Från vision till integration infusion av telemedicin : en översättningsprocess

Sammanfattning: During the 1990's high expectations were put on telemedicine technology in health care organizations, which can be seen as a reflexion of the society's interest in IT. The use of tele-medicine is expected to improve the quality and decrease costs of health care services. However, if these expectations are to be attained the visions have to be translated into fields of application in local settings where the technology would be used. This could be seen as an infusion process, which means that the technology would incrementally be used in a comprehensive and integrated manner.In this thesis, four Swedish telemedicine projects are analyzed. The approach used is that of Actor network theory (ANT), which has enabled the development of a theory of the infusion process, implementation of IT-projects, and parts of ANT, e.g. the model of the translation process and the notion of inscription.By using the concept of translation, it is possible to see the infusion process as a process where the generic features of the technology (transmitting sound and pictures in real time) are translated into concrete activities in local settings. These fields of application are realized by the mobilization of different task-based networks, where the roles of the actors are defined by the task to be solved. An iterated mobilization of the network implies further that the network will become stabilized, which is a central dimension in the process of infusion. Another way to understand the process of infusion is to describe it as cycles of implementation, where one cycle symbolizes the implementation of a field of application, which is a result of the translation of the generic features of the technology.The inscriptions in the studied technology allow a high degree of flexibility of use and flexibility of action. The flexibility means that fields of application ought to be developed in interaction between actors in local settings, and supporting programs of action are to be identified, or developed, in order to integrate technology use into daily routines. The considerable numbers of failed of IT-project implementations can be explained by the fact that a traditional planning perspective has been used on technologies, which allow a high degree of flexibility of use and flexibility of action. However, by categorizing inscriptions in technological artifacts, it becomes possible to predict what kinds of implementation strategies are appropriate for different kinds of technologies. By viewing the implementation of open networking technologies as a process of translation, the infusion process will be facilitated and a comprehensive and integrated use of technology will be enabled.