1. Introduction: How to teach socio-technical analysis in healthcare?
Healthcare is highly information-intensive; i.e., healthcare activities rely heavily on information being transferred between patients and various care providers, collected, stored, processed and used. The purposeful use of information within activities can be seen as a socio-technical information system (IS) [1, 2], within which information technology (IT; manual or computer-based) is used as a means of work by individual actors or as a means of coordination and communication between actors . To develop such socio-technical systems, the focus should on the work activities as the basic unit of analysis, instead of the IT artefacts embedded in the IS .
The Activity Driven (AD) approach on Information Systems Development (ISD) has been studied and developed in the University of Eastern Finland (University of Kuopio until 2009) since the early 1990s [5, 3], with the main focus on healthcare activities and healthcare information systems. It is a socio-technical and participatory approach based on Activity Theory  with the primary goal of providing methods that emphasize the intertwined development of work and IS. The approach encourages IS developers and “users” (e.g., healthcare providers) to study collaboratively how different kinds of work activities are actually arranged and conducted, including what kind of information and technology do the actors need within those activities.
The approach comprises several interrelated parts, including the Activity Analysis and Design (ActAD) framework , the Activity Driven Information Systems Development Model (AD ISD) , and a methodology for depicting healthcare “landscapes” . Some initial practical methods and tools for the various parts have been produced and tested by the researchers in cooperation with healthcare providers and IS developers in practical cases.
Socio-technical analysis of work and information systems is not possible without analysts who have been trained in the respective methods. However, analysts need not be IT experts; experienced “lay” professionals adopt methods that fit their experience and needs . Multi-professional and multi-disciplinary education in teams has proved out particularly useful in health informatics [9, 10]. Pedagogically, ‘almost real life cases’ have been emphasized as promoters of learning .
This paper highlights site visits as a crucial element for adopting socio-technical methods of analysis in healthcare. The paper reports on a study in which four multicultural groups of students used a socio-technical approach that was mostly unfamiliar to them, in a previously unfamiliar context, for the rapid analysis and reporting of a healthcare service activity and its socio-technical information system.
2. Materials and Methods
The experiment was implemented in Mozambique as a part of an Intensive Course on Health Information Systems Development and Implementation (6 days)...