Exploring the Power of Technology in the Institutionalization of Health Information Systems: An Actor-Network Analysis of Information Systems Integration
AbstractBackground and Purpose: Information systems (IS) integration is a complicated exercise. This paper discusses the process of IS integration for a healthcare sector in a resource constrained context. In recognition of power play between the different actors involved, the paper underscores the complexity related to coordination of organisational routines in order to achieve the goals of HIS integration. In particular, the paper tends to explore how artefacts (software and regulations) can be used to facilitate this coordination.Methods: The study employed actor network theory concepts of inscription and alignment to guide the data collection and analysis. Data collection methods include participant observation documents reviews, and interviews both formal and informal discussions.Results: The study reports the implementations of an action research project in Tanzania, where three case studies were presented comparing how different technologies in line with right regulations, is highlighted. The article describes HIS integration as a combinatory actor network building process that needs to consider the nature of the technological artifact, and the manner in which it is implemented, coupled with the policy and guidelines which inscribe and prescribe the use of the system.Conclusions: The article reveals that success of the network building process (the HIS integration process) in the backdrop of myriads of heterogeneous actors with multiplicity of interests can be achieved by a combination of interventions where the agenda is inscribed in a technological artefact, well supported by policy guidelines in place.
Mosse, E. & SAHAY, S. Counter networks, communication and health information systems: a case study from Mozambique. In: KORPELA, MONTEALEGRE & POULYMENAKOU, eds. IFIP TC8 & TC9/WG8.2 + WG9.4 Working Conference on Information Systems Perspectives and Challenges in the Context of Globalization, June 2003 2003 Athens, Greece. 35-51.
Sheikh, Y. H. 2005. Improving routine health information management in Zanzibar: An action research study. Masters in Information Systems, University of Oslo.
HMN 2008. Framework and Standards for Country Health Information Systems, Geneva, World Health Organisation.
Callon, M. (1987). Society in the Making: The Study of Technology as a Tool for Sociological Analysis. The Social Construction of Technological Systems. Bijker, W. E., Hughes, T. P. and Pinch, T. P. (Eds). . Cambridge, Ma, The MIT Press: 85-103.
Tatnall, A. and A. Gilding (1999). Actor-Network Theory and Information Systems Research. Proceedings of the 10th Australasian Conference on Information Systems.
Latour, B. (1986). The Powers of Association’. Power, Action and Belief. A new sociology of knowledge? Sociological Review monograph 32. Law, J. (Ed). Routledge & Kegan Paul, . London: 264-280.
Murdoch, J. and T. Marsden (1995). "The Spatialization of Politics: Local and National Actor-Spaces in Environmental Conflict." Transactions of the Institute of British Geographers, New Series 20(3): 380.
Akrich, M. (1992). The De-Scription of Technical Artifacts. Shaping Technology/Building Society: Studies in Sociotechnical Change, W.E. Bijker and J. Law (eds.). Cambridge, MA, MIT Press, : 205-224.
Monteiro, E. (2000). Actor-Network Theory and Information Infrastructure. From Control to Drift: The Dynamics of Corporate Information Infrastructures, C.U. Ciborra, A. Cordella, B. Dahlbom, A. Failla, O. Hanseth, V. Hepsø, J. Ljungberg, E. Monteiro and K.A. Simon (eds.),. New York, Oxford University Press.
Chawani, M., Kaasbøll, J., Finken, S., Herstad, J., and Malata, A.(2014) Balancing Work Practices and Protocols in the Design Of EMR Systems: The Case of Developing an EMR System for Antenatal Care Services in Malawi, Electronic Journal on Information Systems in Developing Countries 63, 1, 1-26
Sigurdardottir, H. K. (2009). "Use Cases as Inscriptions in Healthcare Information Technologies" Paper presented at the annual meeting of the 4S Annual Meeting - Abstract and Session Submissions, Hyatt Regency Crystal City, Crystal City, VA. 2014-11-28 from http://citation.allacademic.com/meta/p371123_index.html
Håland, Erna. and Melby, Line (2010). "Inscriptions of discipline and control in health information systems: Implications for health care practices" Paper presented at the annual meeting of the 4S Annual Meeting - Abstract and Session Submissions, Komaba I Campus, University of Tokyo, Tokyo, Japan, Aug 25, 2010. 2014-11-27 http://citation.allacademic.com/meta/p421311_index.html
Klein, H. K. and Myers, M. D. (1999). A Set of Principles for Conducting and Evaluating.
Walsham, G. (1993). Interpreting Information Systems in Organizations, Wiley.
Sheikh, Y. H. (2010). Power Imbalances and IS Implementation: A Case of Integrated Health Management Information System in Zanzibar. In: Nunes, M. B., Isaías, P. & Powell, P. (eds.) IADIS International Conference Information Systems 2010. Porto, Portugal. IADIS Press, pp. 258 – 266.
Mwangu, M. A. (2003). "Enhancing district health planning and management in Tanzania. A social politicalanalysis of the role of the HMIS." PhD dissertation. University of Dar es Salaam, Tanzania.
Lungo, J., 2003. Data Flows in Health Information Systems: An action research study of reporting routine health delivery services and implementation of computer databases in health information systems. Master thesis, Department of Informatics, University of Oslo
Nguyen, T. and E. Nyella (2010). Health Information Systems Implementation in Developing Countries: A Translation Process. The 5th Mediterenian Conference in Information Systems. Israel, Telaviv.