Understanding implementation: The case of a computerized physician order entry system in a large dutch university medical center
Understanding implementation: The case of a computerized physician order entry system in a large dutch university medical center
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DOI：
10.1197/jamia.m1372
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发表时间：
2004-05-01
影响因子：
6.4
通讯作者：
Berg, M
中科院分区：
文献类型：
--
作者：
Aarts, J;Doorewaard, H;Berg, M
大多数关于组织中信息系统影响的研究倾向于将实施过程视为技术的“推出”，作为从组织动态中移除的技术问题。人们普遍认为，信息系统的成功实施是由组织因素决定的。然而，目前尚不清楚这些因素是什么。作者建议将信息系统的引入描述为一个相互塑造的过程。因此，技术和技术支持的实践都得到了转化，具体的技术和社会成果逐渐出现。这组作者认为，来自科学和技术社会研究的见解可以帮助理解实施过程。作者从三个理论方面提出，首先，实施过程应该被理解为一个彻底的社会过程，在这个过程中，技术和实践都发生了转变。其次，根据Orlikowski的“紧急变化”概念，他们认为实现一个系统，就其本质而言，是不可预测的。第三，他们认为成功和失败不是二分和静态的范畴，而是社会协商的判断。利用这些见解，作者分析了计算机化医嘱输入（CPOE）系统在荷兰一所大型大学医学中心的实施情况。在本研究过程中，CPOE的全面实施被叫停，但中止的实施暴露了作者最初没有关注的问题。
Most studies of the impact of information systems in organizations tend to see the implementation process as a "rollout" of technology, as a technical matter removed from organizational dynamics. There is substantial agreement that the success of implementing information systems is determined by organizational factors. However, it is less clear what these factors are. The authors propose to characterize the introduction of an information system as a process of mutual shaping. As a result, both the technology and the practice supported by the technology are transformed, and specific technical and social outcomes gradually emerge. The authors suggest that insights from social studies of science and technology can help to understand an implementation process. Focusing on three theoretical aspects, the authors argue first that the implementation process should be understood as a thoroughly social process in which both technology and practice are transformed. Second, following Orlikowski's concept of "emergent change," they suggest that implementing a system is, by its very nature, unpredictable. Third, they argue that success and failure are not dichotomous and static categories, but socially negotiated judgments. Using these insights, the authors have analyzed the implementation of a computerized physician order entry (CPOE) system in a large Dutch university medical center. During the course of this study, the full implementation of CPOE was halted, but the aborted implementation exposed issues on which the authors did not initially focus.