Applying sense-making to integrated health IT: Renal care in the UK and Sweden

Information technology (IT) in healthcare combines opportunities for improved integrated healthcare delivery with barriers which include clinician resistance and low adoption rates. While national level initiatives are taken to promote electronic healthcare (e-health), it is at the grassroots level that their outcomes unfold. This paper employs sense-making theory to extend prior research on the implementation of health IT by investigating the introduction of IT into renal care units in the UK and Sweden. Issues such as management support, user training, usability of systems and perceived benefits of technology were found to have a direct impact on users' sense-making processes. The manner in which people make sense of imposed systems has far reaching effects, as the gap between intended results and actual outcomes is not limited to disparities between micro-level end-users alone, but spans multiple levels including higher authorities, as well as individuals at the grassroots level.