Phase 3: Research Strategy 79

I have chosen a case study methodology for this inquiry, using two landmark case sites (hospitals) in Australia. The choice was based on an Australian milieu being different for implementing RFID technology, as it touches every department in terms of ‘tracking’ ability, as well as people. While other nations, such as the USA, Singapore or Malaysia, where the technology has been deployed successfully, Australian hospitals were still reluctant (as explained in Chapters 1 and 2). The pilots deployed may have been successful, but did not result in full implementation. Therefore, there was need for in-depth investigation of this technology translation (and not diffusion) problem, as RFID was an otherwise accepted technology in sectors such as manufacturing.

Creswell (2003, 2013) recommended that every researcher should consider three questions: (1) what are the knowledge claims; (2) what strategies of inquiry will inform the procedures?; (3) what methods of data collection and analyses can be used. The choice of approaches is based on the nature of the issue under investigation, personal experiences of the researcher and the intended audience (Creswell 2003: 5).

The issue under investigation is innovation translation of RFID in a complex socio- technical context. This is not well understood, and the aim is to gain an in-depth understanding regarding ‘actors’, their opinions and relationships, and changes to their relationships and interactions.

Hence, in this context, I have opted for a qualitative approach to better understand an under-researched phenomenon (i.e., RFID innovation translation into hospitals, which relies on a first-hand account of personal experiences). As presented in Chapter 2, the purpose of this research was not only to identify the factors involved in the translation, but also to better understand how the interplay between them occurs, affecting successful translation. Quantitative methods would have been more suitable if the research evaluated the cost-benefits of RFID as a technology in Australian hospitals. However, RFID is still at a nascent stage of deployment in Australian hospitals, as highlighted in Chapter 2. Technical and economic issues have been discussed in the literature, while the socio-technical issues impeding RFID implementation are largely

absent. A qualitative strategy was more suited to understand the processes that were occurring, as well as the outcomes (Strauss 1990; Creswell 2003). Morse (1991) argued that if a concept is immature due to lack of theory and previous research, and there exists a need to explore and describe the phenomenon and to develop theory, the nature of the phenomenon under study may not be suited for quantitative treatment, as there are no predefined measures, constructs or criteria for success.

The research questions involve understanding how the actors in the network of translation negotiate with each other, to effect successful RFID translation. The process of negotiation and translation involves complex issues in hospital context: a chaotic environment where people continuously negotiate with each other. Information relating to these issues of translation is best obtained through qualitative fieldwork (Creswell 2003, 2013; Merriam 1998). Fieldwork in this research meant that I had to approach people in their settings, interview them, observe and record behaviours in hospitals. I had to become the primary instrument in data assembly.

Case Study, with an interpretive stance, as explicated by Walsham (1993, 1995) advocates a middle course involving a combination of qualitative and quantitative methods of investigation. The story can be told either by me as a participant, reporting the story as it unfolds using ethnography (Suchmann 1987), or by me as an observer, interviewing members of the project and re-narrating the story from the participant perspective (Klein & Myers 1999; Creswell 2013). The choice of this strategy is justified by Yin (2003, 2009) as an appropriate method when I tried to answer ‘how’ and ‘why’ questions, and I had less control over events being observed, and when the project was a contemporary phenomenon with a real life context. All of the above elements are present in this research that investigates RFID translation into Australian hospital contexts.

Yin (2009) claims that case study research involves studying cases within real life contemporary contexts. Other pivotal authors (Creswell 2013; Denzin & Lincoln 2005: Merriam, 1998) present case studies as a strategy of inquiry. I have followed Creswell’s (2013: 97) definition, as follows:

case study research is a qualitative approach in which the investigator explores a real life, contemporary bounded system (a case) or multiple

bounded systems (cases) over time, through detailed in-depth data collection involving multiple sources of information (e.g., Observations, interviews, audiovisual material, documents and reports), and reports a case description and case theme

The defining features of a case study strategy include: identifying a case or multiple cases that can be bounded by time and place; stating the intent such as studying an issue or group of people; presenting an in-depth understanding of the case via varied data collection methods; deciding how to analyse the data collected; describing and presenting themes gathered and strong conclusions elicited from the analysis (Stake 2005; Yin 2009; Creswell 2013).

Yin (2003: 13–14, 2009) suggests that case study inquiry handles unique situations in which there will be many more variables of interest revealed by the data. Every result relies on multiple sources of evidence, with data needing to converge in a technique. Another result benefits from prior development of theoretical propositions to guide data collection and analysis. In Chapter 2, I proposed the conceptual framework that guided this research. Accordingly, the four moments of translation were informed by my literature review. The research motivations were strengthened by the gaps in literature on the moments of translation. The case study observations in Chapters 4 and 5 drew out different moments of translation, from a partially successful and a successful case study, thus addressing gaps in the moments of translation. Assimilating the multiple sources of data allowed me to validate the re-iterated participant narratives in Chapters 4 and 5.

