Actor-Network Theory (ANT) Based Visualisation of Socio-Technical Facets of RFID Technology Translation: An Australian Hospital Scenario

Actor-Network Theory (ANT) Based Visualisation of Socio-Technical Facets of RFID Technology Translation: An Australian Hospital Scenario

Chandana Unnithan (Deakin University, Melbourne, Australia & Victoria University, Melbourne, Australia) and Arthur Tatnall (Victoria University, Melbourne, Australia)
DOI: 10.4018/ijantti.2014010103
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Abstract

In the early 2000s, Information Systems researchers in Australia had begun to emphasise socio-technical approaches in innovation adoption of technologies. The ‘essentialist' approaches to adoption (for example, Innovation Diffusion or TAM), suggest an essence is largely responsible for rate of adoption (Tatnall, 2011) or a new technology introduced may spark innovation. The socio-technical factors in implementing an innovation are largely flouted by researchers and hospitals. Innovation Translation is an approach that purports that any innovation needs to be customised and translated in to context before it can be adopted. Equally, Actor-Network Theory (ANT) is an approach that embraces the differences in technical and human factors and socio-professional aspects in a non-deterministic manner. The research reported in this paper is an attempt to combined the two approaches in an effective manner, to visualise the socio-technical factors in RFID technology adoption in an Australian hospital. This research investigation demonstrates RFID technology translation in an Australian hospital using a case approach (Yin, 2009). Data was collected using a process of focus groups and interviews, analysed with document analysis and concept mapping techniques. The data was then reconstructed in a ‘movie script' format, with Acts and Scenes funnelled to ANT informed abstraction at the end of each Act. The information visualisation at the end of each Act using ANT informed Lens reveal the re-negotiation and improvement of network relationships between the people (factors) involved including nurses, patient care orderlies, management staff and non-human participants such as equipment and technology. The paper augments the current gaps in literature regarding socio-technical approaches in technology adoption within Australian healthcare context, which is transitioning from non-integrated nearly technophobic hospitals in the last decade to a tech-savvy integrated era. More importantly, the ANT visualisation addresses one of the criticisms of ANT i.e. its insufficiency to explain relationship formations between participants and over changes of events in relationship networks (Greenhalgh & Stones, 2010).
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Introduction

Innovations are important to every society for progress. According to Oxford dictionary (2014), to innovate is ‘to make changes in something establishes, especially by introducing new methods, ideas, or products’.Tatnall (2011) delineated that “innovation is the alteration of what is established; something newly introduced” or “introducing new things or method”. If an innovation is rejected, the reasons may be that it is not context ready at that point in time. Users also perceive innovations differently which may result in innovation being rejected.

This research is set in the context of a technological innovation namely Radio Frequency Identification (RFID), which is cogitated an innovation in the health context as it continues to evolve (Yao, Chu, & Li, 2011; Azevedo & Ferreira, 2009). While RFID is a technology that has been in existence and commercially used since 1940s (Landt, 2001), hospitals are still on the verge of adopting this innovation into their contexts (Shirehjini, Yassine, & Shirmohammadi, 2012). Adoption of this mobile technology, similar to other technological innovations, has been investigated over a decade in hospitals (for example, Nagy et al., 2006; Fisher & Monahan, 2008; Coustasse et al., 2013), using ‘essentialist’ approaches (see next section) or using economic models (see for example, Yao, Chu and Li (2012)) that try to explore the cost-benefits of the technology in relation to its rate of adoption. In this research paper, we propose the use of Actor-Network Theory (ANT) for visualising the socio-technical factors that may be pertinent for adoption of this technology in Australian hospitals.

The Australian Healthcare context needs some understanding as a prelude to this paper. Prior to 2001, Australian health context was slow in adopting technologies in hospitals (Whetton, 2005; Duckett, 2007). As technologies had evolved over decades with sporadic funding from federal and state levels, hospitals had legacy systems that did not integrate or rather ‘talk to each other’ (Foster and Fleming, 2008). It was in the decade 2001-2010 that technology refreshments had begun to occur in earnest, with the imminent national health records system (Muhammed, Teo & Wickramasinghe, 2012). Towards end of the last decade, with the joint efforts of organisations such as Health Informatics Society of Australia (HISA, 2014), National E-health Transition Authority of Australia (NeHTA, 2014) and the Australasian College of Health Informatics (ACHI, 2014), hospitals in Australia began experimenting and implementing technologies that would improve their efficiency of care. As Ho (2012) indicated, both public and private health care providers are increasing their investment in technology, particularly in mobile communication, to enable process efficiency in their workforces (Ho, 2012). However, it is still an ongoing question whether the deployment of mobile technologies will have the desired ‘snowball’ effect, gradually overcoming multiple health care challenges such as demand for increased access to high-quality health care, an ageing population, shortage of clinicians, and increasing budgetary pressures in health care institutions (Ho, 2012).

Debatably, two of the largest issues facing hospitals are enhancing worker productivity and reducing human error (Ho, 2012). As most hospitals prohibit mobile phones, communication amongst health professionals occurs with fixed telephones; information is made available through desktop or fixed computers. Time spent on these devices could be more effectively spent with patients. Increased mobility—supported by mobile devices that provide secure access to real time data—for hospital staff means increased productivity, better and faster patient care, and ultimately enhanced patient outcomes (Ho, 2012). Conversely, RFID technology has only begun to be explored in Australian hospitals (Chowdhry & Khosla, 2007) since 2006, typically with vendor driven implementations that suited the cost-benefit analysis of hospitals (Chen, Wu, Su, & Yang, 2008). However, as endorsed by the literature during the time (For example, see Cox, 2008; Lee & Shim, 2007) for continued use of this technology and its adoption, there was a need for eliciting socio-technical factors that may be pertinent (Unnithan, Smith & Fraunholz, 2009).

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