“Access denied”? Barriers for staff accessing, using and sharing published information online within the National Health Service (NHS) in England: technology, risk, culture, policy and practice

Ebenezer, Catherine “Access denied”? Barriers for staff accessing, using and sharing published information online within the National Health Service (NHS) in England: technology, risk, culture, policy and practice., 2017 PhD thesis thesis, University of Sheffield. [Thesis]

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English abstract

The overall aim of the study was to investigate barriers to online professional information seeking, use and sharing occurring within the NHS in England, their possible effects (upon education, working practices, working lives and clinical and organisational effectiveness), and possible explanatory or causative factors. The investigation adopted a qualitative case study approach, using semi-structured interviews and documentary analysis as its methods, with three NHS Trusts of different types (acute - district general hospital, mental health / community, acute – teaching) as the nested sites of data collection. It aimed to be both exploratory and explanatory. A stratified sample of participants, including representatives of professions whose perspectives were deemed to be relevant, and clinicians with educational or staff development responsibilities, was recruited for each Trust. Three non-Trust specialists (the product manager of a secure web gateway vendor, an academic e-learning specialist, and the senior manager at NICE responsible for the NHS Evidence electronic content and web platform) were also interviewed. Policy documents, statistics, strategies, reports and quality accounts for the Trusts were obtained via public websites, from participants or via Freedom of Information requests. Thematic analysis following the approach of Braun and Clarke (2006) was adopted as the analytic method for both interviews and documents. The key themes of the results that emerged are presented: barriers to accessing and using information, education and training, professional cultures and norms, information governance and security, and communications policy. The findings are discussed under three main headings: power, culture, trust and risk in information security; use and regulation of Web 2.0 and social media, and the system of professions. It became evident that the roots of problems with access to and use of such information lay deep within the culture and organisational characteristics of the NHS and its use of IT. A possible model is presented to explain the interaction of the various technical and organisational factors that were identified as relevant. A number of policy recommendations are put forward to improve access to published information at Trust level, as well as recommendations for further research.

Item type: Thesis (UNSPECIFIED)
Keywords: ds:NHS; National Health Service; England; access to information; information behaviour; information seeking; information use; information sharing; clinicians; managers; students; trainees; information technology; user-driven innovation; professional jurisdiction; organisational culture; professional subcultures; risk perception; Web 2.0; social media; web filtering; secure web gateways; cybersecurity risk assessment; security usability; information governance; acceptable use policies; e-learning; mobile devices
Subjects: B. Information use and sociology of information > BZ. None of these, but in this section.
I. Information treatment for information services > II. Filtering.
I. Information treatment for information services > IZ. None of these, but in this section.
L. Information technology and library technology > LZ. None of these, but in this section.
Depositing user: Ms Catherine Ebenezer
Date deposited: 28 Mar 2018 19:34
Last modified: 28 Mar 2018 19:34
URI: http://hdl.handle.net/10760/32585


Adams, A., Blandford, A., & Lunt, P. (2005). Social empowerment and exclusion: a case study on digital libraries. ACM Transactions on Computer-Human Interaction, 12(2), 174–200.

Blenkinsopp J. Bookmarks: web blocking – giving Big Brother a run for his money. He@lth Information on the Internet 2008; 62: 10-11.

Donaldson A, Walker P. Information governance--a view from the NHS. Int J Med Inform 2004; 73(3): 281–4.

Bradley, P. (2012). Why librarians must use social media. At http://www.slideshare.net/Philbradley/why-librarians-must-use-social-media [accessed 23/01/2015]

Cain, J. (2011). Social media in health care: the case for organizational policy and employee education. American Journal of Health-System Pharmacy 68, 1036-1040.

Chretien, K., & Kind, T. (2014). Climbing social media in medicine’s hierarchy of needs. Academic Medicine, 89(10), 1318–1320.

