Ela Klecun | London School of Economics and Political Science (original) (raw)
Papers by Ela Klecun
This panel will discuss what digital literacy (or e-Literacy) means in the context of health care... more This panel will discuss what digital literacy (or e-Literacy) means in the context of health care work, its importance and how it might be attained. The panel topic is of particular importance for the conference's main theme of improved care through informatics. The discussion is informed by our studies of implementation and use of different information systems (such as e-prescribing, electronic transmission of prescriptions, and electronic health records) in healthcare organisations. Our starting point is the need to move beyond narrowly conceived IT skills and 'key-stroke' training and address a wider set of literacies, incorporating skills, capabilities, understandings and sense making activities. We are interested in how healthcare professionals (HCPs) work mediated by digital technologies and performed by individuals, in cooperation and collaboration with others and within wider institutional and inter-institutional contexts, might be facilitated by different approaches to e-Literacy. We discuss how the process of acquiring and sustaining digital health literacy can be conceptualised and facilitated. We ask questions such as what are the implications of these conceptualisations of digital health literacy for HCPs education, for training and for other activities during information system implementation and adoption? We also ask how can digital health literacy be sustained as a competency of the organisation as well as the individual?
and administration system Qualitative evaluation of an electronic prescribing
n Digital divide discourse and initiatives n Social and Digital exclusion n How people perceive d... more n Digital divide discourse and initiatives n Social and Digital exclusion n How people perceive digital exclusion and new technologies n Literacies for skilled ICT use n An inclusion curriculum
Studies in health technology and informatics, 2001
In recent years the focus of ICTs in healthcare has changed from the â back office' to the fr... more In recent years the focus of ICTs in healthcare has changed from the â back office' to the front end of patient care. These changes have been brought about by a number of factors including the potential of technologies, pressures for modernisation and administrative reforms, including blurring of the boundaries between different organisations (within and beyond the health sector), and which break down traditional barriers between administration of health services and the practice of medicine In this paper we explore in particular how technology is implicated in such changes, focussing on the consequences of the use of the new telehealth technologies, as seen in a set of linked case studies from an inner city borough in London. The paper addresses the way these technologies, through routine use, become (or not) resources and rules that embody new structures for health care.
The planned NHS scheme in which patient’s medical records would be compiled into a national datab... more The planned NHS scheme in which patient’s medical records would be compiled into a national database for research purposes has been postponed, amid concerns that the project was communicated poorly to the public. In this post, we ask democracy and health experts to share the views on the value of the care.data scheme and the important safeguards around the privacy of personal information that need to be in place before any re-launch.
Affordance theory has promise for studying technology’s role in organizational change. By disting... more Affordance theory has promise for studying technology’s role in organizational change. By distinguishing properties of technology and their affordances in relation to its users, it facilitates the examination of technological consequences whilst avoiding technological determinism. This paper argues that it is useful to explore affordances and consequences of their actualization (or the lack of) at an organizational field level, because they might emerge from phenomena cutting across organizational and technological boundaries. Such a focus would include exploration of technological architectures not just specific artefacts, and mapping of complimentary affordances, as well as discontinuities helping or hindering organizations in achieving a shared goal. The paper introduces our study of IT-enabled change programs in healthcare to illustrate how such research might be conducted from the affordance theory perspective. Our ultimate aim is to contribute to the development of the afforda...
Studies in health technology and informatics, 2017
Medicines' supply and use is incresingly reliant on digital means and information. This poste... more Medicines' supply and use is incresingly reliant on digital means and information. This poster presents exploratory research over five episodes of digitalisation of medicines across the supply network. We 'follow the drug' through this emerging field, providing an initial map of this new territory.
Abstract Electronic patient records, physicians' office systems, tel... more Abstract Electronic patient records, physicians' office systems, telehealth projects, resource management endeavors, and other applications are undergoing evaluation in the UK. This workshop provides an overview of these projects and an opportunity to discuss evaluation. Keywords:
Objectives To describe and evaluate the implementation and adoption of detailed electronic health... more Objectives To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service. Design A mixed methods, longitudinal, multisite, sociotechnical case study. Setting Five NHS acute hospital and mental health trusts that have been the focus of early implementation efforts and at which interim data collection and analysis are
Information Systems Research, 2004
This paper considers the proposition that actor-network theory (ANT) might be adopted within a br... more This paper considers the proposition that actor-network theory (ANT) might be adopted within a broader critical paradigm to conduct empirical studies. The paper outlines the main tenets of the two theories, with the critical perspective primarily represented by Foucault. The aim is not to provide an extensive discussion of critical theory and ANT but to focus on their approach to the nature, scope, and level of empirical studies, particularly in their treatment of micro/macro analysis. The paper concludes that the differences are less significant than it may appear at first and that some of ANT's ideas are close to Foucault's position. However, ANT focuses on actors and their actions as they are performed in a particular time and place and does not appear to be concerned to what extent they may be historically conditioned. Thus, ANT on its own, in the view of the author, might not offer sufficient explanations as to why the actors under study take particular actions and why some actors are excluded or marginalized from the innovation process, e.g. from the development and implementation of an IS. For these reasons this paper suggests a critical research agenda enriched by ANT insights. The Information Systems field is influenced by a number of disciplines, including computer science, management and organizational studies, social science, and philosophy. Early on, many IS researchers primarily concentrated on technology, seeing technological development as following a predefined trajectory and technology as Critical theory, actor-network theory, information systems, Foucault
This large scale evaluation would not have been possible without the help of a number of people w... more This large scale evaluation would not have been possible without the help of a number of people who we here take great pleasure in acknowledging. First and foremost, we thank the participating NHS Trusts and individual participants for their time and support.
