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The Emergence of Technology-Based Service Systems

•Essén, A. (2009). "The emergence of technology-based service systems". Published in the JOURNAL OF SERVICE MANAGEMENT (formerly: INTERNATIONAL JOURNAL OF SERVICE INDUSTRY MANAGEMENT), Vol 20/1, pp 98 - 121.

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0% found this document useful (0 votes)
218 views24 pages

The Emergence of Technology-Based Service Systems

•Essén, A. (2009). "The emergence of technology-based service systems". Published in the JOURNAL OF SERVICE MANAGEMENT (formerly: INTERNATIONAL JOURNAL OF SERVICE INDUSTRY MANAGEMENT), Vol 20/1, pp 98 - 121.

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A_Essen
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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The current issue and full text archive of this journal is available at

www.emeraldinsight.com/1757-5818.htm

JOSM
20,1 The emergence of
technology-based service systems
A case study of a telehealth project in Sweden
98
Anna Essén
Stockholm University School of Business, Stockholm, Sweden
Received 22 June 2007
Revised 4 January 2008
Accepted 3 April 2008
Abstract
Purpose – The purpose of this paper is to propose a framework for studying the process of
technology-based service system innovation from a broad perspective using an approach that
elucidates the non-linear facets of this process. The framework draws on Lévy-Strauss’s concept
of bricolage, which implies that individuals’ “making do with resources at hand,” as opposed to
managerial visions, can trigger innovation. This concept is combined with the notion of technological
drift and with a model of emergentism.
Design/methodology/approach – The paper uses case study data from the Swedish elderly
homecare setting.
Findings – The findings illustrate how the emergence of technology-based care services can be
triggered by an injection of energy in terms of a new technological resource being made available in an
organization, proceeding as a continuous interaction between personnel repurposing and recombining
resources at hand, positive and negative feedback dynamics, institutional regulations and
culture-related stabilizing mechanisms.
Research limitations/implications – New services can arise as a result of a number of efforts and
events that, in isolation, might appear insignificant. Taken together, and interacting with enabling and
constraining forces that promote the emergence of certain new services and prevent others, such acts
and events generate unpredictable outcomes. The result may be incremental but by no means trivial
innovations.
Originality/value – The paper suggests an approach to innovation that complements conventional
thinking in the new service development literature. The proposed framework can help to explain how
and why certain new services emerge and why others do not in unexpected and unpredictable ways.
Keywords Elder care, Sweden, Customer service management, Technology led strategy,
Service systems
Paper type Research paper

1. Introduction
Knowledge about the service innovation process is important for our understanding of
the transformation of offerings, organizations and sectors over time. However, it is still
an underexposed area in the literature (de Jong and Vermeulen, 2003; Sandén, 2007;
Syson and Perks, 2004), particularly the process of innovating technology-based
service systems (Menor et al., 2002; van Riel, 2005). Authors have recently pointed at
the complexity related to this kind of service innovation, arguing that it involves not
only technological, but also organizational development (Magli et al., 2006; Piccoli et al.,
Journal of Service Management 2004). It has further been suggested that the technology-based service innovation
Vol. 20 No. 1, 2009
pp. 98-121 process encompasses many informal and iterative elements, and that it is influenced by
q Emerald Group Publishing Limited extra-organizational factors, such as prevailing policies and cultural values (Barlow
1757-5818
DOI 10.1108/09564230910936878 et al., 2006). These insights indicate that students of technology-based service
innovation should take on a broad perspective. Regrettably, the emerging Technology-
technology-based service innovation literature does not quite respond to this call. based service
Existing studies largely attempt to:
. model the systematic sides of technology-based service innovation; or
systems
.
investigate to what extent certain technology-based services respond to certain
consumers’ needs (Chircu et al., 2001; Dabholkar et al., 2003; Lanseng and
Andreassen, 2007; Massey et al., 2007; Mørch et al., 2004; Slater and Mohr, 2006;
99
Sung-Eui, 2005; Walker et al., 2002).

