Social and technology entities in an innovation development process. Presented by Elica Safari Mehr, School of Population Health, University of Auckland, at HINZ 2014, 11 November 2014, 12pm, Plenary Room

1. Elica Safari Mehr
University of Auckland
Supervisors: Karen Day, Peter Carswell
HINZ 2014, Auckland

2. Innovation development

 The problem:
 Leadership & Innovation
development
 Context: health-IT
 Case study: NSCPP (National
Shared Care Planning
Programme)
 Leadership: social
perspective
 The question

3. 
NSCPP
 Intention for a large scale change
 Northern region
 A platform to enable communication
 Better management of chronic conditions
 Empower patients
 Participation of users
 new model of care
 Hybrid innovation
 Product (IT tool)
 Process (new model of care)
 Service (CCM)

4. Methods

 General Inductive Approach
 Detailed coding &
categorising
 main themes in interviews
& description
 7/20 in-depth interviews
 formal & informal
influencers
 Social perspective of
leadership
 influential relationships
and decisions in direction
of the programme

5. Findings
Social intervention 
How we came to shared care in particular was that as part of
systems integration we were looking at what kind of structure and
process and both clinical and financial framework we could put
around primary care and multi-disciplinary teams to orientate them
towards proactive assessment care planning for at risk individuals.
Intervention operationalisation
When you’re looking at power imbalances there, certainly the patients
are way down there in the, in the, the power tree and they don’t know
what is available to them unless we, we tell them and sell it, sell it to
them
Adoption & behavioural change

6. Social intervention

 Innovation development & change
 Newness, degree of change, gradual, ambiguity
 Leadership
 Influential mechanisms
 Supporting change
 Control
 Value creation
 Governance
 Resource allocation
 authorities & accountabilities

7. Intervention operationalisation

 Change management
 Change preparation; Balancing…
…The localities, with 100,000 enrolled patients, which brings it down to
manageable sizes in terms of implementation and training, I think.
Yeah, so I see some progress here in the last few months.
 Technology design
 Complexity, Various users …
But driving it from the secondary space, you end up with that siloed disease
management mentality and actually many of the services want to have a tool that
meets their clinical needs for recording and sending out letters etcetera.

8. Adoption & behavioural change

 Individual
 Usefulness of change
 adoption preferences
 scope of application, engagement
 Organisational
 Durability, financial barriers
 performance costs
 Technical
 Tool usefulness,
 usability, technological barriers

9. Discussion

 Social and technology entities detected in this health-
IT innovation development
Intervention:
Innovation & change;
Leadership;
Governance.
Adoption &
Behavioural
change
Intervention
Operationalisation:
Change
management;
Technology design.

10. Leadership Literature: from social
perspective

 Social construction of leadership & organisations
 Meindl, 1995: Seeing relationships from followers’ perspective; less
tightly control of followers and showing the right way
 Bradbury & Lichtenstein, 2000: studying organisations from
members’ interactions.
 Avolio, 2007: a dyadic interaction; role of followers and context
 Hosking, 2006: Start from process not individuals; emphasis on
communication and on language
 Komives, 2007: ethical & effective relationships between people and the leader.
quality of relationships not the process.
 Fairhurst & Uhl-Bien, 2012: Interactional, relational, contextual issues. Seeing
people in interactions and how co-create processes.
 Cunliffe & Eriksen, 2011: a distributed collective act, looking at micro & macro
processes
 Uhl-Bien 2006: “a social influence process through which emergent
coordination (i.e., evolving social order) and change (i.e., new values,
attitudes, approaches, behaviors, ideologies, etc.) are constructed and
produced”

11. Complement our understanding
of leadership

Cunliffe & Eriksen’s concepts of
relational leadership
Comparing with findings
Being-in-the-world Intervention operationalisation
Dialogue & polyphony Influential mechanism.
Power relationships would
complement it
Responsiveness & responsibility Supporting change
Knowing-from-within Value creation (learning coming
from inside tells us how to create it)
Control (structuring behaviour)

12. Questions

e.mehr@auckland.ac.nz
School of Population Health, Tamaki Campus, University of Auckland