E-messages as a tool for improved information exchange across levels in the health care sector: intentions and realities

Purpose The purpose of this paper is to present a study exploring how an electronic message (e-message) system was adapted and used in health care. The e-message system was developed to support and strengthen communication and information exchange between health care providers in a university hospital and the affiliated municipality. Implementing e-messages is expected to enhance quality of care for patients in need of municipal health care services post-hospital. Theory Latour's (1987) model of translation is used to analyse users' adoption of the e-message system. The translation model emphasises agency on part of all users, and is therefore useful for understanding varying acceptance of technologies and consequently varying technological working practices. Methods In total 25 semi-structured interviews were conducted with approx. 50 different actors, covering physicians, nurses, nursing assistants, clerical staff and project leaders for the e-message system. The interviews took place over three periods during 2006 and 2007. Results and conclusion The e-message system is understood and deployed in different ways by various actors, though the overall conclusion by the health personnel is that e-messages are a useful service. Discussion Applying a translation approach is useful for understanding how people put a technology to use, including providing knowledge about both enabling and constraining elements when implementing a technological tool. Changes in working practices and internal routines should accompany the implementation of e-messages in order to utilise its potential.