This tends to produce studies incapable of capturing the complexity of


technology-based service innovation. The prevailing practice-oriented approach
tends to generate studies that neglect the informal and unpredictable dimensions of
the technology-based service innovation process and its sensitivity to the influence of
extra-organizational factors. This weakness applies to the new service development
literature in general. It is dominated by studies depicting service innovation as
a well-planned, formal process, starting with a managerial vision and ending with a
full-scale launch (Cooper et al., 1994; Johne and Storey, 1998; Menor et al., 2002).
Although authors have criticized these models for obscuring the iterative and
bottom-up sides of service innovation (Edvardsson et al., 1995, Dolfsma, 2004; Stevens
and Dimitriadis, 2004; Sandén, 2007), alternative models are hard to find.
In summary, the new service development literature (including studies focusing on
technology-based service innovation) mainly theorizes about the formal, linear and
predictable facets of the innovation process despite observations suggesting that many
innovation processes are cyclical and that they involve unexpected, informal
interactions between factors at the individual, organizational and societal level. The
lack of theoretical understanding of the latter aspects has implications in practice.
Such aspects are not considered in cost analyses or supported with tools or
technologies (Maglio et al., 2006). As a result, informal mechanisms and ideas are not
caught up, potential innovations go unnoticed and many extra-organizational forces
that exert a positive or negative influence on the innovation process are not dealt with,
leading ultimately to a reduction in financial performance.
The present paper seeks to address the imbalance in the literature by proposing a
framework for studying the process of technology-based service system innovation
from a broad perspective using an approach that elucidates the non-linear facets of this
process. The paper draws on Lévy-Strauss’s (1966) concept of bricolage, which implies
that individuals’ “making do with resources at hand,” as opposed to managerial
visions, can trigger innovation. To flesh out this concept, illustrating how it is
influenced by certain institutions, resources and events, the present paper integrates
it with the notion of technological drift (Ciborra et al., 2000) and with a model of
emergentism (Chiles et al., 2004; Prigogine and Stengers, 1984).
The paper illustrates the proposed framework using empirical data on the first
phase of developing technology-based elderly care services. Hence, the paper responds
to calls for innovation research in settings other than the financial sector, which has
received a disproportional amount of attention in the development literature to date
(Smith and Fischbacher, 2005; Stevens and Dimitriadis, 2004). The care setting is
relevant as increased healthcare spending and possibly unsustainable healthcare
funding models motivate many care providers to develop existing care services by
JOSM using information technology (IT) or “telehealth” applications (Koch, 2006; Lanseng
20,1 and Andreassen, 2007; OECD, 2004). Service development in this area, however, is
immature and there are internationally few examples of telehealth services offered in
routine care service delivery (Barlow et al., 2006). This situation in particular and the
public healthcare sector in general have received surprisingly little attention in
the service innovation literature (Smith and Fischbacher, 2005).
100 Drawing on the proposed emergentism framework, this paper describes the
beginning of an innovation process, which is triggered by a new technological resource
being made available in a care organization and proceeding as a continuous interaction
between repurposing mechanisms, feedback mechanisms, institutional regulations and
stabilization mechanisms. This way of understanding the service development process
extends the concepts of bricolage and drift by revealing the enabling and constraining
dynamics that reinforce the emergence of certain services and prevent others from
emerging. The applicability of these insights goes well beyond the care setting and is
relevant to students of innovation processes in general. Overall, the paper opens up
avenues for research studying how new services can arise, actualize and materialize in
a non-linear and rather unpredictable way. In this way, it serves to complement the
new service development and service innovation literature, which to date has been
dominated by studies outlining “success factors” and emphasizing the importance of
systematic innovation processes (Åstebro and Michela, 2005; Atuahene-Gima, 1996;
Avlonitis et al., 2001; de Brentani, 2001).
The paper begins with a selective literature review and a presentation of the
proposed theoretical framework, integrating insights from bricolage (Lévy-Strauss,
1966), technological drift (Ciborra et al., 2000) and emergentism (Chiles et al., 2004;
Prigogine and Stengers, 1984). A case study from a telehealth project conducted by a
public elderly care provider in Sweden follows. The paper concludes with implications,
limitations and suggestions for further research.

2. The innovation of technology-based services


The concern of this paper is the process of innovating new technology-based service
systems[1]. The “new service development” literature has paid little attention to such
innovation processes (Menor et al., 2002). A review of the nascent technology-based
service innovation literature reveals that it largely attempts to shed light on the
systematic, ordered facets of the development process (Chircu et al., 2001; Palmer and
Griffith, 1998; Passerini et al., 2007; Sung-Eui, 2005; van Riel and Lievens, 2004).
For example, Piccoli et al. (2004) conceptualize the development of technology-based
services as a migration from one discrete phase to the next that follows a predictable
pattern determined by the firm’s overarching goal of maximizing its return on its
technology investment. Many service development studies further focus on consumers’
adoption of technological innovations (Dabholkar et al., 2003; Lanseng and
Andreassen, 2007; Massey et al., 2007; Slater and Mohr, 2006; Walker et al., 2002;
Vrechopoulos et al., 2001). This research produces important insights, but tends to
bring about an understanding of the innovation process as predictable and possible to
completely control.
A few recent studies have suggested that the process of innovating
technology-based services is more complex than previously thought. Barlow et al.
(2006) point out that this process involves integration between the technological
innovation and the service provision system (including authority structures). They also Technology-
suggest that the policy context, contemporary values and cultural norms can influence based service
the innovation process[2]. In general, they point at a mishmash of factors, at various
levels, that can play important roles in the process of innovating technology-based systems
services. Maglio et al. (2006) similarly suggest that technology-based service
innovation involves not only technological relationships but also organizational and
individual relationships, i.e. that it should be understood as a matter of developing new 101
service systems. Their examination of IT service delivery systems suggests that such
systems comprise a large share of non-planned tasks and negotiations performed by
individuals and that other “fuzzy” factors, which are beyond the manager’s direct
control, influence the development of such systems.
These latter studies indicate that the technology-based service innovation process:
.
involves more than the ordered implementation of a new technology is;
.
cyclical rather than linear and that it is; and
.
influenced by informal and unpredictable factors, among which many are
beyond the organization’s control.

