APPROPRIATING VALUE FROM INFORMATION TECHNOLOGY IN HEALTHCARE

Abstract

The value potential of information technology (IT) in healthcare settings has generated considerable optimism yet, significant questions remain unanswered. This dissertation employs the lens of social structure to investigate the value of information technology in healthcare situated in two distinct contexts: hospitals, that exemplify the traditional institutional form for the delivery of healthcare services, and online patient communities that represent new organizational forms enabled by IT. It seeks to address the following fundamental research questions "What is the impact of information technology in healthcare settings? How does social structure influence the appropriation of the value of information technology in healthcare?" Each of the two contexts is investigated in a separate essay, drawing upon distinct bodies of literature and using both qualitative and quantitative analytical methods. Essay 1: Evolving Work Routines: A Theory of Successful Adaptation to Information Technology in Healthcare The first essay investigates the impact of healthcare technologies such as electronic medical record systems in the traditional hospital environment. It traces the development of changes in social structure before and after an IT implementation. Using a longitudinal field study, the process of how information technology and routines interact is deconstructed. A theory of the co-evolution of routines and technology is proposed and described. Essay 2: The Social Value of Online Health Communities The second essay examines the impact of health information technology in the form of online patient communities by uncovering the social structure of the community. Using data collected from a popular online patient community, I identify the generative processes using support patterns between patients within the community. I find that online patient communities yield social value through information and emotional support to patients by enabling the transfer of support between patients with differential needs. Results also provide descriptive insights into the attributes of patients that contribute to variation in the provision of support within such online patient communities. The two studies in this dissertation make theoretical and empirical contributions. They shed light on the impact of information technology in healthcare, and further inform us about the appropriation of HIT value from a social structure perspective.