Contextual influences on technology use mediation: a comparative analysis of electronic medical record systems

Abstract

Developing, implementing and assimilating information technologies into organizational practices pose significant technical and social challenges. In this paper, we explore technology use mediation (TUM) processes in two cases of electronic medical record system use in two healthcare organizations. In our analysis, we examine contextual influences on mediation and consider TUM processes and outcomes in projects utilizing modern systems development methods. We found that crucial TUM actions occurred during systems development phases as well as during system use, that mediation was vitally important with these specialized IT artefacts, and that system configuration required changes to software infrastructure and code. Organizational size influenced the availability and the effectiveness of mediation resources; with adequate resources committed to the task, the institutional environment presented substantial, but not insurmountable, challenges to technology use mediation. We consider implications for practice and suggest future research directions.

Keywords:

• Technology use mediation
• electronic medical record
• system development
• commercial-off-the-shelf software
• component-based development
• mediation resources
• SME

Additional information

Notes on contributors

Elizabeth Davidson

About the authors

Liz Davidson is an associate professor in the Department of Information Technology Management of the College of Business, University of Hawaii Manoa. In her research, Dr. Davidson examines how organization members identify opportunities for using information technology and orchestrate IT initiatives. Her research projects include teamwork processes in global IT support, the role of information and communication technologies in scientific research activities, and the adoption and assimilation of information technologies in healthcare organizations. Dr. Davidson received her Ph.D. in Information Technologies from MIT's Sloan School of Management. She has extensive experience as a project manager in the information technology industry in several U.S. Fortune 250 companies.

Mike Chiasson

Mike Chiasson received his Ph.D. in information systems and his postdoctoral in health promotion from the University of British Columbia, and is now an associate professor at the Haskyane School of Business, University of Calgary. His research is increasingly focused on agency-structure issues in the development and implementation of information systems, in both traditional and non-traditional (e.g. entrepreneurial, professional, and legal) contexts. His specific IT areas include web-based systems for e-commerce and knowledge management systems. He is currently investigating the effect of emerging IS on entrepreneurial organizations, criminal and civil cases involving e-commerce and software development, and knowledge management systems in professional organizations.