The evolution of affordances in the Electronic Health Record: understanding the tool’s structure
Keywords:
SIH, misfit, affordance, conception, transformationAbstract
This article looks at the Electronic Health Record (EHR), a core module of the healthcare information system (HIS), to understand how the affordances of the technological tool emerge and can evolve to meet user needs. The case study data is collected from change agents in a university hospital using grounded theory and then coded. Our results analyze the design choices made for the EHR (its structure) to describe the potentialities offered by these design choices (affordances) and the actual use made of these potentialities by users (affordance actualizations). Our contribution to the literature on affordances distinguishes three types of structure within the tool (resulting from technical, legal or organizational design factors). The structure provides a new understanding of how affordances evolve and are updated. From a managerial point of view, these contributions enable the project team to better analyze its interventions on the tool’s structure, leading to changes in the potentialities offered to users.
References
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, vol. 11, n°3, p.p. 207‑216.
Adler P.S. & Borys B. (1996), "Two types of bureaucracy: enabling and coercive", Administrative science quarterly, p.p. 61‑89.
Alter S. (2014), "Theory of workarounds", Communications of the Association for Information Systems, vol. 34, n°55, p.p. 1041‑1067.
Anderson C. & Robey D. (2017), "Affordance potency: explaining the actualization of technology affordances", Information and Organization, vol. 27, n°2, p.p. 100‑115.
Ash J.S., Sittig D.F., Dykstra R., Campbell E. & Guappone K. (2007), "Exploring the unintended consequences of computerized physician order entry", Studies in health technology and informatics, vol. 129, n°1, p.p. 198.
Bagayogo F.F., Lapointe L. & Bassellier G. (2014), "Enhanced use of it: a new perspective on post-adoption", Journal of the Association for Information Systems, vol. 15, n°7, p.p. 361‑387.
Bates D.W. (2007), "Preventing medication errors: a summary", American Journal of Health-System Pharmacy, vol. 64, n°14_Supplement_9, p.p. S3‑S9.
Beaudry A., Vaghefi I., Bagayogo F. & Lapointe L. (2020), "Impact of its user behavior: observations through a new lens", Communications of the Association for Information systems, vol. 46, n°1, p.p. 15.
van Beijsterveld J.A.A. & van Groenendaal W.J.H. (2016), "Solving misfits in erp implementations by smes: misfit identification", Information Systems Journal, vol. 26, n°4, p.p. 369‑393.
Besson P. & Rowe F. (2012), "Strategizing information systems-enabled organizational transformation: a transdisciplinary review and new directions", The Journal of Strategic Information Systems, vol. 21, n°2, p.p. 103‑124.
Birks D.F., Fernandez W., Levina N. & Nasirin S. (2013), "Grounded theory method in information systems research: its nature, diversity and opportunities", European Journal of Information Systems, vol. 22, n°1, p.p. 1‑8.
Black A.D. et al. (2011), "The impact of ehealth on the quality and safety of health care: a systematic overview"B. Djulbegovic, éd., PLoS Medicine, vol. 8, n°1, p.p. e1000387.
Boonstra A. & Govers M.J.G. (2009), "Understanding erp system implementation in a hospital by analysing stakeholders", New Technology, Work and Employment, vol. 24, n°2, p.p. 177‑193.
Boonstra A., Versluis A. & Vos J.F. (2014), "Implementing electronic health records in hospitals: a systematic literature review", BMC health services research, vol. 14, n°1, p.p. 1‑24.
Brehm L., Heinzl A. & Markus M.L. (2001), "Tailoring erp systems: a spectrum of choices and their implications". In System Sciences, 2001. Proceedings of the 34th Annual Hawaii International Conference on. IEEE, p. 9-pp.
Burton-Jones A. & Grange C. (2012), "From use to effective use: a representation theory perspective", Information Systems Research, vol. 24, n°3, p.p. 632‑658.
Charpiat B. et al. (2018), "Problèmes rencontrés par les pharmaciens des établissements de santé avec les systèmes d’information hospitaliers : analyse des échanges opérés au sein de réseaux sociaux". In Annales Pharmaceutiques Françaises. Elsevier, p. 368‑381.
Conger J.A. & Kanungo R.N. (1988), "The empowerment process: integrating theory and practice", Academy of management review, vol. 13, n°3, p.p. 471‑482.
Corbin J. & Strauss A. (2014), Basics of qualitative research: Techniques and procedures for developing grounded theory, Sage publications.
Cresswell K. & Sheikh A. (2013), "Organizational issues in the implementation and adoption of health information technology innovations: an interpretative review", International journal of medical informatics, vol. 82, n°5, p.p. e73‑e86.
Cresswell K.M., Mozaffar H., Lee L., Williams R. & Sheikh A. (2017), "Workarounds to hospital electronic prescribing systems: a qualitative study in english hospitals", BMJ quality & safety, vol. 26, n°7, p.p. 542‑551.
Cutler D.M., Feldman N.E. & Horwitz J.R. (2005), "US adoption of computerized physician order entry systems", Health Affairs, vol. 24, n°6, p.p. 1654‑1663.
