Page - 88 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

organizational dynamics and change. Humans in complex organizational contexts are viewed as being influenced by technological, social and cultural environments which are constantly changing. This is in turn assumed to affect the performance organization. In order to improve performance of the information system and the social context, it is argued that social and technical dimensions need to be aligned - a process referred to as joint optimization [1]. Sociotechnical perspectives have been applied to: 1) information system engineering - in order to inform technological designs that integrate well with the social environments in which they are used; and 2) the evaluation of information system implementation, adoption and optimization - in order to inform organizational efforts to create social environments that maximize benefits of technology [2]. This approach contrasts with earlier perceptions that workers had to adapt to technological requirements in order to realize potential benefits associated with technological change [3]. Sociotechnical approaches are a popular choice when examining the implementation of information technology (IT) in healthcare settings. They are well suited to explore changing organizational and healthcare professional practices accompanying technology introduction in complex environments [4-6]. Here, new technological systems are viewed as an addition to established organizational structures and work practices. These changes can lead to requirements for re-organization in social subsystems, often resulting in a tension between the technological demand for structured data entry and the fluid context-dependent nature of healthcare professional work. Conversely, sociotechnical approaches can also be used to examine how social and organizational practices result in changes in technological design. Box 1 summarizes Coiera’s four rules for sociotechnical design in healthcare settings, which exemplify the implications of a sociotechnical approach [2]. Box 1: Coiera’s four rules for sociotechnical design Rule 1: “Technical systems have social consequences”: technology introduction affects the user and the individuals surrounding the user e.g. the patient Rule 2: “Social systems have technical consequences”: e.g. organizational culture, champions, role models may impact on the uptake of technology Rule 3: “We don’t design technology, we design sociotechnical systems”: design needs to shift to incorporate social processes, and from consideration of a single user to the recognition that collaboration in healthcare is crucial Rule 4: “To design sociotechnical systems, we must understand how people and technologies interact”: the need to gather more data on human computer interaction in clinical environments e.g. cognitive overload, time pressured situations, workload 1.2. Actor-Network Theory-based approaches to studying technology implementation Actor-Network Theory (ANT) can be viewed under the sociotechnical systems umbrella, as it focuses on exploring the interrelated nature of social and technological subsystems. It has its origins in sociological and anthropological approaches to K.Cresswell /UsingActor-NetworkTheory toStudyHealth InformationTechnology Interventions88