Events

Health services around the world are transforming themselves through the use of electronic medical records and other technologies. However, these transformations have been precarious – frequently resulting in mixed outcomes that raise deep questions about the value and future of the transformation. To understand the precarity of these transformations, we bring together two streams of literature – values and affordances – that have so far been relatively separate. Drawing on a longitudinal grounded-theory case study of a transformation of a large, acute-care hospital in Australia, we demonstrate the importance of values custodians engaging in values work to maintain values from users prioritizing and trading-off values when they enact technology affordances. Our analysis reveals new insights of benefit to both research and practice, into: 1) the relationship between values and affordances; 2) the values work required to maintain the value system of the organization; and 3) the importance of value custodians as a new and influential type of actor facilitating the transformation.