As noted above, however, such aspects have not seen much light in the new service
development literature. In their review, Johnson et al. (2000) conclude that the NSD
literature provides three types of innovation process models: models that depict a part
of the process (Schostack, 1984); models based on blueprints for new product
development (Bowers, 1989); and comprehensive models (Scheuing and Johnson (1989)
that propose a model including 15 stages). Common for these models is their normative
character and their focus on intra-organizational issues and phases that the NSD
process “should” encompass. Sandén (2007, p. 41) writes that more recent research has
concentrated on various aspects of NSD but that few studies have examined the NSD
“process”. Interestingly, Sandén (2007, p. 18) argues that NSD is often “ad hoc and
based on trial-and-error type of approach”. It is further important to note that research
on innovation systems more generally is increasingly underlining that innovation can
occur through other pathways than well-managed and systematic processes.
Observations suggest that innovation trajectories are often informal, ad hoc and
unpredictable and that they should be understood as cyclical, including various
feedback loops and evolving through complex – often unexpected and even accidental
– events (Consoli, 2005; Gadrey et al., 1995; Jensen et al., 2007; Metcalfe et al., 2005;
Rothschild and Darr, 2005).
However, few models elucidating how trial-and-error mechanisms and other factors
interact have been suggested. Hence, there appears to be a need for a more
comprehensive framework in the innovation process that allows for a multi-level
analysis of the dynamics between emergent micro-processes at the individual and
organizational level, on the one hand, and structures at societal level, on the other. In
the next section such a framework is outlined. I will start by introducing the notion of
bricolage (Lévy-Strauss, 1966) and technological drift.

2.1 Bricolage and technological drift


The concept of “bricolage,” often referred to as making do with “whatever is
at hand” (Lévy-Strauss, 1966, p. 17; Miner et al., 2001; Weick, 1993), helped
to describe and understand the innovation process observed in this study.
JOSM This paper draws on Baker and Nelson (2005, p. 333), who define bricolage as “making
20,1 do by applying combinations of the resources at hand to new problems and
opportunities.” Resources at hand refer to a set of pre-existing “odds and ends”
(Lévy-Strauss, 1966, p. 18), such as available materials (Lanzara, 1999), coping
mechanisms (Hatton, 1989) and skills and ideas (Baker and Nelson, 2005). Bricolage
implies that such resources-at-hand are reused for different applications than those,
102 which they were originally intended for or used (Garud and Karnoe, 2003; Miner et al.,
2001). In other words, bricolage is the repurposing and refashioning of the old in
making something new (Weick, 1993) and it involves recombining existing elements
rather than fabricating them from scratch (Baker and Nelson, 2005).
Bricolage contradicts the rational model of innovation as seeking means to reach a
given end. In bricolage, the ends are not clearly known at the outset and the
“reasoning” process does not use logical deduction but is more of a spontaneous
process (Innes and Booher, 1999). Bricolage is related to improvisation. To paraphrase
Miner et al. (2001, p. 314):
[. . .] as improvisation permits no temporal gap between the design and execution of activities,
improvisers have little opportunity to seek resources beyond those already at hand, and they
therefore typically engage in bricolage.
Hence, in contrast to conventional views on innovation, bricolage suggests that
innovation can be understood as actors departing from the means and gradually
learning what aims are possible. It is difficult to foresee the result of such practices.
Bricolage is associated with unexpected outcomes that are half-realized, hybrid and
imperfect, but which do their job and can be improved (Lanzara, 1999; Miner et al.,
2001). As this paper deals with technology-based services, insights on the
unpredictability of outcomes in the information systems (IS) literature are relevant
to consider here. The IS literature discusses this in terms of technological drift (Ciborra
et al., 2000, p. 4), i.e. the tendency of technologies to deviate from their planned purpose
for a variety of reasons. Technology often performs in unexpected ways and it tends to
produce unintended side effects when implemented. As a result, users often have to
revise goals and intentions or try to find ways to alter or work around the technological
properties over time (Ciborra et al., 2000; Pickering, 1995). The affordance (Gibson,
1979) of technology, i.e. users’ perception of what action is possible with the
technology, is further highly contextual. This fact shapes the consequences of IS
implementations in unpredictable ways (Orlikowski, 1992; Feenberg, 1999; Murata,
2003).
Summing up, the concepts of bricolage and technological drift complement each
other, suggesting that the innovation of technology-based services can be triggered by
individuals making do with available resources, and that the outcomes of such
practices, i.e. the new technology-based services that actually emerge, may be different
from what was initially envisaged by technology designers or the user organization.
These insights were valuable when analyzing the innovation process studied here.
However, it soon became clear that there was more to the process studied than actors
“making do with resources at hand.” Further, neither bricolage nor technological drift
could sufficiently explain why certain technology-based services emerged while others
were prevented from being realized. Why did outcomes “drift” in one direction and not
another?
2.2 Proposing a framework for studying the emergence of new technology-based services Technology-
Although the literature applying bricolage and technological drift sheds light on based service
the triggering- and outcome-related elements of the innovation process, the bricolage
process has essentially remained a black box. To open this black box, i.e. unpack the systems
intermediate dimension of the innovation process, this paper uses insights from
complexity theory (McKelvey, 1999). Complexity theory is suitable for the study of how
new services can come to be as it focuses on emergence, on “becoming rather than 103
being” and on “process rather than state” (Gleick, 1987, p. 5). It can be used to explain
how and why a phenomenon evolves from the interaction of myriad events, small and
large, spontaneous and deliberate and at multiple levels (Chiles et al., 2004). The idea
that emergent properties amount to more than the sums of the properties of their parts
is central in emergentism theory (Gleick, 1987). This paper uses the dissipative
structures model (Prigogine and Stengers, 1984; Chiles et al., 2004), which posits four
interacting mechanisms of emergence[3]:
(1) “Fluctuation” refers to injections of energy represented by new activities, events
or resources that interrupt the existing order and catalyze the emergence of a
new order.
(2) “Feedback dynamics” amplify the initial fluctuations, helping the new order to
take hold and gain momentum.
(3) “Recombination dynamics” refers to how the system’s existing elements are
reused, rearranged, reconstructed, re-leveraged and re-created.
(4) “Stabilization dynamics” are deep structures that shape novelties and guide
choices in a way consistent with the systems accumulated history and learning,
preserving the systems identity and core behavioral patterns.

