Complex interactions between humans, technology, and organization characterize a health care
organization (Kohn, Corrigan, & Donaldson, 1999; Gaba, 2000; Institute of Medicine, 2001). The level of
complexity is apparent in the contrast between the non-standardized nature of health care work and the standard
working modes required by electronic reporting and/or information systems (Berg, 2003). The complexity is also
evident in the incompatibility between the traditionally applied reactive and punitive approach to deviations and
errors in health care (Hudson, 2003) and the need to develop a reporting system and organizational culture that
supports learning and reflection rather than punishes errors (Kaplan & Fastman, 2003). Moreover, previous
studies have suggested that relations exist between the introduction of new reform processes in health care, the
dominant mentality of increased efficiency among managers and employees, and the culture of silence and lack of
reporting initiatives at the enterprise level (Wiig & Aase, 2007). Further chains of complexity result from those
already described; for example, the absence of an individual and collective learning due to a reactive culture can
be linked to new reforms and production goals shaping the everyday mentality of efficiency rather than safety
among managers and employees within health care. This chain and others like it add to the impression of
complexity when studying the health care organization, making it problematic to clearly isolate individual human,
technological, and organizational influences on information technology and/or systems.
To address this difficulty, the current article focuses on identifying human, technological, and
organizational interactions rather than individual influences by combining several theoretical perspectives on the
human, technological, and organizational aspects of implementing information systems and technology. Together,
these perspectives provide a selection of theoretical interactions used to identify and describe the nature of the
Issue 1 2008
VVOOLL1122
2
specific human-technology-organization interactions identified in a large health care organization and help explain
the process and outcome of a particular implementation endeavor.
Two specific research objectives guide this exploration:
• understanding the particular combinations of human-technology-organization interactions that
influenced the implementation process in the case organization (objective A), and
• understanding how these interactions can help explain the outcome of the implementation process
(objective B).
Select theme