This fully revised and updated second edition of Information Systems Strategic Management continu... more This fully revised and updated second edition of Information Systems Strategic Management continues to provide an accessible yet critical analysis of the strategic aspects of information systems.
International Journal of Digital Literacy and Digital Competence, 2010
This paper outlines and challenges expectations and promises regarding the potential of the inter... more This paper outlines and challenges expectations and promises regarding the potential of the internet and Web 2.0 for empowering patients and citizens. It focuses on literacies required to make a meaningful (to the individual) use of these technologies for health and health care related purposes. The author briefly discusses how these should be taught and concludes that these literacies, including digital literacy and health literacy, are complex and challenging to many while the empowering claims are over-stated. Traditional sources of information and advice will remain essential to maintaining quality of health care.
This panel will discuss what digital literacy (or e-Literacy) means in the context of health care... more This panel will discuss what digital literacy (or e-Literacy) means in the context of health care work, its importance and how it might be attained. The panel topic is of particular importance for the conference's main theme of improved care through informatics. The discussion is informed by our studies of implementation and use of different information systems (such as e-prescribing, electronic transmission of prescriptions, and electronic health records) in healthcare organisations. Our starting point is the need to move beyond narrowly conceived IT skills and 'key-stroke' training and address a wider set of literacies, incorporating skills, capabilities, understandings and sense making activities. We are interested in how healthcare professionals (HCPs) work mediated by digital technologies and performed by individuals, in cooperation and collaboration with others and within wider institutional and inter-institutional contexts, might be facilitated by different approaches to e-Literacy. We discuss how the process of acquiring and sustaining digital health literacy can be conceptualised and facilitated. We ask questions such as what are the implications of these conceptualisations of digital health literacy for HCPs education, for training and for other activities during information system implementation and adoption? We also ask how can digital health literacy be sustained as a competency of the organisation as well as the individual?
IFIP International Federation for Information Processing
Handbook of Critical Information Systems Research
Journal of Intelligent Systems, 2006
It is important to recognize the interplay between continuously evolving information and communic... more It is important to recognize the interplay between continuously evolving information and communication technologies (ICT), and social factors that influence their design and development. This paper draws on insights from the papers in this special issue and other relevant works to present a discussion of different theoretical perspectives on technology. The aim of this review is to highlight potential contributions of those different perspectives to our understanding of ICT and to consider the implications for their design, implementation, and use by individuals or groups of people. The review therefore emphasizes the influence individuals and social networks have, or should have, on the interaction, design, and development of technologies.
Information Technology & People, 2008
PurposeThe purpose of this paper is to critique the discourse of the digital divide and to propos... more PurposeThe purpose of this paper is to critique the discourse of the digital divide and to propose ways of responding to digital inequalities.Design/methodology/approachIllustrations of arguments are based on reviews of academic literature, projects reports, policy documents and research findings from the Penceil project, and are informed by critical theory. The research consisted of 47 semi‐structured interviews and action research involving designing an e‐literacy curriculum and running a course based on it.FindingsA discourse of missed opportunities and “being left behind”, present in policy statements and popular media, leads to objectifying non‐users of information and communication technologies (ICT) as “others”. This discourse is often internalised by non‐users, but it does not necessarily lead to positive actions, leaving some feeling inadequate. So far initiatives seeking to address the digital divide have had moderate success. To respond to digital exclusion we need to opp...
Information Systems Journal, 2000
Over the last decade, British health policy has increasingly considered the role of information a... more Over the last decade, British health policy has increasingly considered the role of information and information technologies in the provision of health care. Recently, there is a growing interest in new health applications, often referred to as telemedicine and telehealth, and incorporating a diverse range of services that can be provided in electronic form over various telecommunications networks. This paper discusses how such use of information and communication technologies (ICTs) in health acquires meanings through a policy process, and what implications it has for telehealth in particular. This is done through a hermeneutic exploration of four principal UK health policy papers published between 1989 and 1998.
