Working around health information systems: The role of power

Abstract

In this paper we analyze the role of power relations in the emergence of workarounds in Health Information Systems (HISs). Using an explorative multi-case study of five healthcare organizations in the Netherlands, we identify 51 workarounds as well as the underlying power relations that underlie them. We distinguish two main types of power that are important for the emergence of workarounds: (1) hierarchical differences between actors and (2) system restrictions. Our study unpacks the link between power and HISs, illustrating how actors respond to hierarchical differences and system restrictions to exert their ‘power to work around’.