Hence, the dissipative structures model overlaps with bricolage but it also extends this
concept by specifying the forces that enable and constrain what individuals can make
of the available technological resources. Although organizational students have used
the dissipative structures model to explain how the evolution of organizational systems
proceed from a “punctuated emergency” to the next, i.e. from one order to another over
time (Chiles et al., 2004; Leifer, 1989), this paper uses it to explain the first phase in a
service development process, i.e. the emergence of a new service, which can be
understood as the evolution of one new order.
The framework (Figure 1) suggests that the development of new services can
be triggered by the injection of energy in terms of a new technology resource
being made available in an organization. The organizational members will engage
in bricolage (Lévy-Strauss, 1966) by making do with the new resource, i.e. they
will repurpose it and recombine it with old resources, and as a result, they will
learn what the technology affords in context. The individual members’ acts of
making do should, however, not be confused with boundless freedom and endless
creativity. Positive and negative feedback mechanisms shape their acts of making
do. That is, the immediate responses the personnel encounter when using the new
resource will amplify certain uses and prevent others from being repeated. The
(unexpected) performance of the new technology, when implemented, will also
actuate responses and developments in certain directions rather than others. These
responses contribute to the definition of the boundaries of the emerging service.
JOSM Institutional constraints &
stabilization mechanisms:
20,1 Personnel adjusting to institutional
constraints, to culture and to values.

104
Feedback
mechanisms:
The injection of energy : A The positive/negative
New
new technological Services responses personnel
resource. This resource is emerging encounter when
redefined over time along introducing novelties
with personnel using it and and personnel
the contextual affordances reacting to
that emerge. unexpected
technological
Drifting outcomes performance.

Figure 1.
A framework for Making do
unpacking the concept of with resources at hand:
bricolage in the context of The recombination, reuse and
the innovation of repurposing of available
technology-based services resources, including the new
technology.

The emergence of new ways of using the new resource, i.e. the birth of new
technology-based services, is further influenced by more permanent institutional
constraints and stabilizing mechanisms, such as organizational structure,
regulations and cultural values (Chiles et al., 2004; Prigogine and Stengers,
1984). The innovation process will unfold as a continuous interaction between
these enabling and constraining mechanisms, producing results that may drift
from the original intention of the technology designers and the user organization
(Ciborra et al., 2000). In general, it is difficult for any single actor to control the
outcome of this process because it is shaped by participants and forces at various
levels and at different points of time.
This view of the innovation process has emerged during the process of writing this
paper (see method section) and it has guided the analysis and presentation of the
present findings.

3. Method
The present paper explores how the mechanisms shown in Figure 1 operate in a
particular context such as technology-based care service innovation, i.e. the purpose is
to develop rather than to test theory. The study is based on a single case. This case was
chosen for theoretical reasons in the sense that it could reveal an unusual phenomenon
(technology-based care service innovation) and support the elaboration of the emergent
theory (theoretical rather than representational sampling (Yin, 1984)). Studying the Technology-
single case over a three-year period (2004-2007)[4] allowed me to follow the informal, based service
gradual processes of service development over time in its real-world context and to use
various information sources (Yin, 1984). In general, the case study approach is suitable systems
for longitudinal research seeking to unravel the underlying dynamics of phenomena
that play out over time (Siggelkow, 2007).
105
3.1 Data generation
A telehealth project conducted by the community care organization in Heby, Sweden
constitutes the case studied. Heby is one of few elderly care providers engaged in
the development of IT-based services in Sweden. The author has participated in a large
number of formal and informal meetings in Heby from 2004 to 2007. Field notes have
been taken from these observations and home-helpers’ service documentation has
further been scrutinized and summarized in field notes. In 2006, 12 unstructured
interviews were performed with home-help and managerial personnel within the Heby
community care organization. The interviews revolved around visions about the
telehealth technology and the actual use and development of services based on this
technology (see Appendix). The longitudinal study allowed the researcher to ask
follow-up questions (see interview guide in the Appendix) and thereby understand how
one thing led to another (interactions).
Interviews were performed at the nursing home where personnel gather before they
deliver home-help services. The interviews, which lasted about 90 minutes each,
included open-ended questions in order to allow for unexpected issues to emerge.
The interviews were recorded, transcribed and translated (Swedish to English) by the
author.

3.2 Data analysis


Following the pattern for inductive research (Denzin and Lincoln, 1998; Miles and
Huberman, 1994), the author worked recursively between the interview transcripts,
field notes and the theory being developed. Field notes and interview transcripts were
analyzed at two levels. The author first focused on building detailed descriptions of
particular acts in which the individuals involved in the telehealth project created new
ways to use the new technology. These descriptions were then coded tentatively using
key words that emerged from the empirical data (Miles and Huberman, 1994). When
documenting patterns in the data, tentative theoretical explanations were constructed
based on an initial framework. The individual-level, pragmatic, ad hoc and bottom-up
tendencies ran across interview transcripts as well as observational notes. Similarly,
the role of forces at the structural level was evident in several sources. The author
discussed uncertainties in the data with two of the home-helpers on several occasions.
Several working papers that attempted to explain regularities in the data were written.
These papers were presented to peer scholars and critical feedback was received.
During the repeated process of interrogating the data, revising the theory and
returning to the data, Lévy-Strauss’s concept of bricolage was discovered as a good
characterization of the behaviors observed in the case. However, it became obvious that
this concept could not explain the process alone. The dissipative structures model
emerged as relevant after some modification. After several rounds of experimental
coding, the themes reported in the present paper emerged (Denzin and Lincoln, 2000).
JOSM In the presentation of the results illustrative examples of the data from which the
20,1 author drew inferences are provided (Miles and Huberman, 1994). When quotes are
used, the names of the informants are coded.

