Seite - 208 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

in their paper on “demystifying theory” the challenge is not whether theory is used, but whether the use of theory is explicated [21]. The use of theory in health informatics can help to understand phenomena, guide our analyses and improve our appreciation of the significance of research findings. Traditionally, theory has not played a dominant role in health informatics. Many researchers have noted the under-utilisation of theory to explain changes or help to predict outcomes [16]. This paucity of theory usually coincides with the absence of information about why an IT system may be useful in one context but not another [32]. Nevertheless, as this text book attests, there has been a significant uptake and growth of theory-driven approaches in health informatics particularly as a means of helping to identify concepts that are critical to understanding complex situations [11]. These developments reflect a strong push by health care administrators, software vendors, consumers, clinicians and academics to enhance understanding the outcomes of health IT systems, as a means of improving their design, implementation and sustainability into the future. How is theory used in health informatics? It is now widely recognised that the implementation of health information systems can have a major impact on the delivery of health care and the outcomes of that care [2]. As a consequence, there is considerable attention provided to the imperative to ensure that health IT is rigorously evaluated. The utilisation of theory in health informatics has paralleled many of the developments in evaluation research over the last few decades. This is because theory can provide a frame of reference that can help us to understand the significance of evaluation findings [15]. In this way health informatics is able to go beyond a simple “black box” evaluationwhich may tell us whether or not a health IT system works, towards a greater appreciation of the underlying causal mechanisms and context in which it is placed. This textbook did not intend to identify all the relevant theories currently used in health informatics. To our knowledge, there are not many comprehensive examinations of the breadth of the use of theory in health informatics [51]. This textbook provides a wide sample of theories currently employed within the health informatics discipline. Our choice of theories was purposive and informed by an intensive and iterative engagement with our health informatics colleagues over many years, including through discussions at workshops and panels at major health informatics events. Health informatics research draws from many other theories in other fields and disciplines including, sociology, psychology, information systems, implementation science and communication. Table 2 identifies some of the key disciplinary origins (drawing on Greenhalgh et al’s meta- narrative on electronic patient record research [28]) of the theories presented in this textbookalong with their scope and existing areas of utilisation. P.J.Scott etal. /ReflectingandLooking to theFuture208