Seeking a Multi-Level Model for Workarounds in Healthcare IT

Authors

Amy J. Connolly, James Madison UniversityFollow
Elizabeth Baker, Virginia Commonwealth UniversityFollow

Abstract

Workarounds in healthcare IT (HIT) have been extensively studied in IS research as to what they are or are not (Ejnefjäll & Ågerfalk, 2019), theories that might explain why individuals create workarounds (Alter, 2014; Van Offenbeek et al., 2023), how to fix individual workarounds (Morquin et al., 2023), and recently, the sharing of workarounds (Raman & Sullivan, 2024). Despite ongoing research, we do not yet clearly understand why workarounds persist. Whether workarounds are viewed positively as necessary innovations or negatively as aberrations that should be avoided, they still represent deviate from proscribed procedures, and they burden clinicians with extra work. At best, workarounds are the result of a poorly-designed human-computer interface; at worst, they cause adverse patient events and clinician burnout. For example, a nurse on their daily rounds types 8,000 keystrokes into an HIT to treat patients; in contrast, a word processor averages 3,000 keystrokes. Add to that workload the need to continue treating patients when an HIT that does not work as it should, and it’s little surprise that the healthcare industry has severe staffing shortages. We posit that IS research is uniquely positioned at the confluence of HIT, people, and organizations to address issues caused by the ongoing redesign and implementation of HIT. The continued persistence of workarounds of HIT contributes to staffing shortages, poor organizational cultures, worker and patient safety issues, and increased costs. The first step to move this research field forward is to stop and recognize that the problem is not with the clinicians, i.e., the HIT users. Rather, IS research needs to consider the problems of workarounds from a multi-method theoretical viewpoint that looks beyond users. Without considering the context which creates the need for workarounds by clinicians in the first place, workarounds will continue happening despite efforts to stop them from happening. In this TREO talk, we will present preliminary research on applying a multi-level view of workarounds in HIT, particularly the value-add of changing our view from that of the individual to that of the whole ecosystem in which HIT is used.

Paper Number

tpp1332

Recommended Citation

Connolly, Amy J. and Baker, Elizabeth, "Seeking a Multi-Level Model for Workarounds in Healthcare IT" (2024). AMCIS 2024 TREOs. 50.
https://aisel.aisnet.org/treos_amcis2024/50