ICTs, globalization and local diversity

This paper is based on a panel discussion at the 2002 International Conference on Information Systems in Barcelona. Three panellists responded to a set of questions on the meaning of the term globalization to them, and the role of information and communications technologies (ICTs) in globalization processes. The panellists also highlighted the importance of local diversity in understanding globalization and ICTs, drawing from their varied research in contexts such as western country financial markets, health systems in Guatemala, and e-commerce in Mexico. A further output of the panel, and this paper, is the identification of key research questions and theories for future IS research in this important area.

Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.