The impact of corporate versus professional control mechanisms on the adoption of health informatics in Australia

This study is grounded in a desire to describe and understand the positioning of eHealth within the health policy process. Policies and politics are intertwined (Corbitt, 1995). The current literature on health policy analysis suggested the problem of how to conceptualize power and relate power to notions like discourse and how to integrate these ideas of power into a conceptual framework for policy analysis. The current literature on power and politics in Information Systems (IS) deployments have drawn on limited conceptual resources to understand IS as artifacts, and power as a definable (and often manageable) entity, in ascribing IS a political role. This thesis questions the power relations that constitute the health policy process and those that are constituted by the health policy process. The research interprets health policy initiatives within the broader political and ideological context in which it is occurring. This study focuses on the discursive nature of health policy, and how various practices and techniques are implicated in governing the interpretation of policy intentions and behaviors to act in relation to policy. Of particular interest in this study are the discursive spaces for action within which acts of power and resistance can unfold.

This study aims to illustrate that the critical interpretive perspective (Doolin and McLeod 2005) applied to an understanding of health policy as a process constituent of power relations, a process involved in governance and advocacy tied to polity, knowledge and intervention can contribute to an understanding of the mobilization of authority and the impact this has on interpretation of policy intentions. This thesis argues that policy contexts create new discursive spaces for action, spaces which provide opportunities to maneuver allowing for framing of issues or resisting practice change. It suggests that the political landscape of action is made apparent within these spaces, and further that information systems become the medium through which the legitimacy of professional and corporate control mechanisms are contested. This thesis argues that renegotiated health information systems illuminate the reform ideas which have diffused into practice and those that have been delayed at a point in time.