Contextual dynamics during health information systems implementation: an event-based actor-network approach

Despite its information-intensive nature and considerable investments, healthcare continues to lag behind other industries in effectively exploiting information technology (IT). This paradox suggests that the healthcare industry presents particular challenges for successful implementation of information systems. As a result, there is an increasing interest in research into how information systems implementation efforts are shaped in interaction with the healthcare context. This paper contributes to this emerging body of knowledge by applying Actor-Network Theory (ANT) to explore the implementation of a radiology network system in a Swedish hospital. The analysis of the process reveals how complex contextual dynamics had disruptive effects. First, we identified important dynamics related to implementation content; these were mainly expressed as tensions between the radiology network system and medical work practices. Second, we found important dynamics related to implementation context; these were mainly expressed as tensions between shifting networks of actors within the implementation project and the broader institutional setting. Seeking to understand contextual dynamics during healthcare information systems implementation, we use events to focus, structure, and present the ANT analysis. This event-based approach furthers our understanding of how researchers can apply ANT to study IT-based change in general.