Technological affordances of risk and blame: the case of the electronic prescription service in England

Information and communication technology (ICT) is often presented by healthpolicymakers and software designers as a means for reducing clinical risk, leadingto safer clinical practice. Studies have challenged this view, showing howtechnology can produce new or unanticipated risks. Although research seeks toobjectively identify these risks, we recognise that technological risks are sociallyconstructed through the interaction of technology and practice. The aim of thisarticle is to explore how technology affords opportunities for the socialconstruction and control of risk in health care settings. Drawing upon a study ofthe electronic prescription service introduced in the National Health Service inEngland, we make three arguments. Firstly, as technology interacts with socialpractice (for example, through policy and the design and use of ICT) it affordsopportunities for the construction of risk through its interpretiveflexibility,transformative capacity and materiality. Secondly, social actors interpret these riskswithin and across professional boundaries and cultures. Thirdly, the socialconstruction of risk affords certain implications to policymakers, designers andusers of health ICT, specifically a reordering of power and responsibility and arecasting of questions of blame. These, in turn, raise questions concerning theboundaries and bearers of responsibility.