Observing the 'Fluid' Continuity of an IT Artefact

Novel contemporary healthcare information systems offer the prospect of exploring unique features of the IT artefact and probing the finer, integral relations between society, technology, and humans. Some of these IT artefacts are innately complex and current theoretical perspectives are too limited to enrich their understanding. Using material from a longitudinal case study of an Internet-based self-service technology implementation in the private healthcare insurance context, this paper explores various aspects of ‘fluid continuity’ enacted by a technological object. The authors observe the object’s varying identities, its vague boundaries, its unexpected usage patterns, and its resourceful designers. They also analyze both the success and failure of the technological object, its complex and elusive relations, and the way in which it shaped new configurations of practice in the RSA and UK. This paper challenges conventional perspectives of a stable and enduring IT artefact and offers an alternative; it claims that a contemporary IT artefact is not necessarily delineated by firm boundaries or stable relations; instead they can be unpredictable and transitory. This paper furthers the understanding of how researchers can apply post actor network theory (ANT) concepts to study contemporary IT-based artefacts and offers several insights to practitioners on the virtues of a flexible implementation approach. DOI: 10.4018/jantti.2012100102 24 International Journal of Actor-Network Theory and Technological Innovation, 4(4), 23-46, October-December 2012 Copyright © 2012, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. generally and the funding of healthcare services specifically (World Health Report, 2000), a number of policymakers view the advances in Internet-based self-service technology (SST) as a potential enabler of more efficient and effective healthcare service delivery (Lang & Collen, 2005; Bitner & Brown, 2008). Proponents of consumer-driven healthcare insurance in particular who seek to use the Internet to make consumers more informed about healthcare funding decisions and to reduce the cost of servicing consumers have been actively experimenting in this area (Cannon & Tanner, 2005; Herzlinger & Parsa-Parsi, 2004). The status and maturity of Internet-based SST’s can be characterised as an emerging subfield of Information Systems (IS). Currently, an incomplete picture has been created for explaining the contradictory robustness of these technologies despite their protracted uptake (Pandya & Dholakia, 2005; Hannemeyr, 2003; Dabholkar, 1996). Despite strong interest in the subject of SSTs, there is clearly a need for empirically testable theories, conceptual models, and frameworks to move research forward (Parasuraman & Zinkhan, 2002). More specifically, the SST as a novel contemporary technology offers us the prospect of exploring unique features of the technological artefact and to probe the integral relations between society, technology and humans (Orlikowski, 2007, 2009). Contemporary IT artefacts such as SSTs are innately complex and current perspectives of IT artefacts are too limited to enrich our understanding of these elusive phenomena. Our principal aim therefore in attempting to understand the SST is to depart from a predictable view of the technological artefact to a more complex and ‘fluid’ understanding of the character of these novel information systems. Our major contention is that their implementation cannot be viewed as predictable and seamless. We therefore need to glean from a framework that is concerned with ‘complexity in practice’. As such we will turn to actor-network theory (ANT), post-ANT, and the more recent feminist work on technological objects. We will do this by highlighting the ‘fluid’ character of the SST based on a case study of an implementation at a large multinational private healthcare insurance firm. The argument of this paper is presented as follows. In the next section, the literature on the technological object is critically reviewed, before we provide an overview of the research context, and a justification for the research methods used, in the following section. The subsequent and most substantive section reports on the implementation of the SST at a healthcare insurance organisation. In the final two sections, we offer an interpretation and discuss the implications of our findings in the context of the literature.