It is hard to overstate the importance of an international forum which brings together leading researchers studying how information and communication technologies (ICT) can be safely and effectively designed, implemented and used within the health system. The ICT research enterprise has increased substantially in the last decade.
Alongside the research interest, investments in clinical systems have grown and their sophistication and capacity to contribute to health sector improvement continues at a rapid pace. Yet, amongst this growth, evidence regarding the benefits of system introduction remains limited and has not kept pace. For example, good studies of benefits realization remain sporadic, and large scale system failures occur all too frequently. Early studies of health information system failures identified the central role of the human, social and organizational contexts in which information systems operate. They set the challenge for researchers to understand how to obtain the best fit between the technical systems (e.g. the information systems and associated work practices) and the social systems (e.g. organisational culture, social practices and behaviours, and political mileu).
The origins of socio-technical theory can be traced to different strands, one of which is the seminal work undertaken by organizational researchers Trist and Bamforth who originally studied British coal miners in the 1940s and 1950s. Another important strand is the work of Bruno Latour and Steve Woolger who in the 1970s examined how scientific facts are constructed in a laboratory. Since this time many health informatics researchers have adapted this theoretical approach implicitly or explicitly, and have framed their research within a socio-technical perspective.
This has resulted in a new and exciting body of work embracing a socio-technical perspective of health information system design, implementation and evaluation contributed to by researchers from many countries. In 2001 the 1st International Conference on Technology in Health Care: Socio-technical Approaches was held in Rotterdam, The Netherlands. It brought together academics to discuss their research under the common theme of socio-technical approaches. This conference was important in identifying an international community of scholars from a broad range of disciplines. The research discussed revealed aspects of the complexity involved in studying the implementation and impact of clinical information systems within health care organisations. In particular, the research highlighted the value in harnessing a multi-disciplinary and multi-method approach to this topic. In 2004 the 2nd International Conference on Technology in Health Care: Socio-technical Approaches was held in Oregon, USA. This showed how innovative researchers were extending the reach and relevance of their research contributions.
This volume presents the papers from the 3rd International Conference on Technology in Health Care: Socio-technical Approaches held in Sydney, Australia in 2007. Six years on from the first conference in Rotterdam the quality of the research papers has continued to improve as have the theoretical sophistication and empirical methodologies. Considerable advances are evident, though many of the underlying challenges, such as our ability to design, implement and evaluate safe, useable and effective systems within complex health care organisations, remain. Several researchers at the original Socio-technical conference present papers in the current volume and the continued development and contribution of their work can be seen. Importantly, there is also a contingent of newer researchers who present papers which bring new insights. Our field is dynamic, and growing, and is a platform for some of the finest research and researchers in any discipline. These contributions demonstrate the vital role that the socio-technical health informatics research community has in fostering greater research capacity, and translating research findings to improve health care service delivery, health policy and outcomes. We are grateful for the support and conference sponsorship provided by the NSW Health Department and Intel Australia. Continued collaborations between researchers and industry are vital in moving this important research agenda forward.
Johanna I Westbrook, Enrico W Coiera, Joanne L Callen, Jos Aarts