Networked Information Technologies

Chapter 5 Translations in Network Configurations (p.90-91)

7. DISCUSSION AND CONCLUDING REMARKS

Our research contributes to the literature on ICT implementation in organizational contexts. Previous research has pointed out that it is difficult to transfer technology from one context and culture to another and that there is a need for small steps and translations in such processes (Akrich, 1992). Our case study shows that this also applies to contexts that are not far apart, i.e. within the same hospital.

The case confirms the necessity for the involved actors to exercise a great amount of care to incorporate the new system into their daily work life, as argued by Ciborra (1996). However, our study points to difficulties involved in making this happen due to differences amongst stakeholder. The care expressed by the physicians, the nurses and the secretaries to incorporate the new system into their daily life appeared as a series of negotiations as the new system met work practices. Similarly, there were negotiations and translations going on between the different management levels of the hospital, the project, and the orthopaedic clinic. The sense making perspective (Henfridsson, 1999) also applies to this case, but the way in which different actors made sense of the new system varied depending on their interests, the negotiations with other stakeholders, as well as the underlying formative context of the implementation process (Ciborra & Lanzara, 1994). The case shows how routines are shaped and reshaped as the involved actors develop specific meanings of the emerging network configuration.

The considered literature (Ciborra, 1996; Henfridsson, 1999; Ciborra & Lanzara, 1994; Rogers, 1995; Orlikowski, 1996) points out the complexity and dynamics of network implementation processes. It emphasizes in particular the need for actors to be actively engaged in the transformation of current work practices. Our study confirms this with a particular emphasis on the intricacy of reactions and interactions between different stakeholders during system implementation.

The analysis of the case shows how the processes of configuring and reconfiguring a socio-technical network can be studied and understood well by focusing on the negotiations and translations between different key actors and stakeholders. This issue needs to be further elaborated in future research to provide a deeper understanding of the challenges involved in the implementation of network technologies.

Our research also contributes to improving the use of ICT within healthcare. Healthcare plays an increasingly important role in contemporary society. The gab between espoused beliefs in the benefits of using ICT and the difficulties faced in many particular situations suggests, however, that we need to know more about information and change management in this particular context. Our study suggests that managers in hospitals need to pay particular attention to the complex relationships between stakeholders when networked technologies are introduced.

Healthcare managers are advised to proactively design implementation initiatives that allow for the necessary negotiations and translations to take place. Future studies could involve action research and experiments to explore more specifically how the notions of negotiation and translation could support tactics and strategies for successful implementation of ICT based networks within healthcare.