Conceptualizing sociotechnical system boundaries in healthcare settings: Within and across teams, organizations, processes, and networks

Healthcare systems are complex dynamic sociotechnical systems, in which groups of people (e.g., patients and families, clinicians) interact with different technologies (e.g., clinical decision support system, consumer health information technology) in various physical (e.g., hospital, patient home) and organizational (e.g., teamwork, culture) environments (Carayon et al., 2006; Effken, 2002; Kleiner, 2007). The complex and dynamic nature of healthcare systems results in their boundaries being increasingly fuzzy (Carayon et al., 2011; Plsek & Greenhalgh, 2001). People are no longer constrained to work in single local work systems. Instead, they work in teams across different system boundaries, including organizational, hierarchical, cultural, spatial, temporal, and process boundaries (Carayon, 2006; Karsh & Alper, 2005). New conceptualizations of healthcare system boundaries are needed to take into consideration the characteristics of complex sociotechnical systems (Carayon et al., 2015). We convene this panel to address the general question of how to conceptualize sociotechnical system boundaries in healthcare. Five panelists present examples from their respective research to illustrate the conceptualization of sociotechnical system boundaries in different healthcare domains.