Understanding technology mediation and new service provider roles in health care

Abstract

Purpose Service research holds that as services become more technology dominated, new service provider roles emerge. On a conceptual level, the potential impact of different roles has been discussed with regard to service provider readiness, job performance and overall experience. However, as yet, there is sparse empirical support for these conceptual interpretations. The purpose of this paper is to provide an understanding of the new service provider roles that emerge due to the increase of technology mediation in services. Design/methodology/approach This study follows a qualitative methodology. Insights are drawn from in-depth interviews with 32 junior and senior health-care service providers (across 12 specialties) and 5 information governance/management staff. Findings This analysis illustrates that new service provider roles include those of the enabler, differentiator, innovator, coordinator and sense-giver. By adopting these roles, health-care service providers reveal that they can encourage, support and advance technology mediation in services across different groups/audiences within their organizations (e.g. service delivery level, peer-to-peer level, organizational level). This paper further shows the relationships between these new service provider roles. Originality/value This study contributes to theory in technology-mediated services by illustrating empirically the range of activities that constitute each role. It also complements prior work by identifying that service providers adopt the additional role of sense-giver. Finally, this paper provides an understanding of how by taking on these roles service providers can encourage, support and advance technology mediation in services across different groups/audiences in their organization.

Discretionary technology bootlegging tensions in institutional healthcare work

“…Most studies consider the disruption that new technologies bring (Petrakaki and Kornelakis, ), yet we find that discretionary technology bootlegging only produces ‘brief intrusions’—disturbances. Nonetheless, our informants’ narratives reveal an acute awareness of the tensions and the fragility of trust in their abilities by patients (Arkes et al ., ; Daskalopoulou et al ., ) and, consequently, their rationale for having to communicate at all times their professionalism and patient‐centeredness (Freeney and Fellenz, ).…”

“…Our informants used mobile apps that support clinical decision-making (i.e. identifying, diagnosing, treating, and monitoring health conditions) (Daskalopoulou et al, 2019). Our informants used a range of externally available (to the NHS) mobile apps; for example, the British National Formulary app that provides access to practical, evidence-based medicines information.…”

“…Congruent with prior research stressing the impetus for healthcare professionals to project their competence and skill (Palmeira and Spassova, ; Daskalopoulou et al ., ), our informants expressed a need to appear knowledgeable during patient care: ‘you don't really want to be seen not knowing something in front of the patient’ (John, JHP). Another informant, Sam, also discusses the expectations he faces as a surgeon with regard to relying on his expert judgment:

I think if you're seen to be using the internet in a clinical situation, [i]t's a little bit like the patient is being on the operating table, and you're saying ‘excuse me, I need to go and see the manual about where to make the cut’, I think perhaps patients would probably expect a certain amount of knowledge base, to know what's out there without having to check it online.

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“…Not all successful technology adoption follows this formal organisation-wide approach, however. Individuals are increasingly gaining ad hoc access to various technological platforms to effectively support institutional work, for example, in the context of healthcare, doctors can use web and mobile applications (apps) for timely, high-speed access to online repositories of information for prescription of difficult to calculate or infrequently used drugs (Daskalopoulou et al, 2019). This article aims to explore such examples of discretionary technology use, taking as its point of departure that such practices are supporting healthcare work and professional identity work and, critically, provide an institutional bridge from the informal to the formal aspects of healthcare work.…”

“…Rather, most studies are concerned with the visible organisationwide and strategic adoption of technology, with an emphasis placed on the antecedents, standard processes and tools to manage work integration and positive interactions (Giebelhausen et al, 2014). However, much of this research has been criticised for neglecting the entanglements of institutional arrangements with technology, where there is individual work autonomy and new roles emerging (Orlikowski, 1994(Orlikowski, , 2007, and also where the ability of professionals to explore, experiment and inscribe technologies in work is not severely restricted (Orlikowski, 1994(Orlikowski, ,2007Daskalopoulou et al, 2019). The literature on bootlegging (Aram, 1973;Augsdörfer, 1996Augsdörfer, , 2005Abetti, 1997) provides an understanding of the questions why and how bootlegging activities take place, yet it is silent on the role of discretionary technology use, not least with regard to the constitutive entanglements of professional identity, individual autonomy, and institutional work.…”