Evolving Work Routines: Adaptive Routinization of Information Technology in Healthcare
Evolving Work Routines: Adaptive Routinization of Information Technology in Healthcare
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DOI：
10.1287/isre.1110.0365
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发表时间：
2011-09-01
影响因子：
4.9
通讯作者：
Agarwal, Ritu
中科院分区：
文献类型：
--
作者：
Goh, Jie Mein;Gao, Guodong (Gordon);Agarwal, Ritu
尽管从健康IT（HIT）的性能增益的显着潜力，一直是有限的研究成功的HIT实施的机制。我们进行了广泛的纵向实地研究，以了解技术和模式的临床工作体现在例程之间的相互作用。我们使用叙事网络的分析工具来确定HIT在哪里以及如何影响工作模式。我们进一步借鉴自适应结构化理论，将HIT概念化为改变叙事网络中事件流的干预。我们的研究结果表明，成功实施的关键是管理的共同进化过程之间的例程和HIT，并积极编排通过代理行动的良性循环。我们提出了一个动态的过程模型的自适应的适应性的HIT，划定的主要渠道，通过HIT和例程相互作用，确定在动态的协同进化过程中的不同阶段，并隔离的关键作用，两种形式的机构，使共同进化的良性循环。这是最早的研究之一，提供了一个过程，在临床环境中的HIT实施微观层面的分析。
Despite the significant potential for performance gains from health IT (HIT), there has been limited study of the mechanisms underlying successful HIT implementations. We conducted an extensive longitudinal field study to gain an understanding of the interplay between technology and patterns of clinical work embodied in routines. We use the analytical device of narrative networks to identify where and how HIT influences patterns of work. We further draw upon adaptive structuration theory to conceptualize HIT as an intervention that alters the flow of events in a narrative network. Our findings suggest that the key to successful implementation is to manage the co-evolution process between routines and HIT and to actively orchestrate a virtuous cycle through agentic action. We propose a dynamic process model of adaptive routinization of HIT that delineates the major channels through which HIT and routines interact, identifies the different stages in the dynamic co-evolution process, and isolates the pivotal role of two forms of agency in enabling the virtuous cycle of co-evolution. This is one of the first studies to offer a processual, microlevel analysis of HIT implementation in a clinical setting.