Exploring the duality of Information Technology in community health trusts

There are two important areas of inquiry, within the information systems domain, that are often framed as dualities. The first relates to the nature of the relationship between technological artefacts and human practices: does technology shape human practice or is technology shaped by human agency? The second concerns the impact of information technologies: does IT empower the user or is the user controlled by IT? The aim of this study is to provide new insights into the nature of these dualities by exploring the development, implementation and use of a standard software application, within a homogenous organisational sector, namely NHS Community Trusts. A multiple case-study design incorporating five Community Healthcare Trusts was utilised. The study found that whilst the information system was perceived as facilitating empowerment in two Trusts, it was felt to be reinforcing management control in another Trust; there was no significant change to the distribution of power in the other two Trusts. Moreover, the differences in outcome could be explained by the degree of ‘interpretive flexibility’ associated with each of the information systems projects: the empowerment of users was found in Trusts where the users were actively engaged in the system’s social and physical constitution.