The evolution of affordances in the electronic patient record: understanding the structure of the tool
DOI:
https://doi.org/10.3917/sim.241.0007Keywords:
DPI, SIH, Affordance, Actualisation, StructureAbstract
This article looks at the Electronic Health Record (EHR), a core module of the healthcare information system (HIS), to understand how the affordances of the technological tool emerge and can evolve to meet user needs. The case study data is collected from change agents in a university hospital using grounded theory and then coded. Our results analyze the design choices made for the EHR (its structure) to describe the potentialities offered by these design choices (affordances) and the actual use made of these potentialities by users (affordance actualizations). Our contribution to the literature on affordances distinguishes three types of structure within the tool (resulting from technical, legal or organizational design factors). The structure provides a new understanding of how affordances evolve and are updated. From a managerial point of view, these contributions enable the project team to better analyze its interventions on the tool’s structure, leading to changes in the potentialities offered to users.

