Suchergebnisse

Purpose
The purpose of this paper is to explore the implications of e-government for horizontal/social accountability (to citizens) by looking into its shifting location. Its main purpose is to show how the introduction of information and communication technology in the public sector changes how public sector work is organised, shifting the traditional sources of accountability and to discuss the implications of those changes.


Design/methodology/approach
The study comes from desk-based research that brings together the literature on electronic government and accountability studies and situates them in the context of a bureaucratic public sector.


Findings
It shows that e-government entails digitalization of public sector work by restructuring work, re-organising public information and knowledge and re-orientating officials-citizens relation. It argues that in the e-government era accountability is inscribed in the technology and its embodied standards; is a horizontal technological relation that renders officials accountable to the handling of digital interfaces; and renders citizens co- producers of digital information responsible for bringing the public to account. The paper shows that these changes do not necessarily bring better or worse accountability results but change the sources of accountability bringing shifts in its locations, thereby rendering it more precarious. The paper ends by discussing the implications of digital accountability for good public administration.


Originality/value
With the unprecedented level of attention currently being paid to "digital government" at the moment, this is a timely paper that seeks to address the accountability implications of these shifts. The study offers a practice-based, relational definition of accountability and a Weberian account of bureaucratic government, followed by an exploration of ways in which this is being challenged or replaced with a new informatisation enabled/supported by new "technologies of accountability".

This article explores the tension between standardization and autonomy raised by the implementation of new technology in healthcare organizations. The theoretical frame of this study is grounded in the impact of new technologies on work organization, routinization and autonomy across settings. Empirically it presents evidence from twoNHSTrusts in England that implemented a national Electronic Patient Record (EPR). The paper aims to reinvigorate the debate on the tension between standardization and autonomy in professional workplaces such as healthcare. It argues that the implication of technology in professional work conditions processes of task routinization that constrain autonomy, and enables reallocation of discretion between professional groups. We argue that routinization is not restricted to low‐skill work but may travel across contexts and be evidenced in high‐skill work environments. The interplay between routinization and autonomy is also useful in drawing insights concerning the dynamics of change that occur in professional work.

PurposeExisting research on how professionals manage after-hours connectivity to work has been dominated by studies on the strategies/practices individuals develop. In these studies, mobile technology is perceived as a tool or an enabler that supports otherwise human-centric connectivity decisions. This view sees technology as separate or external to the organisation, missing out on its nuanced role in shaping connectivity decisions. Our study aims to bring technology back into the sociomaterially imbricated context of connectivity and to unpack its parameters.Design/methodology/approachDrawing on data collected from documents and semi-structured interviews, we adopt the framework of "sociomaterial imbrications" (Leonardi, 2011) to understand the social and material parameters that influence connectivity management practices at two different academic institutions in Saudi Arabia.FindingsThe study identifies a set of social and material parameters (organisational, individual, technological and situational) that imbricate to shape, collectively and not individually, professionals' connectivity management practices. Connectivity decisions to change practice (such as decisions of where, when or why to connect) or technology (how to connect) are not as distinct as they appear but originate from, and are founded on, imbricated sociomaterial parameters. Our study further suggests that connectivity decisions are shaped by individuals' perceptions of sociomaterial imbrications, but decisions are not solely idiosyncratic. The context within which connectivity decisions are taken influences the type of decisions made.Originality/valueConnectivity management emerged from sociomaterial imbrications within a context constitutive of four interacting parameters: organisational, technological, situational and individual. Decisions around the "how" and the "what" of connectivity – i.e. the practice of connectivity and its underpinning technology – originate from how people perceive sociomaterial imbrications as enabling or constraining within a context. Individual perceptions account for changes in practice and in technology, but the context they find themselves in is also important. For instance, we show that professionals may perceive a certain technology as affording, but eventually they may use another technology for communications due to social norms.

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.

This article considers changes in healthcare professional work afforded by technology. It uses the sociology of professionals' literature together with a theory of affordances to examine how and when technology allows change in healthcare professional work. The study draws from research into the introduction of a national electronic patient record in an English hospital. We argue that electronic patient record affords changes through its materiality as it interacts with healthcare professional practice. Its affordances entail some level of standardisation of healthcare professional conduct and practice, curtailment of professional autonomy, enlargement of nurses' roles and redistribution of clinical work within and across professional boundaries. The article makes a contribution to the growing literature advocating a cultural approach to the study of technological affordances in organisations and to studies that explore healthcare professional practice in conjunction with the materiality of technology. Two main lines of argument are developed here. First, that technological affordances do not solely lie with the materiality of technology nor with individual perceptions, but are cultivated and nurtured within a broader cultural–institutional context, in our case a professional context of use. Second, that technological affordance of change is realised when healthcare professionals' (individual and collective) perceptions of technology (and of its materiality) fit with their sense of (professional) self. In this respect, the article shows the extent to which the materiality of technology plays out with professional identity and frames the level and extent to which technology can and cannot afford restructuring of work and redistribution of power across professional groups.

This paper examines critically whether e‐government initiatives can be conceived of as representing a shift from a bureaucratic to a citizen‐centric institutional logic. We draw upon a longitudinal study of aGreek e‐government initiative that introduced one‐stop shops for the delivery of government services. Based on institutional theory, we provide a framework that illustrates the domains of institutional change that accompany e‐government projects and show how such institutional change can be understood as complex imbrications of contrasting institutional logics rather than one institutional logic displacing another. We argue that imbricated logics may have many unintended consequences which are not simply the outcome of either of the logics but are emergent from the imbrication.

AbstractInformation and communication technology (ICT) is often presented by health policymakers and software designers as a means for reducing clinical risk, leading to safer clinical practice. Studies have challenged this view, showing how technology can produce new or unanticipated risks. Although research seeks to objectively identify these risks, we recognise that technological risks are socially constructed through the interaction of technology and practice. The aim of this article is to explore how technology affords opportunities for the social construction and control of risk in health care settings. Drawing upon a study of the electronic prescription service introduced in the National Health Service in England, we make three arguments. Firstly, as technology interacts with social practice (for example, through policy and the design and use ofICT) it affords opportunities for the construction of risk through its interpretive flexibility, transformative capacity and materiality. Secondly, social actors interpret these risks within and across professional boundaries and cultures. Thirdly, the social construction of risk affords certain implications to policymakers, designers and users of healthICT, specifically a reordering of power and responsibility and a recasting of questions of blame. These, in turn, raise questions concerning the boundaries and bearers of responsibility.