Aarts Jos, Doorewaard Hans, Berg Marc
Institute of Health Policy and Management, Erasmus University Medical Center, Rotterdam, The Netherlands.
J Am Med Inform Assoc. 2004 May-Jun;11(3):207-16. doi: 10.1197/jamia.M1372. Epub 2004 Feb 5.
Most studies of the impact of information systems in organizations tend to see the implementation process as a "rollout" of technology, as a technical matter removed from organizational dynamics. There is substantial agreement that the success of implementing information systems is determined by organizational factors. However, it is less clear what these factors are. The authors propose to characterize the introduction of an information system as a process of mutual shaping. As a result, both the technology and the practice supported by the technology are transformed, and specific technical and social outcomes gradually emerge. The authors suggest that insights from social studies of science and technology can help to understand an implementation process. Focusing on three theoretical aspects, the authors argue first that the implementation process should be understood as a thoroughly social process in which both technology and practice are transformed. Second, following Orlikowski's concept of "emergent change," they suggest that implementing a system is, by its very nature, unpredictable. Third, they argue that success and failure are not dichotomous and static categories, but socially negotiated judgments. Using these insights, the authors have analyzed the implementation of a computerized physician order entry (CPOE) system in a large Dutch university medical center. During the course of this study, the full implementation of CPOE was halted, but the aborted implementation exposed issues on which the authors did not initially focus.
大多数关于信息系统在组织中影响的研究往往将实施过程视为技术的“推广”，视为与组织动态无关的技术问题。人们普遍认为，信息系统实施的成功取决于组织因素。然而，这些因素具体是什么却不太明确。作者们提议将信息系统的引入描述为一个相互塑造的过程。结果，技术以及由该技术支持的实践都发生了转变，特定的技术和社会成果逐渐显现。作者们认为，科学技术的社会研究中的见解有助于理解实施过程。聚焦于三个理论方面，作者们首先认为，实施过程应被理解为一个彻底的社会过程，在这个过程中技术和实践都会发生转变。其次，遵循奥利克owski的“突发变革”概念，他们认为实施一个系统本质上是不可预测的。第三，他们认为成功和失败并非二分且静态的类别，而是社会协商的判断。运用这些见解，作者们分析了荷兰一家大型大学医学中心实施计算机化医嘱录入（CPOE）系统的情况。在这项研究过程中，CPOE的全面实施被中止，但这次流产的实施暴露了一些作者最初并未关注的问题。
