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The lack of alignment of these positions was apparent in ongoing tensions and
eventually broke up the network, reflected in the media discourse surrounding “the
spectacular failure of the NPfIT”.
4. Discussion
This chapter has illustrated that drawing on ANT can be helpful in conceptualizing
technology implementation in healthcare settings. In particular, the approach can help
to inform sampling and to examine how technology actively shapes human relationships
and vice versa. It can further inform deliberations on the alignment of various networks
at different levels including healthcare professional work, organizational practices,
political and supplier relationships. In line with this, ANT-informed approaches continue
to be used by health service researchers as tools to facilitate tracing networks of human
actors and technologies over time. However, these are mostly small-scale studies
exploring health IT implementations in particular settings [24-26].
Due to its limitations, the traditional “purist” ANT approach is likely to be too
restrictive and too prone to getting lost in detail to be usefully employed in studying
health IT implementation and this is reflected in the current literature, where the use of
ANT to inform analysis is generally less common than its role in informing design
considerations [24-26]. It is therefore often employed in conjunction with other
theoretical lenses under the more general sociotechnical umbrella [20,25].
Sociotechnical lenses are well suited to explore processes surrounding technology
implementation across a variety of different stakeholder levels [27,28]. These approaches
are proving to be relatively flexible, in particular when considering large-scale
implementations of complex programmes where drawing on one single lens may be quite
restrictive [29]. However, many existing approaches still examine health IT at one
selected level, be it micro contexts, meso (organizational) contexts or macro contexts
[30-33]. The relationships between these are often poorly understood and this is where
pragmatic ANT-informed approaches, as outlined in the case study above, may be useful
for evaluators going forward.
It is difficult to predict if the NPfIT would have had more successes if the design
of technologies and implementation strategy had drawn on ANT. This is because the
application of the method is very much subjective. However, more generally, rigorous
independent formative evaluation methods (informed by ANT in combination with other
sociotechnical lenses) are crucial to accelerate learning and optimization of implemented
technologies and practices.
Teaching questions for reflection
1. Consider which objects in your environment may be viewed as having agency.
2. Would you draw on ANT in your work? How could you do this?
3. What do you consider to be the most helpful/unhelpful aspects of ANT in
health IT implementation?
K.Cresswell /UsingActor-NetworkTheory toStudyHealth InformationTechnology Interventions 95
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Buch Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Titel
- Applied Interdisciplinary Theory in Health Informatics
- Untertitel
- Knowledge Base for Practitioners
- Autoren
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Verlag
- IOS Press BV
- Ort
- Amsterdam
- Datum
- 2019
- Sprache
- englisch
- Lizenz
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Abmessungen
- 16.0 x 24.0 cm
- Seiten
- 242
- Kategorie
- Informatik