3.3 The case


The study focused on a sub-unit of the Heby community care organization (as this unit
106 implemented the new technology). This sub-unit employed 18 home-helpers at the time
of the study. The municipality director of Heby is ultimately in charge of the care
delivered by these home-helpers. There are also regional managers, heading over
group leaders, who in turn lead groups of home-helpers.
In 2003-2004, the Heby municipality director and regional manager decided to
invest in an activity monitoring technology. At this time, Heby was suffering from
financial constraints (budget deficit). The managers used money from a temporary
municipal development fund to cover the investment. The new technology has
similarities with “traditional safety alarms” that are provided to seniors in the
community. The monitoring units are wrist-worn and include a button that seniors can
manually press when they are in an emergency situation. The new monitoring units,
however, also include functionality that differs radically from the traditional alarms.
Embedded sensors continuously monitor the activity level of the seniors, transmit this
information to service providers and present it in the form of graphical activity curves
displayed on a computer screen. The monitoring system also sends automatic alarms to
personnel if significant changes in activity level are detected (e.g. if a senior is
completely inactive as this can indicate an emergency). The system thus provides
information about subtle changes in activity patterns over time (i.e. non-emergency
information), but also about drastic changes in activity levels via automatic inactivity
alarms (i.e. emergency information). The Heby managers bought 23 end-user
monitoring units. The technology was installed in 23 elderly households located in a
sub-region of Heby. They also purchased a PC with a certain application installed,
which was needed in order for personnel to be able to analyze the patient activity
information (graphical activity curves) generated by the system.

4. Findings
The development process studied was characterized by a continuous interaction
between the mechanisms in the proposed theoretical framework. The mechanisms are
illustrated with examples from situations where they were salient.

4.1 An injection of energy: introducing a new technological resource without a clear end
in sight
A group of managers in the Heby community care organization initiated the
development process studied. They envisioned that new technology-based services
could contribute to a more cost-effective care service production and thus decided to
invest in a telemonitoring system. There were numerous new care technologies
available on the market, but few targeted the elderly homecare sector. Therefore, the
managers pragmatically “settled” with a technology that seemed to hold some promise.
An important reason for the managers paying attention to this particular technology
was an informal relationship between key actors (as opposed to a systematic scanning
of all technologies available). Serendipitous events, such as people being seated next to
each other at a grand dinner, played a role here. The vendor marketed the monitoring Technology-
system as a tool for ensuring the safety of seniors living in single households: based service
[. . .] The message was that the monitoring system would enhance our capacity to detect systems
emergencies [. . .] And the extended information about the senior patient’s “general status”
would enable us to “know” our seniors better [. . .] (Birgitta, Manager).
Although the managers were animated by such claims, they were uncertain about 107
what benefits the use of the technology could produce at a more concrete level:
We found it difficult to predict [. . .] At this stage, our belief was that the advantages of the
monitoring technology in practice would emerge along with the staff members starting to use
it (Anna, Manager).
It was difficult for the managers to formulate a new service concept at this stage because
they were unsure of what the new technology, in the hands of the home-helpers, could do.

4.2 Making do: “creating” the resources needed to innovate services


The managers saw to that the new hardware and software were paid for.
Their engagement, however, was limited to the purchase of the new technology.
Hence, the front-line employees (home-helpers and their group leader) faced the
challenge of installing, configuring and using the new technology without any new
resources formally being allocated to this purpose. The empirical material revealed
that the personnel, “out of nothing,” created resources that, taken together, made it
possible for the technology to be used and the innovation of new services to begin.
Take, for example, the issue of finding a place for the new PC (to which the monitoring
information would be sent). The home-helpers do not have an “office” as they are
always out visiting seniors. The home-helpers, however, meet every morning at one of
the community nursing homes for demented patients. The group leader repurposed a
room that was not occupied by any senior to create space for using the technology:
This room is rarely used, and it can be locked, which is important as the elderly [nursing
home residents suffering from dementia] may otherwise wander through the door and start
playing with the computer (Liv, Group Leader).
There was also a need to “find” time to install the new monitoring devices in the elderly
households. The group leader managed this by reallocating time from other tasks that
could wait. As this was not always possible, the installation was sporadic and spanned
over a long period. Moreover, because there were no formal resources allocated to this,
the personnel were forced to “create” technical support. The group leader took
advantage of her good relationship with an employee at the technology vendor in this
context:
There were a lot of unexpected problems in the beginning. I can tell you that [. . .] so I called
Fredrik [employed at the technology firm] and told him that we just had to make the
monitoring devices work again [. . .] Poor Fredrik I called him often, but he was always
willing to help. He has a hard time saying no – he’s that type of guy [. . .] Fredrik really wants
us to like the new technology [. . .] so that we can spread the gospel I guess [. . .] we don’t pay
for this [. . .] (Eva, Group Leader).
Finally, there was a need to innovate some rules for how to respond to the new alarms
generated by the new technology. The personnel reused existing routines in
JOSM this context. They decided to respond to the new inactivity alarms in exactly the same
way as when they are notified about the traditional manual alarms: two home-helpers
20,1 working shift at the nursing home take a community car and drive immediately to the
senior in question to check on him/her:
[. . .] we’re not sure of what kind of events would actually trigger inactivity alarms.
What I mean is that these automatic alarms are totally different from the other alarms
108 [manually triggered alarms], but it seemed reasonable to use our existing routines [. . .] that
we are all familiar with ( Jenny, Home-helper).
Hence, by making do with the resources that are accessible, the front-line employees
created a platform that enabled them to start using and innovating services based on
the new technology.

