Conclusion
The rapidly changing IT environment creates challenges for individuals, organizations, and policy makers in negotiating technological innovations and their resultant influence on information and communication transactions within organizations. The literature suggests that maximal IT infusion across an organization is often not fully realized as organizations commonly fall short in the integration of IT applications with their existing business processes and with individual and organizational level work systems [60]. A more thorough explanation focuses on organizational communication and politics. Healthcare organizations are complex and messy, constantly evolving to keep up with change; creating tension which constrains everyday actions leading to a state of disorder which becomes the norm. The dynamic interactions among discursive and nondiscursive practices in an organization lead to an ongoing translation of meanings, development of structures, modes of management, and control systems. This in turn affects the recursive discourse related to technology and the organization. Thus, communication and power are interwoven in the very essence of organizing and organization.
The case study illuminates that careful examination of various forces beyond the HIT itself, such as power and communication, impact the adoption and diffusion of new technology in organizational life. The hope is that this discussion provides a contextual understanding of the difficulty inherent in technology acceptance and the unique perspective that communication and power have on policies in clinical practice. Suggestions for further study focus on the realities of IT use in clinical practice. Studies investigating organizational and policy contexts for the adoption of clinical technologies are needed. An example is initiation of a pilot project on a nursing unit, which involves the use of mobile devices as a communication tool between instructors, preceptors, and students. Implications of such a study would help explicate how rules, norms and usage structures arise through practice based use of mobile technology.
