This dissertation examined the process of conversion to computerization in a health care organization. More specifically, it looked at the way in which computerization changed everyday organizational practices and relationships, as well as at the processes whereby technological change was managed and institutionalized, and organization members "converted" to an acceptance of computerized work.
At an epistemological level, the study was located within the theoretical traditions of symbolic interaction. Accordingly, it was inductive and sought to develop theory about the symbolism and experience of computerized work based on fieldwork in an organization. The researcher followed the process of computerization in a Health Maintenance Organization from before its introduction up to its use and adoption by the organization. Three major research techniques were used. They were participant observation, in-depth semi-structured interviews and a questionnaire. The qualitative data analysis was guided by the principles of grounded theory. Descriptive statistics, a discriminant analysis and ANOVAs of mean scores on questionnaire items were also computed.
First, the study sought to understand the symbolic aspects of work computerization. The researcher documented multiple meanings and imagery around computerized work and classified them into three broad categories viz. pragmatic, pessimistic and romantic symbols of computerization. The study also demonstrated how these symbolic constructions of computerized work had distinct consequences for organization-level action by fostering acceptance, engendering resistance and setting up a series of organizational paradoxes.
The study also explored the process whereby computerization changed the practice of health care in the organization. It examined this from the subjective perspectives of different occupational positions including nurse, physician, physician assistant, receptionist, clerk and manager. Based on these findings, a model for understanding transformations in medical care as a result of computerization was generated. This suggests that managers are likely to be enabled by the technology, professionals restricted by it and workers impacted in more ambivalent ways. The study also discussed how a conversion to computerization altered the nature of available information, reduced the reliance on personal knowledge and changed power relations within the organization.
