A theory of collective participation on leadership of an innovation and its development in a Health-IT context

Abstract

Health‐IT (HIT) innovations aiming to transform healthcare delivery have encountered challenges associated with social factors, e.g. leadership. Contextual factors have rarely been investigated in HIT innovation studies. Since innovation development and leadership are both social processes, it brought me to the question: How do patterns of behaviour in leadership and development of large scale innovations in the HIT context affect each other? I use a social construction view of leadership to examine how people interact and collectively contribute to leadership of HIT innovations, while an innovation is being developed. The aim is to develop a theory that identifies main categories and their inter‐relationships to explain the link between innovation development and its leadership process. The research methodology appropriate for this interpretive study is Grounded Theory, which enables an inductive approach of analysing data and building a theory grounded in it. Data were gathered from participant observations, documents, and interviews, to explore the social context selected, a Health‐ IT innovation development programme in New Zealand. After conceptualisation and categorisation of the interview data and interweaving the findings from observations and document analysis, one core category emerged, labelled ‘intervening in the health system’. This category describes the main behaviour found in the interactions of people who were involved with the innovation, its leadership, and governance processes, associated with an intervention. Detailed data coding revealed three high level categories (i.e., HIT innovation, leadership relationships, and governance) and interconnected subcategories. The theory indicated that we should think of leadership as more than creating value and influencing people. We need to find relationships that can adjust behaviours, and provide supporting conditions for the innovation process. It also revealed that we should consider the impact of complexity and emergence, as the characteristics of the development process, on what influences people. The theory can be used in leadership education to reduce ambiguity of the relational perspective on leadership and how it can be studied without examining individual’s traits and behaviour. This theory is a substantive theory that can be used by other researchers as it allows comparing the categories with other contexts and extending them toward a more abstract theory (i.e., a formal theory). The strength of the theory is on the detailed elaboration of how concepts are systematically generated and grounded in data. The weakness of it, though, is that it needs to be tested. Therefore, future studies in HIT contexts can apply the theory and examine it when patients’ experience is explored in the innovation development (as one of the limitations of the study).