4.3 Feedback mechanisms during the use of the new technology


As the personnel started using the new technology, feedback mechanisms reinforced
certain features and affordances and impeded others. An important feedback link was
that from the monitored senior consumers. Most of the seniors appreciated being
provided with new, “modern” alarms with monitoring functionality. This encouraged
the personnel to keep on using and learning about the new technology. However, some
of the seniors started to rely too much on the technology:
[. . .] Jim told me he’d felt really bad before my visit. But he didn’t call on us as he thought the
technology would notice this anyway. You could see this on the computer, couldn’t you, he
said [. . .] but we couldn’t [. . .] (Jessica, Home-helper).
This feedback taught personnel what the monitoring technology was not, i.e. a general
health monitor, as they had initially envisaged. Instead, the personnel started to define
it as a complementary source of information, which reflected a single and very specific
aspect of the seniors’ health.
4.3.1 Redefining the automated alarms triggered by the new technology. As opposed
to what was initially expected by the vendor and the care providers, none of the
automatic inactivity alarms triggered was caused by emergencies[5]. The
home-helpers’ alarm documentation revealed that the automatic alarms were caused
by various subtle changes in activity. For example, one note said:
The alarm was presumably triggered by Jeff lying still most of the day. He was tired, recently
being discharged from hospital. I gave Jeff a sandwich when I arrived. He appreciated this.
Another example:
Lillian confirmed she was just tired and a bit sad when I arrived. We talked for a few minutes.
This made her happy. I told her I would call back in half an hour.
The personnel learned that the monitoring system could detect and notify them about
situations when seniors were “unusually weak.” New services emerged as the
personnel responded to such situations. They paid the seniors, from whom alarms were
automatically triggered, extra “support visits.” The content of these visits was deemed
highly contingent on the senior and necessary to innovate in situ. A home-helper
explains:
You have to feel what is right in these moments. The automatic alarms can be triggered for
various reasons. Perhaps the seniors are weak and just need you to sit next to them, holding
their hand for a minute. In other cases, making them laugh may be the recipe in making them Technology-
feel better [. . .] (Joni, Home-helper).
based service
The seniors’ responses suggested that the new customized support visits could systems
produce feelings of safety and reduce anxiety among the seniors:
[. . .] Essentially, I think these visits make the seniors feel watched over and cared for [. . .]
(Hannah, Home-helper). 109
Interviewees also reported that the new support services have preventive value:
[. . .] Visiting a senior who is merely feeling a bit tired and sad may prevent him/her from
getting really anxious and completely passive [. . .] and if seniors feel safe at home, this may
prevent them from applying for placement at a nursing home [. . .] (Gunilla, Group Leader).
4.3.2 Redefining the patient data continuously provided by the technology. The
monitoring technology also generates real-time information about the seniors’ activity
level over time, displayed as graphical activity curves on a computer screen.
The personnel realized that this activity information allowed them to see whether the
seniors wear their alarm. This is important as many seniors forget to wear their alarms
and are therefore unable to call for help in emergencies:
[. . .] I realized that I can see if seniors are wearing their alarm or not on the screen [. . .] if the
line is straight, this means there is no signal, [that] the senior is not wearing the alarm [. . .] we
didn’t think of this in the beginning [. . .] (Ulla, Home-helper).
The personnel started to remind the seniors (who, according to the activity data, were
not wearing their alarm) to wear their alarms. That is, a “making-sure-that-seniors-
wear-their-alarms” service started to take shape. As there were no pre-existing routines
to copy in this context, the personnel improvised when reminding the seniors about the
alarms, combining the new patient data with their “old” consumer knowledge. For
example, Jenny says:
We saw on the screen that Siv never wears her alarm during the night [. . .] I did not really
know how to talk to her about this though. I didn’t want to say that we “can see” if she wears
it or not [. . .] Siv would find this privacy threatening – I know her. I ended up not talking
about the monitoring system at all. Instead, I talked about the risk of falling [. . .] and I think it
worked [. . .] ( Jenny, Home-helper).
This way of using the new patient data generated the desired results:
[. . .] We’ve seen an effect on the curves. When we tell them specifically about this, more or
less directly, they tend to start using their alarm. Thus, they can call on us when in danger.
This provides the seniors and their relatives with a greater sense of safety [. . .] they’ve told us
this [. . .] (Maria, Home-helper).

