Imran Muhammad

Why Using Actor Network Theory (ANT) Can Help to Understand the Personally Controlled Electronic Health Record (PCEHR) in Australia

Globally, healthcare reforms are being initiated to address the tremendous challenges facing healthcare systems. Without exception these reforms include the implementation of a variety of e-health solutions. Such e-health solutions are complex and have far reaching implications. In this paper, the authors argue that while these implementations and adoptions of e-health solutions are necessary, it is essential that an appropriate lens of analysis should be used to maximise and sustain the benefits of IS/IT (information systems/information technology) in healthcare delivery.

Using ANT to uncover the full potential of an intelligent operational planning and support tool (IOPST) for acute healthcare contexts

Based on initial pre-clinical data and results from focus group studies, proof of concept for an intelligent operational planning and support tool (IOPST) for nursing in acute healthcare contexts has been demonstrated. However, moving from a simulated context to a large scale clinical trial brings potential challenges associated with the many complexities and multiple people-technology interactions. To enable an in depth and rich analysis of such a context, it is the contention of this paper that incorporating an Actor-Network Theory (ANT) lens to facilitate analysis will be a prudent option as discussed below.

Using ANT to Understand Key Issues for Successful E-Health Solutions

Faced by a confluence of onerous challenges including escalating healthcare costs, ageing populations and the advance of technology as well as the need to provide effective and efficient healthcare services, OECD countries today are turning to e-health as the silver bullet or panacea. However, despite the initial euphoria and notwithstanding the significant investments made, to date, many of these e-health solutions have yet to prove their success. This paper presents the findings from an exploratory study that examined e-health initiatives in five countries Australia, China, Germany, UK and US to understand why these e-health solutions have not as yet delivered the promised results. A key aspect from this study was the need to have a robust and rich theory so it is possible to more fully understand all the implications, barriers and facilitators of the respective e-health solutions. Hence, the paper proffers Actor Network Theory (ANT) as such a candidate theory and illustrates how it can help to identify and support an in depth understanding of key success factors.

How Using ANT Can Assist to Understand Key Issues for Successful e-Health Solutions

Globally in healthcare, the focus is on designing and implementing national e-health solutions in an attempt to address key challenges that are plaguing healthcare delivery. However, despite the initial euphoria and notwithstanding the significant investments made, to date, many of these e-health solutions have yet to prove their success or have been complete failures. This paper presents the findings from an exploratory study that examined e-health initiatives in five countries Australia, China, Germany, UK and US to understand why these e-health solutions have not as yet delivered the promised results. The paper proffers Actor-Network Theory ANT as an appropriately rich theoretical lens that can be used to assist in the understanding of key issues for successful e-health solutions.

The Need for a Socio-Technical Analysis in E-Health: The Case of the PCEHR

Healthcare systems around the globe are facing a number of challenges. Thus Increasing focus is being placed on constructing appropriate healthcare reforms which are attempting to address how to tackle these challenges. A critical enabler in these reforms is the adoption of an e-health solution. Such e-health solutions are not only expensive and complex endeavours, but also have far reaching implications. Given that the implementation and adoption of these e-health solutions is so important, not to mention also requiring a substantial investment in various resources such as time and money, it is therefore essential to ensure their success. The following proffers a socio-technical analysis as an appropriate strategy to ensure more successful outcomes. An exemplar case study of the Personally Controlled Electronic Health Record PCEHR, the chosen e-health solution by the Australian government is provided to illustrate the benefits such an analysis might provide

Trying to Streamline Healthcare Delivery in Australia via the Personally Controlled Electronic Health Record (PCEHR)

Healthcare systems around the world are facing a number of challenges. Increasing focus is thus being placed on constructing appropriate healthcare reforms to address challenges and streamline healthcare services. One of the critical enablers in this reform is the adoption of an e-health solution. These e-health solutions are not only expensive and complex endeavours but also have far-reaching implications. Given that the implementation and adoption of these e-health solutions is so important; it is also vital to have an extensive evaluation and analysis of these systems with a theoretically informed lens. This then will serve to maximise and sustain the benefits of the proposed solution and realise its full potential for achieving superior healthcare delivery. To date the literature is void of such evaluations. Hence, this paper proffers the use of a sociotechnical systems (STS) analysis. The exemplar case study under consideration is that of the personally controlled electronic health record (PCEHR), the chosen e-health solution by the Australian government.

