School of IT seminar slot (compulsory if scheduled)

School of IT seminar slot (compulsory if scheduled)

Speaker: Meke Kapepo Title: A socio-technical analysis of workarounds to digital health interventions: Insights from case studies. Abstract: Digital health interventions (DHIs) are designed to automate and streamline complex clinical workflows across healthcare organisations. However, in practice, end-users frequently encounter limitations and constraints  that hinder their ability to perform tasks efficiently. As a result, end-users  enact workarounds (improvised practices that deviate from the prescribed use ) to overcome these constraints to complete their clinical tasks. In some instances, end-users may bypass official systems entirely by adopting unsanctioned third-party applications, known as Shadow Information Technologies, to maintain continuity of services and care. These practices point to a mismatch between the intended design, objectives of  DHIs and their actual use in public hospitals. This research examined healthcare providers’ workaround practices in Southern African public hospitals. Adopting an interpretive paradigm and a multiple case study approach, the study provides a theoretical elaboration of how these practices emerge from design–reality gaps such as lack end-user involvement, weak management systems and structures, and the absence of clear data policies which often lead to unintended risks related to data integrity, security and patient safety.  Employing a socio-technical lens, the research draws on the Process Framework for Healthcare Information System Workarounds and Impacts ,the Systems Engineering Patient Safety (SEIPS 3.0 and 101) framework and the design-reality gap framework  to develop an integrative framework. Findings show that the subversion of official digital DHIs is a result of a mismatch between the system design and contextual realities of end-users. This study provides practical insights for practitioners and system developers on workaround behaviours arising from the design-reality gaps. The research also highlights the importance of robust change management strategies, that not only address technical limitations but ensure that business requirements are meaningfully incorporated with end-user input. By embracing innovation  emerging from appropriation processes, developers can better align the design of DHIs with contextual realities, ultimately safeguarding patient safety and strengthening data governance in clinical settings. Biography: Meke Kapepo has over 18 years of experience in the higher education sector. Her academic journey began at the Cape Peninsula University of Technology (CPUT), where she completed both her undergraduate and master’s degrees in information technology. During this period, she also served as an assistant lecturer, marking the beginning of her teaching career. She later joined the Namibia University of Science and Technology, where she worked for five years, further developing her academic and research interests. For the past 12 years, Meke has been a lecturer in the Department of Information Systems (ADP) at the University of Cape Town.  Her research interests are on digital health in underserved communities, with a particular focus on public health systems. She is also passionate about Information Systems education, particularly in curriculum design for academic development and student success. Meke recently completed her PhD in Information Systems. Her Thesis is titled “Investigating the Use of Electronic Referrals to Facilitate the Patient Referral Process in Southern African Public Hospitals.”

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