Systems and Qualitative Research, 31st May–3rd June 1997, Philadelphia, Pennsylvania, USA (pp. 466–481).

    Google Scholar 

  • Weimar, C. (2009). Electronic health care advances, physician frustration grows. Physician Executive, 35(2), 8–15.

    PubMed  Google Scholar 

  • Wickramasinghe, N., & Bali, R. K. (2009). The S’ANT imperative for realizing the vision of healthcare network centric operations. International Journal of ActorNetwork Theory and Technological Innovation IJANTTI, 1(1), 45–58.

    Article  Google Scholar 

  • Wickramasinghe, N., & Schaffer, J. (2010). Realizing value driven e-Health solutions. Washington DC: IBM Centre for the Business of government.

    Google Scholar 

  • Williams-Jones, B., & Graham, J. E. (2003). Actor-network theory: a tool to support ethical analysis of commercial genetic testing. New Genetics and Society, 22(3), 271–296.

    Google Scholar 

  • Yusof, M., Stergioulas, L., & Zugic, J. (2007). Health information systems adoption: Findings from a systematic review. Studies in Health Technology and Informatics, 129(Pt 1), 262.

    Google Scholar 

  • Yusof, M. M., Papazafeiropoulou, A., Paul, R. J., & Stergioulas, L. K. (2008). Investigating evaluation frameworks for health information systems. International Journal of Medical Informatics, 77(6), 377–385. https://doi.org/10.1016/j.ijmedinf.2007.08.004

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Authors and Affiliations

  1. Deakin University, Burwood, VIC, Australia

    Imran Muhammad & Nilmini Wickramasinghe

  2. Epworth HealthCare, Richmond, VIC, Australia

    Imran Muhammad & Nilmini Wickramasinghe

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  1. Imran Muhammad
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Editors and Affiliations

  1. Epworth HealthCare, Richmond, Victoria, Australia

    Nilmini Wickramasinghe

  2. Deakin University, Burwood, Australia

    Jonathan L. Schaffer

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Muhammad, I., Wickramasinghe, N. (2018). Using Structuration Theory to Assist in Understanding the Implementation and Adoption of Health Information Systems. In: Wickramasinghe, N., Schaffer, J. (eds) Theories to Inform Superior Health Informatics Research and Practice. Healthcare Delivery in the Information Age. Springer, Cham. https://doi.org/10.1007/978-3-319-72287-0_13

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