TY - JOUR
T1 - Utilizing a discourse-based understanding of organizational change to explore the introduction of National Electronic Health Records in England
AU - Morrison, Zoe
AU - Marsden, Kate
AU - Cresswell, Kathrin
AU - Fernando, Bernard
AU - Sheikh, Aziz
PY - 2013
Y1 - 2013
N2 - The authors utilized pragmatic discursive analysis to consider their empirical study of the introduction of an electronic patient record system within hospitals based in a large region of the National Health Service in England. Their aim was to gain insight into the interplay between discourse and change as mediated by technology by exploring how a politically driven programme of change was translated during the introduction of a computer system intended to provide an electronic patient record. They identified contrasting discourses, determined by situated professional practices and stakeholder expectations that framed alternate understandings of the proposed systems implementation and related change processes. Over time, these contrasting local discourses in turn became increasingly dissonant with the national change programme policy rhetoric as the systems software failed to deliver anticipated benefits. The authors’ work emphasizes the mediating effect of technology in discourses of change. Limitations in systems functionality and a related lack of discourses of success slowed social momentum. Consequently, local and political articulations of change began to fragment. The authors suggest that understandings of change are experienced through different interpretive frameworks and mediated through the materiality of technology, highlighting the possibility of many and alternate meanings within any change process, and the considerable challenges in the development and implementation of information technology in healthcare.
AB - The authors utilized pragmatic discursive analysis to consider their empirical study of the introduction of an electronic patient record system within hospitals based in a large region of the National Health Service in England. Their aim was to gain insight into the interplay between discourse and change as mediated by technology by exploring how a politically driven programme of change was translated during the introduction of a computer system intended to provide an electronic patient record. They identified contrasting discourses, determined by situated professional practices and stakeholder expectations that framed alternate understandings of the proposed systems implementation and related change processes. Over time, these contrasting local discourses in turn became increasingly dissonant with the national change programme policy rhetoric as the systems software failed to deliver anticipated benefits. The authors’ work emphasizes the mediating effect of technology in discourses of change. Limitations in systems functionality and a related lack of discourses of success slowed social momentum. Consequently, local and political articulations of change began to fragment. The authors suggest that understandings of change are experienced through different interpretive frameworks and mediated through the materiality of technology, highlighting the possibility of many and alternate meanings within any change process, and the considerable challenges in the development and implementation of information technology in healthcare.
U2 - 10.1080/14697017.2013.822672
DO - 10.1080/14697017.2013.822672
M3 - Article
SN - 1469-7017
VL - 13
SP - 266
EP - 282
JO - Journal of Change Management
JF - Journal of Change Management
IS - 3
M1 - 13
ER -