Seite - 107 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

collective mindfulness has rarely been applied in health informatics. As shown in the case discussed in this paper, a process of translation may be necessary to make the theory applicable to HIT implementations. Through this act of translation, the case shows how the theory of collective mindfulness can enrich our understanding of organisational processes of adoption and adaptation post-implementation. Indeed, the case also suggests the theory’s potential to explain and support the entire HIT project life-cycle – from design, to implementation and evaluation. For example, some of the experiences of the scanning team are akin to those eliciting requirements for system development, or those pre-implementation steps when decisions are taken on what needs to be done, including the necessary changes to workflows. It also shows how theory-based qualitative evaluations of HIT projects based on dimensions of collective mindfulness can explain implementation outcomes. Healthcare services are high reliability-seeking organisations, struggling to eliminate errors and low-quality patient care. Improving patient safety is the main objective underlying many health IT initiatives – i.e. technology has been endorsed with the key task of helping healthcare organisations achieve safe and reliable patient outcomes. The theory of collective mindfulness explains how HROs achieve reliability of operations. A dimension of these organisations’ ‘success’ is the capability to manage ‘the unexpected’ despite uncertain and risky conditions. Building on these foundations, we conclude this chapter with a proposal for a twofold definition of success for HIT projects, that others may wish to test: HIT is successful when it fosters reliable and safe patient outcomes by sustaining collective mindfulness capabilities. HIT implementations are successful not when they avoid ‘the unexpected’ (perhaps an impossibility) but when they manage the unexpected-related challenges through a mindful collective mind. Teaching questions for reflection 1. What recommendations for HIT practice could be drawn from the application of the theory of collective mindfulness to the implementation of health IT? 2. How can the theory of collective mindfulness assist in evaluating the impact of HIT? 3. What would be the metrics for a mindfulness scale aimed at measuring HIT implementations? And could the scale be used to predict outcomes of HIT project ‘success’ or ‘failure’? 4. How could the theory of collective mindfulness to HIT implementations be translated to consider ‘organisations’ that are ill-defined, such as in telecare for community care, or in the implementation of patient facing systems, such as a patient portal? Acknowledgments Valentina Lichtner received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie-Skłodowska Curie Grant Agreement number 740131. V.LichtnerandJ.I.Westbrook /CollectiveMindfulnessandProcessesofSensemaking 107