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

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

Imran Muhammad (RMIT University, Melbourne, VIC, Australia & Epworth Research Institute, Epworth HealthCare, Richmond, VIC, Australia), Manuel Zwicker (RMIT University, Melbourne, VIC, Australia) and Nilmini Wickramasinghe (RMIT University, Melbourne, VIC, Australia & Epworth HealthCare, Richmond, VIC, Australia)
DOI: 10.4018/jantti.2013070105
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Abstract

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.
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Introduction

Most if not all countries today are investing heavily in health information technology in general and e-health in particular (Eysenbach, 2001; OECD, 2012; Wickramasinghe & Schaffer, 2010). One of the key reasons for this is due to immense pressures currently facing healthcare delivery caused by a confluence of factors including changing patient demographics, financial implications, work force shortages, advancements in medical technologies and the need to provide efficient and effective patient centric healthcare delivery (Muhammad, Teoh, & Wickramasinghe, 2012; Wickramasinghe & Schaffer, 2010). While logically at least it appears e-health should be part of any healthcare delivery solution, the benefits from such investments are yet to be realized in practice and too often e-health solution implementations have to be abandoned after large investments have been made.

Data and information permeate all healthcare activities (Lubitz & Wickramasinghe, 2006; Wickramasinghe & Schaffer, 2010). Moreover, healthcare processes are complex and more often than not require the extraction of multi-spectral data and information to make unstructured and intricate decisions in compressed time periods. Medical errors that can have detrimental consequences can result when relevant data and pertinent information cannot be easily accessed and integrated (ibid). Hence, a key underlying assumption in support of the introduction of IT (information technology) generally, and e-health in particular, into healthcare service delivery is that it will be possible to realize significant improvements in health outcomes and quality of care (Mort, Finch, & May, 2009; Muhammad et al., 2012). This can be achieved by improving the ways of accessing and sharing data and information across healthcare systems and moving away from pen, paper and human memory towards a new environment, where key stakeholders (for example: service providers, consumers, government agencies and healthcare managers) can reliably and securely share information electronically. IT can also help with cost savings, improve patient involvement and produce useable secondary data for further research and training (Black et al., 2011; Muhammad et al., 2012). Such a transformation though is not a straightforward proposition. This is particularly so in healthcare given the complex and multifaceted environment of healthcare service delivery not to mention the inherent complexities of healthcare operations (Ammenwerth, Iller, & Mahler, 2006; Catwell & Sheikh, 2009; Cresswell, Worth, & Sheikh, 2010; Cresswell, Worth, & Sheikh, 2011; Lorenzi et al., 2009; Lubitz & Wickramasinghe, 2006). Furthermore, it is because of the complex and dynamic nature of healthcare that makes the uses of technology mediated collaborations in healthcare both unique and challenging.

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