Service Provider’s Experiences of Service Separation

Abstract

As more and more technologies are infused into service delivery, service providers must continuously renegotiate the ways in which they understand service delivery across increasingly high-tech, low-touch modalities. This exploratory qualitative study examines what health care service providers experience when offering separated services in the empirical context of telehealth. In-depth phenomenographic interviews sourced across multiple hospital and health care sites revealed that service providers experience (1) depersonalization, (2) clinical voyeurism, (3) intangibility negotiation, and (4) a need to manage change around identities and roles. These emergent understandings highlight the individual and qualitatively distinct differences in the ways in which service providers experience service separation in telehealth. Our findings address current service science priorities to leverage technology for service delivery as a way to advance separated service design. Further they provide an understanding-based approach toward building new theories from the service provider’s perspective on separation in technology-infused services. Our findings suggest strategies and tactics service providers use to overcome the potential challenges arising from not being physically colocated with their customers during service separation.

Registered nurse and midwife experiences of using videoconferencing in practice: A systematic review of qualitative studies

“…The case of telephone‐based nursing services, for example, lacking in both presence and visibility with patients, has raised the question of what is considered as “real nursing” (Snooks et al., ). Lack of physical presence, combined with technical and other problems, disrupts patient relationships which contributes to healthcare providers feeling less engaged and hence less accepting of VC (Bradford, Young, Armfield, Herbert, & Smith, ; Green et al., ). Yet, presence in nursing is often poorly conceived (Finfgeld‐Connett, ); frequently situated within a context of physical proximity.…”

“…What is shared, and with whom, become less secure with VC, a concern identified in other studies (Bradford et al., ). Medical practitioners share this concern not the least because healthcare staff and patients may not know who is “off screen” during consultations and that a sense of privacy during examinations is not the same as in face‐to‐face consultations (Green et al., ). Further demands include how nurses and midwives take on additional roles to accommodate VC because of gaps in technical and liaison support.…”

“…Despite the cited advantages, VC remains widely underutilised and continues to be perceived as "novel," with only a small proportion of practitioners using it routinely in practice (Hawkins, 2012;Royal College of Nursing, 2013). Various barriers and enablers to the integration of the technology into routine practice have been described in an effort to address this perception (van Gemert-Pijnen et al, 2011;Green, Hartley, & Gillespie, 2016;Moffatt & Eley, 2011;Nagel, Pomerleau, & Penner, 2013;Raven, Butler, & Bywood, 2013;Sanders et al, 2012;Wade, Eliott, & Hiller, 2014). Factors such as clinician acceptance, organisational readiness, economics and policy directives can all influence integration of the technology into practice (Brewster, Mountian, Wessels, Kelly, & Hawley, 2013;Wade et al, 2014).…”

Discretionary technology bootlegging tensions in institutional healthcare work

“…We extend the ideas put forth by Green et al . () by illustrating the types of identity work that are essential in coping with tensions that can arise by moving away from a secure, stable, and familiar sense of professional self, due to discretionary technology bootlegging activities. It became evident that our informants’ identity work enabled them to deal with tensions induced by the use of technology that lacked legitimacy in the context of patient care.…”

“…In his seminal study, Barley (1986) found that the introduction of CT scanner technology and its use transformed radiologists' work routines, identities and roles. Similarly, Green et al (2016) showed how technology use influenced healthcare professionals' transition from a secure, stable, and familiar professional identity as a 'physician' to an insecure, unstable, and unfamiliar role as a tele-health 'technician'. These studies are situated in formal organisation-wide technology setting, where policy, structures and institutional repairs enforce or sanction practice.…”