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Talking Past Each Other

A Discursive Approach to the Formation of Societal-Level Information Pathologies in the Context of the Electronic Health Card in Germany

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Abstract

An explorative case study is used to investigate the formation of information pathologies on the societal level. The paper conceptualizes these particular information pathologies as ‘interaction-related information pathologies’ (Picot et al., Information, organization and management. Springer, Berlin, 2008) and proposes that the production of information by multiple stakeholders leads to ‘distortions’ (Cukier et al., Inf Syst J 19(2):175–196, 2009) on the societal level. This broad proposition is then explored by means of a qualitative case study of the media coverage surrounding the implementation of the ‘Electronic Health Card’ in Germany. Based on that study, the initial proposition is further specified by conceptualizing how a process of path constitution ‘distorts’ a debate from being about legitimacy of an ICT innovation to being about illegitimacy of stakeholders.

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Notes

  1. This number was reported by the ‘GKV-Spitzenverband’ on June 1st 2016.

  2. A ‘discursive approach’ is a wider term than ‘discourse analysis.’ We opted for ‘discursive approach’ because it is not as strictly linked to certain theoretical traditions as ‘discourse analysis’ is (Talja and McKenzie 2007). Our intent is to use a ‘discursive approach’ as analytical tool and less as theoretical perspective in its own right. Yet, both are generally possible in the context of discursive studies (for overviews see, e.g., Phillips and Hardy 2002; Talja and McKenzie 2007).

  3. The ‘e-prescription’ was considered a core functionality of EHC. Initially, it was planned that doctors could issue a prescription by storing it on a server from where a pharmacists would be able to retrieve it. The ‘e-prescription’ was tested in EHC field tests in 2006/2007.

  4. Consistent with Constantinides and Barrett (2015, p. 4), we acknowledge that legitimacy is a key concept in institutional theory but we do not intend to deploy institutional theory in our own study. This is appropriate because legitimacy is also used in many other contexts (see, e.g, the review in Suchman 1995).

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Acknowledgements

We thank the special issue editors and two anonymous reviewers for their tremendous help during the review process. Leonhard Dobusch, Daniel Fuerstenau, Nora Lohmeyer, Hannes Rothe, Hannes Schlieter, Karl-Werner Ratschko and further colleagues provided thoughtful feedback on earlier drafts. Anna Hutfils and Mona Timmermann assisted in data collection. Funding for Lauri Wessel and his research group ‘Health-IT and Business Model Innovation’ is provided by the ‘Excellence Initiative II’ and supported by the Focus Area ‘DynAge.’

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Wessel, L., Gersch, M. & Harloff, E. Talking Past Each Other. Bus Inf Syst Eng 59, 23–40 (2017). https://doi.org/10.1007/s12599-016-0462-0

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