Further, I have chosen a multiple case strategy, wherein in the pursuit of one problem for research, two case study sites are used for comparing data, and are validated by views from peers in the health care industry sector, to ensure the findings are current.

3.3.1Consideration and Elimination of Other Strategies

Farhoomand (1992) classified varied strategies for research into case study, survey, field test, experimental and non-empirical research, based on articles in the 1980s. Myers (1997) offered the most accepted classification in IS broadly as: case studies (developed by Benbasat, Goldsten & Mead 1987; Kaplan & Duchon 1988; Lee 1989; Orlikowski & Baroudi; 1991, Alavi & Carlson 1992; Yin 2009; Walsham 1993, 1995),

Ethnography (developed by Suchmann 1987, Zuboff 1988); grounded theory (developed by Martin & Turner 1986); and action research (developed originally by Lewin 1946, and subsequently by Rapoport 1970; Checkland 1991; Baskerville 1998). Taking into account another decade of IS research, Tatnall (2011) added soft systems methodology (developed by Peter Checkland from 1981–1991, and further developed by Finegan 1994; and Rose 1997) and ANT (developed by Latour 1986; Callon 1986; Law 1992) into this milieu.

I did not use an ethnographic approach because I could not be part of the translation over a sustained long period. Observation alone would not have provided in-depth understanding of issues. I had to become an observer, interviewing the ‘actors’ or participants of the case, recording their narration and reconstructing it from their perspective to tell the story.

It is worthwhile noting in this section that I originally considered action research as my inquiry strategy.16 I had chosen a hospital that was pioneering RFID, and was to be involved in the steps leading to planning, action and evaluation. However, the applicability of action research was invalidated, as full implementation was mired during 2009. As a researcher, I could not be part of the change process that would then be continuously deployed.

Subsequently, I focused on the hospital ‘in-house’, examining some departments only and considering the structured case approach, propagated by Carrol and Swatman (2000), based on the concept of learning cycles and resulting conceptual frameworks.

16 _{Please refer to also Chapter 1, Section 1.9 where I had noted that I am presenting myself as a Cameo} Actor. It is due to the fact that originally this investigation began as Action Research. However, the research journey then continued to the realm of cases study and ANT based information visualisation.

The structure case approach consists of three main elements: (1) the conceptual framework; (2) the research cycle and; (3) the literature-based analysis of theory built (Carroll & Swatman 2000). There has been much discussion about the conceptual framework structure used to direct the initial stages of qualitative research projects (Strauss & Corbin 1990; Miles & Huberman 1994). Recently, I have also used the structured case method to study the implementation of scanned medical records in Australian hospitals (McAauley, Unnithan & Karamzalis 2012).

The structured case strategy is based on the idea that there are cycles of learning resulting in conceptual frameworks, with each spiral feeding into the learning. Based on this, the methods of data collection may be different for each cycle (Carroll & Swatman 2000; McAuley 2009). This series of conceptual frameworks results in better interpretation of research themes and data, and more efficient learning for the organisation. This method builds on the case study research method (Yin 2009), which provides a pathway for conducting case study research. This strategy was also rendered infeasible, as the hospital in the first site I chose had temporarily shut down implementation altogether.

In 2009, I had reached a cul-de-sac, and was contemplating a pathway to research the problem as such. This is when I met with the second hospital and realised I had to use multiple case strategy of inquiry to approach the socio-technical issue of RFID translation, timeboxing the first case in 2007–2009 and the second case in 2010–2012. The strength of cross-case comparisons in this strategy lent itself to revealing insights. While timeboxing the cases was necessary, the findings’ validity was confirmed through a series of interviews in 2013, with peers in the health care sector (including Australian hospitals, practitioners & consultancies).

At the same time in 2009 I was also introduced to the realm of ANT and innovation translation theories (as presented in Chapter 2), enhancing the case-based strategy insights.

I considered the variant of action research, SSM (Checkland 1981), which attempts to give due recognition to human and technological aspects of IS. However, Checkland (1991) has explicitly identified this method with action research. This method was not

suited to my research quest, as SSM begins with a detailed study of the system and how it might work, followed by model development as to how it might apply in any given situation. It then compares this to real situations to become a basis for how the system could be improved. The basic intent of my study is not an improvement of RFID technology; rather, it is an understanding of how the technology has been translated into this context. Equally, SSM would have also considered humans as taking positive action, and technology a passive instrument. In my research, active interplay between both technology and humans, as they negotiated the innovation translation, was significant.