Davenport T.H. (2000), "The future of enterprise system-enabled organizations", Information Systems Frontiers, vol. 2, n°2, p.p. 163‑180.
David M. (2015), "La contribution des différents types d’agents à un usage performant d’un plms:", Systèmes d’information & management, vol. Volume 19, n°4, p.p. 89‑126.
DeSanctis G. & Poole M.S. (1994), "Capturing the complexity in advanced technology use: adaptive structuration theory", Organization science, vol. 5, n°2, p.p. 121‑147.
Devaraj S. & Kohli R. (2000), "Information technology payoff in the health-care industry: a longitudinal study", Journal of management information systems, vol. 16, n°4, p.p. 41‑67.
Devaraj S. & Kohli R. (2003), "Performance impacts of information technology: is actual usage the missing link?", Management science, vol. 49, n°3, p.p. 273‑289.
Devaraj S., Ow T.T. & Kohli R. (2013), "Examining the impact of information technology and patient flow on healthcare performance: a theory of swift and even flow (tsef) perspective", Journal of Operations Management, vol. 31, n°4, p.p. 181‑192.
Doolan D.F. & Bates D.W. (2002), "Computerized physician order entry systems in hospitals: mandates and incentives", Health affairs, vol. 21, n°4, p.p. 180‑188.
Elmes M.B., Strong D.M. & Volkoff O. (2005), "Panoptic empowerment and reflective conformity in enterprise systems-enabled organizations", Information and Organization, vol. 15, n°1, p.p. 1‑37.
Ferneley E.H. & Sobreperez P. (2006), "Resist, comply or workaround? an examination of different facets of user engagement with information systems", European Journal of Information Systems, vol. 15, n°4, p.p. 345‑356.
Flamholtz E.G., Das T.K. & Tsui A.S. (1985), "Toward an integrative framework of organizational control", Accounting, organizations and society, vol. 10, n°1, p.p. 35‑50.
Gagnon M.P., Orruño E., Asua J., Abdeljelil A.B. & Emparanza J. (2012), "Using a modified technology acceptance model to evaluate healthcare professionals’ adoption of a new telemonitoring system", Telemedicine and e-Health, vol. 18, n°1, p.p. 54‑59.
Garg A.X. et al. (2005), "Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review", Jama, vol. 293, n°10, p.p. 1223‑1238.
Gebauer J., Shaw M.J. & Gribbins M.L. (2010), "Task-technology fit for mobile information systems", Journal of Information Technology, vol. 25, n°3, p.p. 259‑272.
Goodhue D.L. (1998), "Development and measurement validity of a task-technology fit instrument for user evaluations of information system", Decision Sciences, vol. 29, n°1, p.p. 105‑138.
Goodhue D.L. (1995), "Understanding user evaluations of information systems", Management science, vol. 41, n°12, p.p. 1827‑1844.
Grosjean S. & Bonneville L. (2007), "Logiques d’implantation des tic dans le secteur de la santé", Revue française de gestion, , n°172, p.p. 145‑157.
Habib J., Béjean M. & Dumond J.-P. (2017), "Appréhender les transformations organisationnelles de la santé numérique à partir des perceptions des acteurs", Systèmes d’information & management, vol. 22, n°1, p.p. 39.
Hillestad R. et al. (2005), "Can electronic medical record systems transform health care? potential health benefits, savings, and costs", Health affairs, vol. 24, n°5, p.p. 1103‑1117.
Holden R.J. (2011), "What stands in the way of technology-mediated patient safety improvements? a study of facilitators and barriers to physicians’ use of electronic health records", Journal of patient safety, vol. 7, n°4, p.p. 193.
Hustad E., Haddara M. & Kalvenes B. (2016), "ERP and organizational misfits: an erp customization journey", Procedia Computer Science, vol. 100, n°Supplement C, p.p. 429‑439.
Kuperman G.J. et al. (2007), "Medication-related clinical decision support in computerized provider order entry systems: a review", Journal of the American Medical Informatics Association, vol. 14, n°1, p.p. 29‑40.
Leonardi P.M. (2007), "Activating the informational capabilities of information technology for organizational change", Organization science, vol. 18, n°5, p.p. 813‑831.
Leonardi P.M. (2011), "When flexible routines meet flexible technologies: affordance, constraint, and the imbrication of human and material agencies", MIS quarterly, vol. 35, n°1, p.p. 147‑167.
Malaurent J. & Karanasios S. (2020), "Learning from workaround practices: the challenge of enterprise system implementations in multinational corporations", Information Systems Journal, vol. 30, n°4, p.p. 639‑663.
Matavire R. & Brown I. (2013), "Profiling grounded theory approaches in information systems research", European Journal of Information Systems, vol. 22, n°1, p.p. 119‑129.
Minvielle É. & Sicotte C. (2018), "La quête de rationalité: le cas de la standardisation de la prise en charge des malades", Revue internationale de psychosociologie et de gestion des comportements organisationnels, vol. 24, n°58, p.p. 69‑90.
