The emergence of digitalisation in the context of health care

Abstract

Digitisation of medical records by means of Electronic Patient Record (EPR) systems promises to improve the overall quality of health care. However, studies show that the outcome of their use is mixed. Derived from a critical realism lens the morphogenetic approach is used to understand and explain how does digitalisation emerge in health care settings. We draw on a longitudinal case study of a hospital that implemented an EPR system. Interviews and observations were used as data collection techniques. The initial analysis identified three tentative generative mechanisms: data-sharing, process-streamlining, and connectivity mechanisms which help to describe and explain the emergence of digitalisation in health care context. By using the morphogenetic approach, two grains are seen to accrue: the critical role of digital materiality in organisational change and clarity about the interplay between the materiality of technology (an emergent property of structure) and agential reflexivity (an emergent property of agency).