Enhancing Understanding of Cross-Cultural ERP Implementation Impact with a FVM Perspective Enriched by ANT

Enterprise Resource Planning ERP Systems, and more especially their successful adoption and implementation, have been the subject of extensive research as can be evidenced by the large body of literature on this and related topics in the extant literature to date. However, the effect of cross-cultural issues has been less widely studied, perhaps because of the difficulty and complexity of such cross-cultural studies. In todays global business environment this remains a key issue and critical success factor. Hence, this paper explains how challenging the cross-cultural ERP implementation implementation success is for organizations and how important it is to assess a fit and viability of cross-cultural ERP implementations in diverse cultures which is especially important in economies heavily reliant on off-shoring services. By drawing upon multiple streams of theory building, a framework, from the Fit-Viability Model FVM perspective, is developed. The framework provides important and valuable guiding principles for organizations for their decisions on adoption and deployment of Enterprise Systems ES. Further, the paper proffers the use of ANT Actor-Network Theory to enrich the analysis and provides a systematic approach for moving forward with a multi-case study to test the proposed framework.

Integrating Two Sociotechnical Theories to Develop a Suitable Analytic Framework to Assess the Development of a Hospital Secure Messaging and Communication Platform

This chapter seeks to develop a conceptual framework for the theoretical underpinning for a larger study and to answer the key research question: How can ICT (information communication technology) solutions ameliorate the current challenges regarding communication inefficiencies within healthcare? Given the identified complexities, it was realised a sufficiently robust theoretical framework was essential; hence, this study has served to develop a theoretical research framework by integrating two sociotechnical theories, namely, actor-network theory and activity theory, to investigate the possibility of designing a bespoke ICT solution for a specific context at one of the largest private hospitals in Australia.Pagers and phone conversations have been the stalwarts of hospital communication. With good reason, they are simple, reliable and relatively inexpensive. However, with the increasing complexity of patient care, the need for greater speed and the general inexorable progress of health technology, hospital communication systems appear to be increasingly inefficient, non-secure, and inadequate. It is unsurprising then, that methods other than pagers and phone-calls, are often utilized; be it residents communicating with other residents, nurses seeking consultant feedback, or patients seeking advice from their clinicians. Thus, this study seeks to develop a conceptual framework for the theoretical un-derpinning for a larger study and to answer the key research question: How can ICT (information communication technology) solutions ameliorate the current challenges regarding communication inefficiencies within healthcare? To answer this question, this study has served to develop a theoreti-cal research framework by integrating two socio-technical theories namely Actor-network theory and Activity Theory to investigate the possibility of designing a bespoke ICT solution for a specific context at one of the largest private hospital in Australia.

Using Structuration Theory to Assist in Understanding the Implementation and Adoption of Health Information Systems

Successful adoption and implementation of health information systems (HIS) has been the subject of extensive research as can be evidenced by the large body of recent research literature on this topic. Most scholars agree that these solutions are complex to understand and should be analysed under the lens of theoretically informed analytical tools. One approach identified in the literature used to facilitate correct and accurate capturing of the complexities and levels of interactions in healthcare operations and technologies is to use structuration theory (ST). To demonstrate the benefits and strengths of using ST, this chapter evaluates the merits of an ST analysis for the implementation and adoption of health information systems (HIS).

Fit-Viability Model Examination of e-Health Solutions

Healthcare delivery, irrespective of the region in the world, is facing the key challenges of escalating costs, aging populations, an increase in a myriad of diagnostic technologies and the rise of chronic diseases which, in turn, is leading to a more and more preventative focus. In short, the current state of healthcare delivery is not sustainable (OECD 2010, http://www.oecd.org/document/11/0,3343,en_2649_ 34631_45549771_1_1_1_37407,00.html, http://stats.oecd.org/Index.aspx?DatasetCode=HEALTH; Pearce and Haikerwal, Med J Aust 193(7):397–398, 2010; Porter and Guth, Redefining German health care moving to a value-based system. Springer, Berlin, Heidelberg, 2012; Porter and Teisberg, Redefining health care: creating value-based competition on results. Harvard Business School Press, Boston, 2006; Wickramasinghe and Schaffer, Realizing value driven e-Health solutions Improving Healthcare Series. IBM Center for the Business of Government, Washington, 2010). Most countries are responding with various types of healthcare reform and turning to e-health solutions as possible efficiency tools. However, e-health is not a panacea for the maladies faced by healthcare delivery. Moreover, it is important to understand the key macro and micro issues as well as vital people, process and technology aspects if superior and sustainable healthcare delivery is to ensue. The following proffers a fit viability model as a systematic framework to assess and identify critical considerations for designing and developing sustainable e-health solutions. Current national and regional solutions are mapped onto this framework to demonstrate its usefulness and benefits.