4.4 Institutional constraints and stabilizing mechanisms


The personnel assert that they could use the monitoring system in a number of
preventive ways beyond what has been mentioned:
[. . .] We could use it [the new patient data] to identify seniors who appear to be extremely
passive during the daytime or suffer from insomnia at night and help them become more
active during the day: for example, [. . .] introducing targeted daily activity services could
JOSM prevent a lot of sleeping disorders from getting worse. This could prevent fall accidents,
which are more common among tired seniors [. . .] (Maria, Home-helper).
20,1
However, the home-helpers do not have the authority to make any major changes in the
services they deliver:
[. . .] The home-helpers have to stick to the service plans: they cannot just add new services
110 [. . .] We would need to create a new role structure, where front-line employees could adjust
the content of the services they deliver on the basis of real-time information generated by
technologies like this [. . .] (Anna, Manager).
In general, the data revealed that the reimbursement system and organization of the
national care system constrained the organization’s possibilities to realize service
innovations that respond to “new” needs:
Addressing seniors sleeping disorders or irregular activity patterns as a preventive measure
[. . .] is beyond our public commitment [. . .] we would have to bear such production costs
without being reimbursed by the government for this [. . .] sure this could generate long-term
health improvements and reduce costs [. . .] but there is no evidence of this. And who knows if
I’ll ever get any return on such investments as political shifts may change my budget totally
[. . .] (Karin, Manager).
Privacy concerns further hampered more extended customized prevention services
from being accomplished. The monitoring technology actually provides a good deal of
information about the seniors: when they leave the house, when they sleep, how deep
they sleep and it is possible to infer quite a lot on the basis of their general activity
level. As a preventive measure, the home-helpers could use this information to
intervene in the seniors’ behavior. However, the home-helpers did not use the data in
this way. Eva explains:
[. . .] I mean sure, we can see if the senior leaves the house and at what time. I can see that Elov
leaves the house every day at about the same time and that he returns after 15 minutes.
I knew this before: he likes to take a morning walk every day. But if I would see that he didn’t
leave the house one day, I wouldn’t call him and tell him to take a walk, even if it is good for
his health. This would invade on his privacy! But if he would stop performing this daily
routine completely, I would perhaps tell the girls to check on him a bit extra during their
regular visits [. . .] (Liv, Group Leader).
Similarly, Jessica says:
If an activity curve indicates that something is not OK, you feel like asking the senior about
this [. . .] But we cannot say to a senior that “we have seen on the curves that you are very
inactive during the days.” This might make the seniors feel they are being continuously
watched and thus have a negative impact [. . .] (Jessica, Home-helper).
The data also indicated that the value attached to principles, such as autonomy and
pluralism, impeded certain services from emerging:
[. . .] Unless there’s an alarm, we rarely do anything about the changes in activity level we see
on the screen [. . .] I mean, for how long is it normal to have a “low activity” level? In some
cases low activity level can be a sign of depression or a signal that something is wrong
health-wise [. . .] something that could get worse if we do nothing about it [. . .] but seniors
may simply need a lot of rest some days [. . .] and who are we to decide what’s “normal” and
not? [. . .] (Eva, Group leader).
[. . .] It is a scary thought that we would use this to see that everyone has a perfectly regular Technology-
pattern, i.e. sleeping during the night and being active during the day. We know that sleeping
patterns change with age. It is important to allow variation here. Some elderly may enjoy based service
staying up until 3 am, sleeping until 6 am and then sleeping again in the afternoon [. . .] systems
(Birgitta, Manager).
Skepticism toward “high-tech business” further discouraged the personnel from
exploiting the functionality of the new technology. The monitoring system can be set to 111
trigger various alarms (e.g. if the senior leaves the apartment). The home-helpers
however decided to keep such alarm functions latent:
We decided to only activate the inactivity emergency alarms in this first stage of use [. . .]
using all the new functions seemed too demanding and complicated [. . .] We’re not in a
high-tech business. We’re not high-tech people [. . .] ( Jenny, Home-helper).
Finally, the data indicated that the deeply rooted view of elderly care as a matter of
human (read: face-to-face) contact contributed to the personnel using the new
information as a complement rather than as a replacement of face-to-face visits:
[. . .] We would never collect information about our elderly merely via computers instead of
visiting them. This would be out of the question: care is about human contact [. . .] (Ulla,
Home-helper).

4.5 Interactions
There were numerous interactions between the mechanisms. For example, stabilization
mechanisms influenced the “energy-injection mechanism” as financial constraints
encouraged the managers to choose a relatively low-cost technology and the prevailing
healthcare culture made them inclined not to choose a too radical technology
(e.g. robotics). Stabilization mechanisms in terms of prevailing values further
influenced the “feedback mechanism” in terms of the positive reaction among seniors
(via their high belief in the reliability of modern technology). Prevailing values also
influenced how the care workers interpreted the feedback signals from the seniors and
how the care workers, as a result, redefined the purpose of the technology. There were
also interactions between the stabilization mechanisms and the “making-do
mechanisms” (operational employees’ acts of bricolage). Care workers were forced to
make do with available resources because of institutional constraints, such as a limited
budget and the rigid financial structure. Cultural values further constrained their use of
the technology. Hence, stabilization mechanisms influenced how care workers made
do with the technology, which greatly influenced how seniors reacted to the
new technology, which influenced how care workers continued to make do with the
technology. These examples illustrate the cyclical nature of the emergence of new
technology-based services in the case studied.

