Using Actor Network Theory and Agency Theory to identify critical factors in the adoption and implementation of a chemotherapy ordering system: a case study from the Australian private health-care sector.

Abstract

In today’s dynamic and complex health-care environment, we are witnessing increasing reliance on various types of information systems solutions to support the delivery of high-quality, efficient health care. At Epworth HealthCare, a key clinical area of practice is cancer services. Within cancer services, the administration of chemotherapy is a major component. This is a complex task involving many different categories of staff and has a low margin of safety due to the intrinsic toxicity of the drugs used and their narrow therapeutic margin. A computerised physician order entry (CPOE) system for the ordering, make-up, and administration of cytotoxic drugs is likely to improve the quality, safety, and efficiency of this process. A major consideration is the effectiveness of the implementation of such a system; the facilitators and barriers to this process as well as how to address them form the central focus of this chapter. Specifically, the objective of this study is to answer the research questions “How can a group of non-employee clinicians’ goals be aligned to use a single information system? What are the barriers, facilitators, and critical success factors that must be addressed?” This is done using a combination of agency theory and actor network theory to provide a robust lens of analysis as presented in the chapter.