Broadening the Socio-Technical Horizons of Health Informatics

Abstract

This special socio-technical supplement of the Open Medical Informatics Journal showcases a number of innovative and unique research approaches that highlight the current scope of socio-technical perspectives in the health informatics discipline. In just three short decades the discipline of health informatics has evolved from a primary focus on the " application of computers to all fields of medicine – medical care, medical education and medical research " [1] to an increasing focus on socio-technical issues where " people and organizational issues are critical " (page 79) [2]. The incorporation of socio-technical perspectives arose as researchers sought to analyse the reasons behind the limited successes of many early health information management systems. The application of socio-technical analyses demonstrated that effective systems implementation required an appreciation of both technological and organisational factors. While technical elements continue to be core to health informatics knowledge, socio-technical research seeks to further our understanding of the organisational and cultural factors inherent in the introduction of information management systems into the health care environment. Early socio-technical research included reflections both on its role in knowledge development and its application to the practice of health informatics [3-5]. Research and discussion often took the form of a critique of the established technology focussed approaches. However, as Coiera notes, " for the contribution of socio-technical systems thinking to be more than simply a means of critiquing current practices and systems, it needs to also contribute to the process of developing new and more effective systems " (page S98) [6]. The papers in this supplement highlight how many of today's researchers have adopted a socio-technical focus as an established and credible methodology, not just for critiquing past mistakes, but for developing an understanding of key success factors in the development and implementation of new systems. The papers also show how researchers are using the basic concepts and multi-method socio-technical approaches, and applying these to a range of research situations. Chhanabhai and Holt demonstrate the universal relevance of socio-technical perspectives in their analysis of information and communications technologies in developing countries [7]. The authors present an overview of current methods through which healthcare information is communicated to the public within these countries. Niazkhani applies socio-technical analyses to a clinical environment. This exploratory research draws on socio-technical theories to provide insights into the differences between the perceptions of surgical and non-surgical clinicians in relation to Computerised Provider Order Entry (CPOE) systems [8]. The papers by Scott [9] and Li [10] highlight the increasing interest of today's researchers in making connections between academic research and the professional environment. Li's paper seeks to develop a model that will bring together the theory and practice of socio-technical perspectives in health informatics. Scott also investigates this area as a means of constructing an innovative socio-technical assessment tool for health information system implementations. The authors contributing to this special edition also highlight the multi-disciplinary, interrelated character of health informatics. The papers by Borycki and Kushniruk [11], and Cummings and Turner [12] demonstrate how a melding of socio-technical perspectives with other approaches can offer new insights for health informatics practitioners. Borycki and Kushniruk combine socio-technical and cognitive approaches to facilitate a more holistic understanding of the impact of health information systems [11], while Cummings and Turner adopt a multi-disciplinary approach in their critical review of current research and evaluation practices [12].