This panel will discuss what digital literacy (or e-Literacy) means in the context of health care... more This panel will discuss what digital literacy (or e-Literacy) means in the context of health care work, its importance and how it might be attained. The panel topic is of particular importance for the conference's main theme of improved care through informatics. The discussion is informed by our studies of implementation and use of different information systems (such as e-prescribing, electronic transmission of prescriptions, and electronic health records) in healthcare organisations. Our starting point is the need to move beyond narrowly conceived IT skills and 'key-stroke' training and address a wider set of literacies, incorporating skills, capabilities, understandings and sense making activities. We are interested in how healthcare professionals (HCPs) work mediated by digital technologies and performed by individuals, in cooperation and collaboration with others and within wider institutional and inter-institutional contexts, might be facilitated by different approaches to e-Literacy. We discuss how the process of acquiring and sustaining digital health literacy can be conceptualised and facilitated. We ask questions such as what are the implications of these conceptualisations of digital health literacy for HCPs education, for training and for other activities during information system implementation and adoption? We also ask how can digital health literacy be sustained as a competency of the organisation as well as the individual?
and administration system Qualitative evaluation of an electronic prescribing
n Digital divide discourse and initiatives n Social and Digital exclusion n How people perceive d... more n Digital divide discourse and initiatives n Social and Digital exclusion n How people perceive digital exclusion and new technologies n Literacies for skilled ICT use n An inclusion curriculum
Studies in health technology and informatics, 2001
In recent years the focus of ICTs in healthcare has changed from the â back office' to the fr... more In recent years the focus of ICTs in healthcare has changed from the â back office' to the front end of patient care. These changes have been brought about by a number of factors including the potential of technologies, pressures for modernisation and administrative reforms, including blurring of the boundaries between different organisations (within and beyond the health sector), and which break down traditional barriers between administration of health services and the practice of medicine In this paper we explore in particular how technology is implicated in such changes, focussing on the consequences of the use of the new telehealth technologies, as seen in a set of linked case studies from an inner city borough in London. The paper addresses the way these technologies, through routine use, become (or not) resources and rules that embody new structures for health care.
The planned NHS scheme in which patient’s medical records would be compiled into a national datab... more The planned NHS scheme in which patient’s medical records would be compiled into a national database for research purposes has been postponed, amid concerns that the project was communicated poorly to the public. In this post, we ask democracy and health experts to share the views on the value of the care.data scheme and the important safeguards around the privacy of personal information that need to be in place before any re-launch.
Affordance theory has promise for studying technology’s role in organizational change. By disting... more Affordance theory has promise for studying technology’s role in organizational change. By distinguishing properties of technology and their affordances in relation to its users, it facilitates the examination of technological consequences whilst avoiding technological determinism. This paper argues that it is useful to explore affordances and consequences of their actualization (or the lack of) at an organizational field level, because they might emerge from phenomena cutting across organizational and technological boundaries. Such a focus would include exploration of technological architectures not just specific artefacts, and mapping of complimentary affordances, as well as discontinuities helping or hindering organizations in achieving a shared goal. The paper introduces our study of IT-enabled change programs in healthcare to illustrate how such research might be conducted from the affordance theory perspective. Our ultimate aim is to contribute to the development of the afforda...
Studies in health technology and informatics, 2017
Medicines' supply and use is incresingly reliant on digital means and information. This poste... more Medicines' supply and use is incresingly reliant on digital means and information. This poster presents exploratory research over five episodes of digitalisation of medicines across the supply network. We 'follow the drug' through this emerging field, providing an initial map of this new territory.
Abstract Electronic patient records, physicians' office systems, tel... more Abstract Electronic patient records, physicians' office systems, telehealth projects, resource management endeavors, and other applications are undergoing evaluation in the UK. This workshop provides an overview of these projects and an opportunity to discuss evaluation. Keywords:
Objectives To describe and evaluate the implementation and adoption of detailed electronic health... more Objectives To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service. Design A mixed methods, longitudinal, multisite, sociotechnical case study. Setting Five NHS acute hospital and mental health trusts that have been the focus of early implementation efforts and at which interim data collection and analysis are
Information Systems Research, 2004
This paper considers the proposition that actor-network theory (ANT) might be adopted within a br... more This paper considers the proposition that actor-network theory (ANT) might be adopted within a broader critical paradigm to conduct empirical studies. The paper outlines the main tenets of the two theories, with the critical perspective primarily represented by Foucault. The aim is not to provide an extensive discussion of critical theory and ANT but to focus on their approach to the nature, scope, and level of empirical studies, particularly in their treatment of micro/macro analysis. The paper concludes that the differences are less significant than it may appear at first and that some of ANT's ideas are close to Foucault's position. However, ANT focuses on actors and their actions as they are performed in a particular time and place and does not appear to be concerned to what extent they may be historically conditioned. Thus, ANT on its own, in the view of the author, might not offer sufficient explanations as to why the actors under study take particular actions and why some actors are excluded or marginalized from the innovation process, e.g. from the development and implementation of an IS. For these reasons this paper suggests a critical research agenda enriched by ANT insights. The Information Systems field is influenced by a number of disciplines, including computer science, management and organizational studies, social science, and philosophy. Early on, many IS researchers primarily concentrated on technology, seeing technological development as following a predefined trajectory and technology as Critical theory, actor-network theory, information systems, Foucault
This large scale evaluation would not have been possible without the help of a number of people w... more This large scale evaluation would not have been possible without the help of a number of people who we here take great pleasure in acknowledging. First and foremost, we thank the participating NHS Trusts and individual participants for their time and support.
