Change and resistance to change in health care Inertia in sociotechnical systems

Abstract: This thesis explores change and resistance to change of IT systems in organisations from a sociotechnical perspective. The work is drawing on empirical data gathered during two Action Research projects in Swedish Health Care: one regarding the deployment of electronic patient record systems within health care organisations, and the other regarding the deployment of eHealth services geared towards patients and citizens. Resistance to change is classified as an indicator of social inertia, and the concept of counter-implementation, comprising three general strategies to obstruct change initiatives, is used to highlight the political aspects of social inertia. For the analysis, the concept of social inertia is used as a point of departure towards inertia in sociotechnical systems by applying values and principles from sociotechnical systems research, most prominently the interdependence-characteristic. This extended concept is used to show and discuss how IT systems can either enforce change or be a source of inertia preventing change in organisations, and such planned or inadvertent effects of implementing IT systems are discussed as a significant source of user resistance.