How Can We Develop Contextualized Theories of Effective Use? A Demonstration in the Context of Community-Care Electronic Health Records

We contribute to the shifting discourse in the literature on information system use, towards context-specific rather than general theories and effective use rather than just use. Organizations are under great pressure to use information systems effectively but they have few theories to turn to for insights. Motivated by this need, we propose an approach for developing context-specific theories of effective use. The approach suggests that effective use can be theorized by: 1 understanding how a network of affordances supports the achievement of organizational goals, 2 understanding how the affordances are actualized, and 3 using inductive theorizing to elaborate these principles in a given context. We demonstrate the approach in the context of a Canadian health authority's use of a community-care electronic healthcare record EHR. We discovered that effective use in this context can be viewed at a high level as the accuracy and consistency with which users work with the EHR, and how they engage in reflection-in-action across a network of nine affordances. The key, however, is understanding how those elements interact with the multiple levels of data needed to achieve the organization's various goals. Overall, we contribute by offering an approach for developing context-specific theories of effective use, demonstrating its usefulness in an important context, and discovering the importance of understanding in a new way the multilevel nature of information systems. The online appendix is available at https://doi.org/10.1287/isre.2017.0702 .

[1]  Edward Bernroider,et al.  Information systems as a discipline in the making: comparing EJIS and MISQ between 1995 and 2008 , 2012, Eur. J. Inf. Syst..

[2]  K. Charmaz,et al.  Constructing Grounded Theory: A practical guide through qualitative analysis Kathy Charmaz Constructing Grounded Theory: A practical guide through qualitative analysis Sage 224 £19.99 0761973532 0761973532 [Formula: see text]. , 2006, Nurse researcher.

[3]  H. Tsoukas,et al.  What is Reflection-in-Action? A Phenomenological Account , 2009 .

[4]  D. Swinglehurst,et al.  Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method. , 2009, The Milbank quarterly.

[5]  D. Blumenthal,et al.  The "meaningful use" regulation for electronic health records. , 2010, The New England journal of medicine.

[6]  Cathy Urquhart,et al.  Using grounded theory method in information systems: the researcher as blank slate and other myths , 2013, J. Inf. Technol..

[7]  Craig Larman,et al.  Applying UML and Patterns: An Introduction to Object-Oriented Analysis and Design and the Unified Process , 2001 .

[8]  H. Tsoukas,et al.  Grasping the logic of practice: Theorizing through practical rationality , 2011 .

[9]  Diane M. Strong,et al.  Panoptic empowerment and reflective conformity in enterprise systems-enabled organizations , 2005, Inf. Organ..

[10]  N. Thompson,et al.  Developing critically reflective practice , 2012 .

[11]  K. Weick,et al.  Collective mind in organizations: Heedful interrelating on flight decks. , 1993 .

[12]  Gurpreet Dhillon,et al.  A Framework and Guidelines for Context-Specific Theorizing in Information Systems Research , 2014, Inf. Syst. Res..

[13]  Andrew Burton-Jones,et al.  From Use to Effective Use: A Representation Theory Perspective , 2013, Inf. Syst. Res..

[14]  D. Beckett,et al.  CRITICAL JUDGMENT AND PROFESSIONAL PRACTICE , 1996 .

[15]  David Boud,et al.  Relocating reflection in the context of practice , 2009 .

[16]  Ryad Titah,et al.  Information System Use - Related Activity: An Expanded Behavioral Conceptualization of Individual-Level Information System Use , 2007, Inf. Syst. Res..

[17]  Detmar W. Straub,et al.  Reconceptualizing System Usage: An Approach and Empirical Test , 2006, Inf. Syst. Res..

[18]  K. Mann,et al.  Reflection and reflective practice in health professions education: a systematic review , 2009, Advances in health sciences education : theory and practice.

[19]  David Higgins,et al.  Why reflect? Recognising the link between learning and reflection , 2011 .

[20]  D. Schoen,et al.  The Reflective Practitioner: How Professionals Think in Action , 1985 .

[21]  Michael J. Gallivan,et al.  ORGANIZATIONS: A MULTILEVEL PERSPECTIVE , 2007 .

[22]  Reuben R. McDaniel,et al.  Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting , 2011, J. Am. Medical Informatics Assoc..

[23]  Leysia Palen,et al.  Going wireless: behavior & practice of new mobile phone users , 2000, CSCW '00.

