Adaptive structuration theory (AST) is rapidly becoming an important theoretical paradigm for comprehending the impact of advanced information technologies. In this chapter, a modified AST model was designed to illustrate the changing interrelationships among the variables affecting the adoption and application of a new technology into a medical organization setting. Using findings from a case study conducted over a 10-month period, the authors apply the case to the model to illustrate the complex interactions between medical billing technology and organizational processes. As the organization attempted to install and implement the new system, it found that in order to maintain daily operations, it would have to modify and adapt several aspects of the organization, technology and operations. As the system was slowly integrated into operations and the organization’s needs evolved through the adaptation process, the study, in turn, found that different iterations of the model could emphasize different structures. The case illustrated that the capacity to manage health information systems (HIS) often requires the organization to prioritize its needs and focus its energies on a critical structure while temporarily disregarding others until the primary healthcare processes are under control.
Analysis of the Acceptance Process of District Health Information Systems (DHIS) for Vertical Health Programmes: A Case Study of TB, HIV/AIDS and Malaria Programmes in Tanzania