Donaldson A, Walker P. Information governance--a view from the NHS. Int J Med Inform 2004; 73(3): 281–4.

Eysenbach, G. (2008). Medicine 2.0: social networking, collaboration, participation, apomediation, and openness. Journal of Medical Internet Research 10(3), e22.

Fléchais, I., Riegelsberger, J., & Sasse, M. A. (2006). Divide and conquer: the role of trust and assurance in the design of secure socio-technical systems. In Proceedings of the 2005 workshop on new security paradigms (pp. 33–41). ACM.

Hamm, M. P., Chisholm, A., Shulhan, J., Milne, A., Scott, S. D., Klassen, T. P., & Hartling, L. (2013). Social media use by health care professionals �and trainees: a scoping review. Academic Medicine : Journal of the �Association of American Medical Colleges, 88(9), 1376–83.

Hughes, B., Joshi, I., & Wareham, J. (2008). Health 2.0 and Medicine 2.0: tensions and controversies in the field. Journal of Medical Internet Research, 10(3), e23.

Hughes, B., Joshi, I., Lemonde, H., & Wareham, J. (2009). Junior physician’s [sic] use of Web 2.0 for information seeking and medical education: a qualitative study. International Journal of Medical Informatics, 78(10), 645–55.

Kaplan, A. M. & Haenlein, M. (2010). Users of the world, unite! The challenges and opportunities of social media. Business Horizons 53(1), 59-68.

Kaganer, E. & Vaast, E. (2010). Responding to the (almost) unknown: social representations and corporate policies of social media. ICIS 2010 Proceedings. At http://aisel.aisnet.org/icis2010_submissions

Koch, H., Leidner, D. E., & Gonzalez, E. S. (2013). Digitally enabling social networks: resolving IT-culture conflict. Information Systems Journal, 23(6), 501-523.

Kolkowska E. Security subcultures in an organization – exploring value conflicts. In ECIS 2011 Proceedings, paper 237. http://aisel.aisnet.org/ecis2011/237

Lafferty, N. (2013). NHS-HE connectivity project: Web 2.0 and social media in �education and research. Retrieved from �https://community.ja.net/groups/search/NHS-HE%2520forum.

NHS Employers (2014). A social media toolkit for the NHS. �London: NHS Employers. Retrieved from www.nhsemployers.org.

NHS Employers (2013). HR and social media in the NHS. London: NHS Employers. Retrieved from www.nhsemployers.org.

Prince, N. J., Cass, H. D., & Klaber, R. E. (2010). Accessing e-learning and e-resources. Medical Education, 44 436-437.

Renaud, K., & Goucher, W. (2012). Health service employees and information security policies : an uneasy partnership? Information Management and Computer Security, 20(4), 296–311.

Provos, N., Mavrommatis, P., Rajab, M. A., & Monrose, F. (2008). All your iFRAMEs point to us. Mountain View, CA. http://research.google.com/archive/provos-2008a.pdf

Sasse, M. A. (2015). Scaring and bullying people into security won’t work. IEEE Security and Privacy, (June), 80–83.

Technical Design Authority Group (2008). TDAG survey of access �to electronic resources in healthcare libraries. London: TDAG.

Vaast, E. & Kaganer, E. (2013). Social media affordances and governance in the workplace: An examination of organizational policies. Journal of Computer-Mediated Communication 19(1) 78-101

Verma, S., Kavita, & Budhiraja, S. (2012). Internet security. �International Journal of Computer Applications in Engineering �Sciences, II(III), 210–213.

Darmstadt: Technische Universität Darmstadt. http://bit.ly/2cpN7LO

Ward, R., Moule, P., & Lockyer, L. (2009). Adoption of Web 2.0 technologies in education for health professionals in the UK: where are we and why? Electronic Journal of e-Learning 7(2) 165-172. Retrieved from www.ejel.org.

Zhang, W., & Janssen, F. (s.d.). The relationship between PR and ROC curves.


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