[24]  Marie-Claude Boudreau,et al.  Quality of Use of a Complex Technology: A Learning-Based Model , 2005, J. Organ. End User Comput..

[25]  Alan R. Hevner,et al.  It's more than just use: An exploration of telemedicine use quality , 2007, Decis. Support Syst..

[26]  J. Mathieu,et al.  The Etiology of the Multilevel Paradigm in Management Research , 2011 .

[27]  W. Orlikowski Using Technology and Constituting Structures: A Practice Lens for Studying Technology in Organizations , 2000 .

[28]  Natalia Levina,et al.  Collaborating on Multi-Party Information Systems Development Projects: A Collective Reflection-in-Action View , 2005, Inf. Syst. Res..

[29]  P. Jarvis,et al.  Reflective practice and nursing. , 1992, Nurse education today.

[30]  Peter Basch,et al.  Clinical documentation in the 21st century: executive summary of a policy position paper from the American College of Physicians. , 2015, Annals of internal medicine.

[31]  D. Hofmann,et al.  The Structure and Function of Collective Constructs: Implications for Multilevel Research and Theory Development , 1999 .

[32]  Diane M. Strong,et al.  Data quality in context , 1997, CACM.

[33]  G. Lakoff,et al.  Women, Fire, and Dangerous Things: What Categories Reveal about the Mind , 1988 .

[34]  Malcolm Munro,et al.  Assessing User Competence: Conceptualization and Measurement , 2000, Inf. Syst. Res..

[35]  C. Adair,et al.  Continuity of care: a multidisciplinary review , 2003, BMJ : British Medical Journal.

[36]  Tony Lawson,et al.  ECONOMIC SCIENCE WITHOUT EXPERIMENTATION , 1997 .

[37]  K. Weick,et al.  Organizing for high reliability: Processes of collective mindfulness. , 1999 .

[38]  Ritu Agarwal,et al.  Technological viewpoints (frames) about electronic prescribing in physician practices , 2010, J. Am. Medical Informatics Assoc..

[39]  Guy Paré,et al.  Health information technology success and the art of being mindful: Preliminary insights from a comparative case study analysis , 2012, Health care management review.

[40]  A. Jha,et al.  Meaningful use of electronic health records: the road ahead. , 2010, JAMA.

[41]  Wanda J. Orlikowski,et al.  Research Commentary: Desperately Seeking the "IT" in IT Research - A Call to Theorizing the IT Artifact , 2001, Inf. Syst. Res..

[42]  D. Blumenthal Wiring the health system--origins and provisions of a new federal program. , 2011, The New England journal of medicine.

[43]  Golam Sorwar,et al.  Implementation of E-health record systems in Australia , 2013 .

[44]  Neil C. Ramiller,et al.  Management Implications in Information Systems Research: The Untold Story , 2009, J. Assoc. Inf. Syst..

[45]  Bengisu Tulu,et al.  A Theory of Organization-EHR Affordance Actualization , 2014, J. Assoc. Inf. Syst..

[46]  Paul M. Leonardi,et al.  When Does Technology Use Enable Network Change in Organizations? A Comparative Study of Feature Use and Shared Affordances , 2013, MIS Q..

[47]  Lesley Treleaven,et al.  Organizing practices of reflection: A practice-based study , 2011 .

[48]  Chrisanthi Avgerou,et al.  Social Mechanisms for Causal Explanation in Social Theory Based IS Research , 2013, J. Assoc. Inf. Syst..

[49]  Jan Recker,et al.  A Thermometer for Interdependence: Exploring Patterns of Interdependence Using Networks of Affordances , 2015, ICIS.

[50]  J. Gibson The Ecological Approach to Visual Perception , 1979 .

[51]  Diane M. Strong,et al.  Critical Realism and Affordances: Theorizing IT-Associated Organizational Change Processes , 2013, MIS Q..

[52]  A. Strauss,et al.  The Discovery of Grounded Theory , 1967 .

[53]  Mary Butler,et al.  Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care , 2015, Journal of aging & social policy.

[54]  R Davis,et al.  Care planning and case conferencing. Building effective multidisciplinary teams. , 2001, Australian family physician.

[55]  G. Sartori Concept Misformation in Comparative Politics , 1970, American Political Science Review.

[56]  G. Johns The Essential Impact of Context on Organizational Behavior , 2006 .