Unintended consequences of technology-enabled work activities experienced by healthcare professionals in tertiary hospitals of sub-Saharan Africa

Abstract

The unintended consequences experienced by healthcare professionals while using health ICTs at points-of-care are disruptive to their work activities. Failure to address these consequences inhibits efforts to support the delivery of quality healthcare services in hospital settings. Hence, the aim of this paper is to identify how unintended consequences disrupt technology-enabled work activities of healthcare professionals in hospital settings. An interpretive stance was adopted to investigate healthcare professionals’ experiences with the use of health ICTs for their work activities through open-ended interview questions, to acquire in-depth information about unintended consequences events. A total of 19 participants were selected using a purposive sampling technique to identify healthcare professionals from two tertiary hospitals with varying levels of technology implementation. The participants included doctors and nurses in clinical departments that use health ICTs for medical imaging, referrals and reporting. Ethics clearance for data collection were granted by the University research ethics committee and the hospitals. Thematic analysis was adopted to identify and interpret patterns that emerged from participants’ responses. Findings indicated that the unintended consequences experienced by healthcare professionals are protracted time to complete tasks; interruption of tasks and workarounds at points-of-care. The unintended consequences are caused by contradictions that result from tensions between contextual conditions that inhibit perceived usefulness, and a lack of fit between tasks of work activities and health ICTs. Hospital managers and health technology vendors should actively consider the likely undesirable experiences or disruptions from feedback recorded during the pilot implementation phase within use contexts.