This fully revised and updated second edition of Information Systems Strategic Management continu... more This fully revised and updated second edition of Information Systems Strategic Management continues to provide an accessible yet critical analysis of the strategic aspects of information systems.
International Journal of Digital Literacy and Digital Competence, 2010
This paper outlines and challenges expectations and promises regarding the potential of the inter... more This paper outlines and challenges expectations and promises regarding the potential of the internet and Web 2.0 for empowering patients and citizens. It focuses on literacies required to make a meaningful (to the individual) use of these technologies for health and health care related purposes. The author briefly discusses how these should be taught and concludes that these literacies, including digital literacy and health literacy, are complex and challenging to many while the empowering claims are over-stated. Traditional sources of information and advice will remain essential to maintaining quality of health care.
This panel will discuss what digital literacy (or e-Literacy) means in the context of health care... more This panel will discuss what digital literacy (or e-Literacy) means in the context of health care work, its importance and how it might be attained. The panel topic is of particular importance for the conference's main theme of improved care through informatics. The discussion is informed by our studies of implementation and use of different information systems (such as e-prescribing, electronic transmission of prescriptions, and electronic health records) in healthcare organisations. Our starting point is the need to move beyond narrowly conceived IT skills and 'key-stroke' training and address a wider set of literacies, incorporating skills, capabilities, understandings and sense making activities. We are interested in how healthcare professionals (HCPs) work mediated by digital technologies and performed by individuals, in cooperation and collaboration with others and within wider institutional and inter-institutional contexts, might be facilitated by different approaches to e-Literacy. We discuss how the process of acquiring and sustaining digital health literacy can be conceptualised and facilitated. We ask questions such as what are the implications of these conceptualisations of digital health literacy for HCPs education, for training and for other activities during information system implementation and adoption? We also ask how can digital health literacy be sustained as a competency of the organisation as well as the individual?
IFIP International Federation for Information Processing
Handbook of Critical Information Systems Research
Journal of Intelligent Systems, 2006
It is important to recognize the interplay between continuously evolving information and communic... more It is important to recognize the interplay between continuously evolving information and communication technologies (ICT), and social factors that influence their design and development. This paper draws on insights from the papers in this special issue and other relevant works to present a discussion of different theoretical perspectives on technology. The aim of this review is to highlight potential contributions of those different perspectives to our understanding of ICT and to consider the implications for their design, implementation, and use by individuals or groups of people. The review therefore emphasizes the influence individuals and social networks have, or should have, on the interaction, design, and development of technologies.
Information Technology & People, 2008
PurposeThe purpose of this paper is to critique the discourse of the digital divide and to propos... more PurposeThe purpose of this paper is to critique the discourse of the digital divide and to propose ways of responding to digital inequalities.Design/methodology/approachIllustrations of arguments are based on reviews of academic literature, projects reports, policy documents and research findings from the Penceil project, and are informed by critical theory. The research consisted of 47 semi‐structured interviews and action research involving designing an e‐literacy curriculum and running a course based on it.FindingsA discourse of missed opportunities and “being left behind”, present in policy statements and popular media, leads to objectifying non‐users of information and communication technologies (ICT) as “others”. This discourse is often internalised by non‐users, but it does not necessarily lead to positive actions, leaving some feeling inadequate. So far initiatives seeking to address the digital divide have had moderate success. To respond to digital exclusion we need to opp...
Information Systems Journal, 2000
Over the last decade, British health policy has increasingly considered the role of information a... more Over the last decade, British health policy has increasingly considered the role of information and information technologies in the provision of health care. Recently, there is a growing interest in new health applications, often referred to as telemedicine and telehealth, and incorporating a diverse range of services that can be provided in electronic form over various telecommunications networks. This paper discusses how such use of information and communication technologies (ICTs) in health acquires meanings through a policy process, and what implications it has for telehealth in particular. This is done through a hermeneutic exploration of four principal UK health policy papers published between 1989 and 1998.