Technology Use in Healthcare - An Activity-Theoretical Extension

Information technology (IT) is envisioned to improve healthcare delivery performance. However, the outcomes of implementing IT are mixed. Insufficient consideration of the implementation context was found to limit our understanding about why systems that work well in one setting, may fail in another. We analyze these shortcomings by developing an activity-theoretical perspective on technology-affordance actualization in healthcare and analyzing the roles the electronic medical record (EMR) plays in two distinct, yet comparable use-contexts. Conducting a multiple case-study in six hospitals in Germany and the US, this paper provides evidence that affordances actualization relates to the characteristics of activity system components, their complementary nature, and dynamic interplay. Overall, this study demonstrates that augmenting affordance theory with activity theory enables thoughtful analysis of the both, the materiality of technology and the context of technology use, that is the emergent properties of the actor-environment system.