Theorising big IT programmes in healthcare: strong structuration theory meets actor-network theory

Area of Science:

• Health Informatics
• Sociology of Technology
• Information Systems Research

Background:

• The UK National Health Service faces challenges with large-scale IT modernization programs.
• Existing theoretical frameworks offer limited insight into the complex interplay of technology and human factors in healthcare IT.

Purpose of the Study:

• To develop a robust theoretical perspective on the impact of large IT programs in healthcare modernization.
• To integrate structuration theory and actor-network theory for empirical investigation of healthcare IT initiatives.

Main Methods:

• Adaptation of Strong Structuration Theory (SST) by integrating elements of material interactionism and Actor-Network Theory (ANT).
• Utilizing micro-level data fragments from clinical work to inform the theoretical framework.
• Employing a quadripartite approach to analyze social structures, agent capabilities, agency, and outcomes within socio-technical networks.

Main Results:

• SST, enhanced with ANT, provides a framework to study socio-technical networks where humans and technologies act as 'actants'.
• Technological artifacts possess structurally relevant properties that constrain and enable human agency within social practices.
• The success of healthcare IT programs depends on the dynamic interplay between embedded technological properties and human agents' socio-cultural frames.

Conclusions:

• A combined SST and ANT approach offers a powerful lens for analyzing the macro-, meso-, and micro-level dynamics of healthcare IT modernization.
• Understanding the socio-technical 'actants' and their recursive relationship is crucial for effective implementation and outcomes of healthcare technology programs.
• This theoretical integration facilitates disciplined, empirically grounded research into the complexities of healthcare IT initiatives.