Digitalization as institutional work: a case of designing a tool for changing diabetes care

Abstract

Purpose E-health tools for patients aim to change current care practices. However the role of IT in transforming health care is not straightforward. The purpose of this paper is to understand how this change process unfolds and what characterizes the process by which visions of new care practices become inscribed into digital tools. Design/methodology/approach The study adopted a qualitative research design and it is based on an interpretive case study on the digitalization of a tool for diabetes care used in a hospital in Norway. Data have been collected via interviews and observations. Digitalization activities are understood as institutional work in order to examine the relation between the decisions taken in the design process and the intended change of the practices of diabetes care. Findings The study identifies three types of activities of institutional work: inscription of self-reflection, inscription of legitimation and inscription of new usage. The analysis of these activities shows how the vision of patients’ more active, learning and reflection-oriented role is inscribed into digital technology; how institutional work strives both for change and for legitimation thus smoothing the transition to a new institutional arrangement; and how institutional work relates to digital materiality. Originality/value The study contributes to the institutional theory literature by conceptualizing digitalization as institutional work toward changing institutions. It also contributes to the IS literature on digitalization by providing an analysis of how the affordances of digital materials support the work toward new institutions.

Health information systems implementation: Weaving alliances in East African Community

“…Various IS studies have drawn upon the concept of Institutional work to analyse change processes within organisations (Sahay, Nielsen, & Aanestad, 2018; Senyoni, Kimaro, Braa, & Kumalija, 2019; Thorseng & Grisot, 2017; P. Wang & Swanson, 2008). For example, in their analysis of designing a tool for changing diabetes care, Thorseng and Grisot (2017) described how the change process unfolds, by illustrating how visions of new practices become inscribed into digital tools. Similarly, in their study of introducing Universal Health Coverage (UHC) in primary healthcare, Sahay et al (2018) describe how countries ensure new practices take root in a sector with multi‐stakeholders.…”

“…Various IS studies have drawn upon the concept of Institutional work to analyse change processes within organisations (Sahay, Nielsen, & Aanestad, 2018;Senyoni, Kimaro, Braa, & Kumalija, 2019;Thorseng & Grisot, 2017;P. Wang & Swanson, 2008).…”

Digitalization: A Literature Review and Research Agenda

“…Accessibility, availability, and transparency) (citing Amit and Zott [34]) Clerck [28] Digitalization is defined as the use of digital technologies and of data in order to create revenue, improve business, replace/transform business processes and create an environment for digital business, whereby digital information is at the core Lenka et al [20] The industrial management literature defines the digitalization as the phenomenon of intelligent connected machines that information and digital technologies power (citing Lerch and Gotsch [35] and Parida et al [36]) Machekhina [37] Digitalization means transformation of all information types (text, sound, visuals, video and other data from various sources) into the digital language Parviainen et al [2] The action or process of digitizing; the conversion of analogue data (esp. in later use images, video, and text) into digital form Thorseng and Griot [38] The transformation of existing socio-technical structures that were previously mediated by non-digital artefacts or relationships into ones that are mediated by digitized artefacts and relationships with newly embedded digital capabilities (citing Yoo et al [39]) Valenduc and Vendramin [40] The term "digitalisation" is not the irruption of a new revolution, but the pervasive synergy of digital innovations in the whole economy and society (citing Perez [41]) Crittenden et al [23] Digitalization creates new forms of interaction between companies and customers through channels (citing Hansen et al [42]) Devereux and Vella [43] Digitalization is the process of spreading of a general purpose technology. The last similar phenomenon was electrification.…”

Boundary Object in HIS: Designing and implementation of a regional scorecard

“…Wang & Swanson, 2008). For example, in their analysis of designing a tool for changing diabetes care, Thorseng and Grisot (2017) described how the change process unfolds, by illustrating how visions of new practices become inscribed into digital tools. Similarly, in their study of introducing Universal Health Coverage (UHC) in primary healthcare, Sahay et al (2018) describe how countries ensure new practices take root in a sector with multi-stakeholders.…”