Searcharxiv⌕ Search
Home/Archive/arXiv

arXiv · 2502.09049

WhatsApp as an improvisation of health information systems in Southern African public hospitals: A socio-technical perspective

Meke Kapepo·Jean-Paul Van Belle·Edda Weimann
View original source ↗Read source document ↗Export metadata ↓

Abstract

Digital health interventions, particularly electronic referrals (e-referrals) and health information systems, have revolutionised clinical workflows in public hospitals by automating processes. However, the utilization of e-referrals has yielded mixed outcomes, with varying levels of success in organisational processes.This paper explores improvisation of health information systems in Southern African public hospitals from a socio-technical perspective. In particular the paper explains the design-reality gaps giving rise to improvisations of mandated health information systems in order to understand their occurrence and impact on referral outcomes. We employed the design-reality framework and the Process framework for Healthcare Information System Workarounds and Impacts to explain the socio-technical issues related to the phenomenon of interest.We conducted semi-interviews with 31 respondents from health organisations as case studies.Respondents from two public hospitals in South Africa and two in Namibia were interviewed to examine how they devised improvisations to various health information systems in each setting.The findings showed that using WhatsApp or improvising existing health information systems (HIS) improved efficiency and productivity of healthcare practitioners (HCPs) referral activities. Additionally, HCPs reported positive outcomes related to continual professional development in the given settings.The findings further show a relationship between design-reality gaps and improvisations enacted by HCPs.The observed gaps are related to poor management systems and structures lack of HCPs' involvement in the roll-out of HIS and inadequacies of existing HIS to support referral tasks.These study findings can be insightful and useful to system developers and other stakeholders for devising measures to address the gaps.

Explore related subjects

cs.CY

Keep this discovery

BibTeXRIS

Meke Kapepo, Jean-Paul Van Belle, Edda Weimann. 2025-02-13. WhatsApp as an improvisation of health information systems in Southern African public hospitals: A socio-technical perspective. https://arxiv.org/abs/2502.09049

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Work, Wellbeing, and Choice: Empirical Lessons for AI Futures

Advances in AI-driven automation have raised questions about how humans might find wellbeing in a world where paid employment is less necessary or less available than before. Paid work has been variously characterized as both a contributor and an impediment to human wellbeing. What is already known about the relationship between paid work and wellbeing? What factors influence wellbeing among people who do not work---or who do not need to work? And how might these factors bear upon prospective AI-induced economic transformations? To help provide empirical grounding for these questions, we survey the psychological, sociological, and economic literature that investigates the relationship between wellbeing and work. We draw on evidence from multiple populations, including the unemployed, retirees, lottery winners, and financially dependent spouses. This comparative review draws from studies across OECD countries, China, India, and Gulf states. We identify three key factors that mediate the relationship between work status and wellbeing: (1) agency and choice---whether the exit from work is voluntary or involuntary, as well as long-term agency; (2) the availability of alternative sources of work's latent benefits---such as volunteering, hobbies, or state-provisioned employment; and (3) social and systemic context---including cultural norms around work and the robustness of social safety nets. We draw on these three factors to derive specific implications for different AI automation scenarios, connecting the empirical evidence to concrete policy considerations.

cs.CY↗
arXiv2026

From Digital Accountability to Accountable Digitality Through Needs-Aware Information Systems: The Case of Auditable Child-Welfare Judgments

Digital accountability research asks how digital systems can, among other aims, be made transparent, explainable, auditable, contestable, and supportive of ongoing learning and improvement. This paper reverses the question: how can digital transformation make established human institutions more accountable? It theorizes this reversal as accountable digitality and specifies needs-aware information systems as the mediating mechanism. The hard and paradigmatic case is child-welfare judgment, where best-interest procedures must protect children, preserve confidentiality, and respect judicial independence while enabling aggregate learning about needs, reasons, exceptions, and disparities. The case is used diagnostically and illustratively to derive and examine the design logic, not as empirical evidence or validation. Conceptual design-oriented analysis decomposes and recombines digital and legal accountability under child-rights constraints, deriving a canonical theory-to-design chain, contingent mechanisms, implications, and safeguards. It advances IS responsibility and ethics research by showing how privacy-preserving, co-created, needs-aware information systems can support institutional self-knowledge and auditable justice.

cs.CY↗
arXiv2026

(Whose defaults?) Is artificial intelligence reorienting archaeological methods?

Generative AI and the practice of "vibe coding" are changing how archaeologists carry out computational research, but their effects on the discipline's range of methods is still understudied. In this paper, we evaluate whether large language models (LLMs) are narrowing the variety of methods archaeologists use. We first analysed approximately 119,000 archaeology abstracts from Scopus, covering publications from 2010 to 2025. Using a locally run LLM, we identified the computational methods reported in each abstract and organised them into 25 broad categories (L2) and 241 finer clusters (L3). A Bayesian Dirichlet-multinomial model of method composition within sub-disciplines found a small but credible shift in method use after 2023. However, this shift was smaller than the variation already present across the full study period. No individual technique showed a significant change, and overall methodological diversity increased rather than declined. We then ran a controlled experiment to see whether LLMs recommend a narrower set of methods than archaeologists have used in practice. Two different open-weight models were asked to suggest methods for 28 archaeological research problems, with prompts providing three levels of methodological guidance: novice, intermediate, and expert. Recommendation diversity was much lower than in the published literature, particularly without methodological guidance. The models also tended to favour methods that were widely used before 2023, and their recommendations more closely resembled the post-2023 literature. Taken together, these results are consistent with LLMs pushing methodological choice towards convergence, although our study cannot establish a causal effect. They raise a broader question: how can archaeology retain methodological diversity as LLMs become more involved in research?

cs.CY↗