Negotiating ICT development and use: The case of a telemedicine system in the healthcare region of Crete

Recent research on the development and use of information and communication technology (ICT) has focused on the emergent use of technology in practice and the multiplicity of outcomes being simultaneously negotiated by different groups and individuals. In this paper, we seek to understand this emergent process by examining the interrelationship between the context(s) in which ICTs are introduced, the ways in which ICTs are enacted in practice, and the role of different technological artifacts. We pursue the value of these conceptual developments in an interpretive case study on the introduction of a telemedicine system in the healthcare region of Crete, Greece. Some key implications arising from the case study refer to the relationship between power relationships and organizational change; the relationship between existing work practices and resistance to ICT-mediated change; and the role of different artifacts in negotiations of power, as well as in processes of community formation.