Niazkhani Z., Pirnejad H., van der Sijs H. & Aarts J. (2011), "Evaluating the medication process in the context of cpoe use: the significance of working around the system", International Journal of Medical Informatics, vol. 80, n°7, p.p. 490‑506.
Nuckols T.K. et al. (2014), "The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis", Systematic reviews, vol. 3, n°1, p.p. 56.
Orlikowski W.J. (1993), "CASE tools as organizational change: investigating incremental and radical changes in systems development", MIS Quarterly, vol. 17, n°3, p.p. 309‑340.
Queenan C.C., Angst C.M. & Devaraj S. (2011), "Doctors’ orders—-if they’re electronic, do they improve patient satisfaction? a complements/substitutes perspective", Journal of Operations Management, vol. 29, n°7‑8, p.p. 639‑649.
Robey D. & Boudreau M.-C. (1999), "Accounting for the contradictory organizational consequences of information technology: theoretical directions and methodological implications", Information Systems Research, vol. 10, n°2, p.p. 167‑185.
Romanow D., Rai A. & Keil M. (2018), "CPOE-enabled coordination: appropriation for deep structure use and impacts on patient outcomes", MIS Quarterly, vol. 42, n°1, p.p. 189‑212.
Samaranayake N.R., Cheung S.T.D., Chui W.C.M. & Cheung B.M.Y. (2012), "Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents", International Journal of Medical Informatics, vol. 81, n°12, p.p. 828‑833.
Sia S.K. & Soh C. (2007), "An assessment of package–organisation misalignment: institutional and ontological structures", European Journal of Information Systems, vol. 16, n°5, p.p. 568‑583.
Sligo J., Gauld R., Roberts V. & Villa L. (2017), "A literature review for large-scale health information system project planning, implementation and evaluation", International journal of medical informatics, vol. 97, p.p. 86‑97.
Soh C., Kien S.S. & Tay-Yap J. (2000), "Enterprise resource planning: cultural fits and misfits: is erp a universal solution?", Communications of the ACM, vol. 43, n°4, p.p. 47‑51.
Southon F.G., Braithwaite J. & Lorenzi N.M. (1997), "Strategic constraints in health informatics: are expectations realistic?", The International journal of health planning and management, vol. 12, n°1, p.p. 3‑13.
Strong D.M. et al. (2014), "A theory of organization-ehr affordance actualization", Journal of the association for information systems, vol. 15, n°2, p.p. 2.
Strong D.M. & Volkoff O. (2010), "Understanding organization-enterprise system fit: a path to theorizing the information technology artifact", MIS Quarterly, vol. 34, n°4, p.p. 731‑756.
Urquhart C., Lehmann H. & Myers M.D. (2009), "Putting the ‘theory’ back into grounded theory: guidelines for grounded theory studies in information systems: guidelines for grounded theory studies in information systems", Information Systems Journal, vol. 20, n°4, p.p. 357‑381.
Veiga J.F., Keupp M.M., Floyd S.W. & Kellermanns F.W. (2013), "The longitudinal impact of enterprise system users’ pre-adoption expectations and organizational support on post-adoption proficient usage", European Journal of Information Systems, vol. 23, n°6, p.p. 691‑707.
Walsh I., Kalika M. & Dominguez-Péry C. (2018), Les grands auteurs en systèmes d’information, Caen, Éditions EMS, management & société.
Wand Y. & Weber R. (1995), "On the deep structure of information systems", Information Systems Journal, vol. 5, n°3, p.p. 203‑223.
Wessel L., Baiyere A., Ologeanu-Taddei R., Cha J. & Blegind Jensen T. (2021), "Unpacking the difference between digital transformation and it-enabled organizational transformation", Journal of the Association for Information Systems, vol. 22, n°1, p.p. 102‑129.
Wiesche M., Jurisch M.C., Yetton P.W. & Krcmar H. (2017), "Grounded theory methodology in information systems research", MIS quarterly, vol. 41, n°3, p.p. 685‑701.
Yeow A. & Huat Goh K. (2015), "Work harder or work smarter? information technology and resource allocation in healthcare processes.", Mis Quarterly, vol. 39, n°4.
Published
How to Cite
Issue
Section
License
The author bears the responsibility for checking whether material submitted is subject to copyright or ownership rights (e.g. figures, tables, photographs, illustrations, trade literature and data). The author will need to obtain permission to reproduce any such items, and include these permissions with their final submission.
It is our policy to ask all contributors to transfer for free the copyright in their contribution to the journal owner. There are two broad reasons for this:
- ownership of copyright by the journal owner facilitates international protection against infringement of copyright, libel or plagiarism;
- it also ensures that requests by third parties to reprint or reproduce a contribution, or part of it, in either print or electronic form, are handled efficiently in accordance with our general policy which encourages dissemination of knowledge within the framework of copyright.
In conformity with the French law, the author keeps the 'moral rights' related to the article:
- The 'authorship right': It is the author's right to have his name associated with each publication and exploitation of the article.
- The 'integrity right': It can be claimed by the author if he finds that during an exploitation, his work has been distorted (cutting, reassembly...).
