TY - JOUR

T1 - Boundary factors and contextual contingencies

T2 - Configuring electronic templates for healthcare professionals

AU - Bjørn, Pernille

AU - Burgoyne, Sue

AU - Crompton, Vicky

AU - MacDonald, Teri

AU - Pickering, Barbe

AU - Munro, Sue

N1 - Funding Information: This study is a part of the research project ACTION for Health, funded by the Social Sciences and Humanities Research Council of Canada, Grant #512-2003-1017, titled ‘The role of technology in the production, consumption and use of health information: Implications for policy and practice’, with contributions from Simon Fraser University, Vancouver General Hospital, and British Columbia Children’s Hospital. We would especially like to acknowledge Denise Hudson, Liz Turner, Elaine Penner, and Nina Boulus, who contributed to the research presented in this paper.

PY - 2009/10

Y1 - 2009/10

N2 - In this paper, we propose an approach to balance the legitimate and yet conflicting perspectives between standardization and reconfiguration embedded within hospital information systems (HIS) design activities. We report on an action research study of the customization process of an electronic triage and tracking system that was reconfigured to be used in eight Canadian emergency departments. We argue that during HIS design activities, it is essential for both practitioners and system designers to articulate and identify which aspects can be standardized without constraining important local flexibility and which aspects require local reconfiguration to function in a particular work context. To identify these differences, we suggest an analytical distinction between boundary factors and contextual contingencies, which can be used in a design and reconfiguration process. We argue that the process of designing shared electronic templates should be perceived as a common design process, where multiple stakeholders articulate, identify, and negotiate boundary factors and contextual contingencies. Boundary factors are then represented within the shared electronic system, whereas contextual contingencies form the basis for constructing localized versions of the shared application. All local versions include both boundary factors and the reconfigured contextual contingencies.

AB - In this paper, we propose an approach to balance the legitimate and yet conflicting perspectives between standardization and reconfiguration embedded within hospital information systems (HIS) design activities. We report on an action research study of the customization process of an electronic triage and tracking system that was reconfigured to be used in eight Canadian emergency departments. We argue that during HIS design activities, it is essential for both practitioners and system designers to articulate and identify which aspects can be standardized without constraining important local flexibility and which aspects require local reconfiguration to function in a particular work context. To identify these differences, we suggest an analytical distinction between boundary factors and contextual contingencies, which can be used in a design and reconfiguration process. We argue that the process of designing shared electronic templates should be perceived as a common design process, where multiple stakeholders articulate, identify, and negotiate boundary factors and contextual contingencies. Boundary factors are then represented within the shared electronic system, whereas contextual contingencies form the basis for constructing localized versions of the shared application. All local versions include both boundary factors and the reconfigured contextual contingencies.

KW - Action research

KW - Boundary factors

KW - Boundary objects

KW - Contextual contingencies

KW - Healthcare technology

KW - Standardization

UR - http://www.scopus.com/inward/record.url?scp=71249136045&partnerID=8YFLogxK

U2 - 10.1057/ejis.2009.34

DO - 10.1057/ejis.2009.34

M3 - Journal article

AN - SCOPUS:71249136045

VL - 18

SP - 428

EP - 441

JO - European Journal of Information Systems

JF - European Journal of Information Systems

SN - 0960-085X

IS - 5

ER -