A Dynamic View of Users’ Exploitation and Exploration of Healthcare Information Systems in Long-Term Care

Healthcare organizations are often confronted with the underutilization of health information systems (HIS), preventing them from leveraging full benefits from their investments. The post-implementation stage requires several adaptation processes from users to appropriate the system. More specifically, appropriating a complex HIS and moving beyond satisfying use, or at least fighting against underutilization, requires constant adaptation of use. Therefore, in this paper, we aim to discuss the appropriation of HIS from a user perspective. We report from a qualitative study in nursing home settings to understand better how healthcare users exploit and explore their HIS. Drawing on exploitation and exploration theory and using causal loop diagrams as analytical and visualization devices, we propose a dynamic model of HIS appropriation, and we demonstrate the importance of both users' cognitive style and the context in fostering HIS appropriation in stable and innovative situations. We conclude by identifying three propositions as suggestions for future research avenues but also to help users and managers find the right balance between HIS exploitation and exploration.