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The Internet is serving as one of the major technological options to perform services for customers (Rayport & Jaworski, 2005). It is estimated that 70% of customer service interactions for information and remote transactions will be automated (Gartner, 2002). As a result, integrating products and services using Internet-based technologies appears to be among the most complex problems facing firms today (Meuter, Bitner, & Ostrom, 2005; Schultze & Orlikowski, 2004). In particular, there has been rampant growth in healthcare service delivery options, based on the Internet and related Information and Communication Technology (ICT) (Goldstein, 2000). Consequently, there is a great deal of expectation among national governments, regulators, healthcare organisations, and other stakeholders about the role of the Internet in healthcare service provision. Given the global crisis in healthcare services generally and the funding of healthcare services specifically (World Health Report, 2000), a number of policymakers view the advances in Internet-based self-service technology (SST) as a potential enabler of more efficient and effective healthcare service delivery (Lang & Collen, 2005; Bitner & Brown, 2008). Proponents of consumer-driven healthcare insurance in particular who seek to use the Internet to make consumers more informed about healthcare funding decisions and to reduce the cost of servicing consumers have been actively experimenting in this area (Cannon & Tanner, 2005; Herzlinger & Parsa-Parsi, 2004).
The status and maturity of Internet-based SST’s can be characterised as an emerging subfield of Information Systems (IS). Currently, an incomplete picture has been created for explaining the contradictory robustness of these technologies despite their protracted uptake (Pandya & Dholakia, 2005; Hannemeyr, 2003; Dabholkar, 1996). Despite strong interest in the subject of SSTs, there is clearly a need for empirically testable theories, conceptual models, and frameworks to move research forward (Parasuraman & Zinkhan, 2002). More specifically, the SST as a novel contemporary technology offers us the prospect of exploring unique features of the technological artefact and to probe the integral relations between society, technology and humans (Orlikowski, 2007, 2009).
Contemporary IT artefacts such as SSTs are innately complex and current perspectives of IT artefacts are too limited to enrich our understanding of these elusive phenomena. Our principal aim therefore in attempting to understand the SST is to depart from a predictable view of the technological artefact to a more complex and ‘fluid’ understanding of the character of these novel information systems. Our major contention is that their implementation cannot be viewed as predictable and seamless. We therefore need to glean from a framework that is concerned with ‘complexity in practice’. As such we will turn to actor-network theory (ANT), post-ANT, and the more recent feminist work on technological objects. We will do this by highlighting the ‘fluid’ character of the SST based on a case study of an implementation at a large multinational private healthcare insurance firm. The argument of this paper is presented as follows. In the next section, the literature on the technological object is critically reviewed, before we provide an overview of the research context, and a justification for the research methods used, in the following section. The subsequent and most substantive section reports on the implementation of the SST at a healthcare insurance organisation. In the final two sections, we offer an interpretation and discuss the implications of our findings in the context of the literature.