Identifying micro-level generative mechanisms of ICT-enabled performance improvement in resource-constrained healthcare organisations: a critical realist perspective

SOURCE: Electronic Journal of Information Systems in Developing Countries
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2018
TITLE AUTHOR(S): Y.Buchana, M.Garbutt, L.F.Seymour
KEYWORDS: INFORMATION AND COMMUNICATION TECHNOLOGY, PRIMARY HEALTH CARE CENTRES
DEPARTMENT: Center for Science, Technology and Innovation Indicators (CESTII)
Print: HSRC Library: shelf number 10552
HANDLE: 20.500.11910/12703

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Abstract

Healthcare studies in the information and communication technology for development (ICT4D) domain have attempted to understand how technology can be used to support healthcare organisations in developing countries; organisations whose performance is negatively impacted by resource constraints. Current studies, predominantly informed by positivist and interpretivist paradigms - produce analyses and prescriptions designed without an in-depth understanding of the underlying mechanisms influencing performance. The result is limited ability to explain how organisational performance is enabled by ICT. Critical realism as a philosophy of science provides a deeper ontological and broader epistemological approach that makes it possible to theorise the micro-level mechanisms that hold potential for explaining observed outcomes. The study reported here, informed by the critical realism paradigm, uses interviews, observation and organisational data collected from a single case study to identify the resource optimisation micro-level generative mechanisms that have improved emergency medical services. The study integrates the technological affordances lens to explain ICT-enabled organisational performance. Additionally, the paper proposes and tests an understanding of the Bygstad, Munkvold, and Volkoff stepwise framework as a methodology for doing critical realist research using affordances.