4.6 Drift: redefining the new technological resource – unexpected services emerging
In summary, as a result of the implementation of the monitoring technology, new
technology-generated patient data entered the work-life of personnel. The new data
unexpectedly made it known that seniors often forget to wear their alarms and it
occurred to the personnel that they could use the technology to detect and respond to this
problem. The personnel also understood that the technology could notify them when
seniors were “weak” and thus provided them with an opportunity to address these subtle
JOSM health changes. Overall, the personnel gradually learned that the new technology
20,1 enabled various preventive services. This view differed from the technology vendor’s
claims and the managers’ initial expectations of the new technology, which revolved
more around its role as an emergency-detector. The personnel redefined the new
technological resource, increasingly referring to it as a complementary decision support
and an “early warning” tool. Based on this contextualized understanding of the
112 technological resource, the personnel started to provide seniors with new “extra support
visits” and “alarm-usage control services,” carefully adjusted to the individual senior
and the situation. Neither the vendor nor the managers had anticipated the emergence of
these new services. The services are still in a beginning stage. The personnel and
managers, however, assert that they will continue to use the technology to learn what it
enables them to do for their senior consumers.

5. Conclusion, implications and further research


The aim of this paper was to propose a theoretical framework for studying
technology-based service system innovation as a non-linear and emergent process.
The proposed framework draws on complexity theory (the dissipative structures
model, Prigogine and Stengers (1984)) as well as the notion of technological drift
(Ciborra et al., 2000) and bricolage (Lévy-Strauss, 1966); concepts that have not been
discussed in the NSD literature heretoforth. The paper uses empirical data from the
elderly care setting to show the relevance of the enabling and constraining dynamics
incorporated in the proposed framework in the study of service innovation. More
specifically, the paper has described the emergence of new technology-based care
services as a continuous interaction between “the injection of energy” in terms of a new
technological resource, personnel “making do with resources at hand,” “feedback
dynamics” and “stabilizing mechanisms.” These dynamics helped to explain how and
why certain new care services emerged and why others did not in the case studied. For
example, the personnel started to tinker with the new technological resource in the
actual context, combining it with existing resources, and various unexpected actions
made possible by the technology, i.e. new “service affordances” emerged. The
personnel’s realization of these possibilities was influenced by feedback mechanisms
that attenuated certain acts and strengthened others. There were also more permanent
stabilizing forces that prevented the personnel from even starting to carry out certain
ideas that emerged.
The proposed framework contributes to the NSD literature in several ways.
Although there are many models of the service innovation process, these models are
largely normative and focused on the sequential and formal facets that the process
“should” (ideally) encompass (see discussion above and in the reviews of Johne and
Storey, 1998; Johnson et al., 2000; Sandén, 2007). In contrast, the framework proposed
here allows a broad analysis of the innovation process, including its non-linear,
informal and unpredictable facets. The framework also highlights the influence of
individual factors and of extra-organizational dimensions at the societal level, on
the innovation process. In general, the present paper suggests an approach that
complements established thinking on service innovation. Much of the service
innovation literature to date appears primarily interested in identifying success factors
in innovation projects. It typically underlines the importance of allocating resources to
multi-functional, autonomous development teams and engaging external parties,
including consumers, suppliers, competitors and other stakeholders in all stages of the Technology-
process (Alam and Perry, 2002; Åstebro and Michela, 2005; de Brentani, 2001; de Jong based service
and Vermulen, 2003; Johne and Storey, 1998; Kelly and Storey, 2000; Matear et al., 2004;
Ottenbacher et al., 2006). In contrast, the present paper reports about “trivial” acts and systems
events, which, taken together led to the emergence of new service ideas and to the
provision of a few new services. There is reason to believe that “mundane”
development processes and results such as those reported in this paper are no less 113
common than innovation processes that are aligned with the recommendations in the
new service development literature. As noted by Sundbo (1997), service industries
seldom have R&D departments. To understand how new services emerge we therefore
need to acknowledge that services may sometimes emerge as a result of fluctuations,
i.e. injections of energy, spontaneous or deliberate, that trigger more or less unexpected
responses and in an ad hoc manner lead to incremental changes. This, too, is
innovation in services. And such innovation does most likely occur also in strictly
managed processes, where sequential models are used and where there is a
development team and development budget.

5.1 Research implications


As Siggelkow (2007) noted, single cases can serve as counterexamples that enable
the development of existing theory by pointing to gaps and beginning to fill them. The
present study can be viewed as an attempt to, if not “falsify,” then at least challenge the
prevailing tendency to model technology-based service innovation only as a
predictable, systematic process contingent on managerial decisions (Chircu et al.,
2001; Palmer and Griffith, 1998; Passerini et al., 2007; Piccoli et al., 2004; Sung-Eui,
2005; van Riel and Lievens, 2004). The present study has attempted to illustrate that as
an alternative, the concepts of bricolage, technological drift and complexity theory can
sensitize researchers to important cyclical dynamics inherent in the emergence of new
technology-based service systems. In general, the purpose of this explorative study
was to begin to outline a new direction in new service development research, one that
goes beyond the interest of providing managers with unrealistic recipes for how to
create optimal innovation processes, but instead takes on a multilevel analysis and
considers the influence of forces at both the individual and societal level to describe
how new services actually come into being. Complexity theory (McKelvey, 1999)
provides opportunities for learning more about how new services can emerge in this
context. The service innovation literature would benefit from this theory being applied
to help crystallize how single events at the micro level can trigger changes at macro
levels, leading to the emergence of new orders and paradigm shifts in the services
industry, i.e. multilevel analysis (Chiles et al., 2004).

5.2 Managerial implications


This paper does not set out to provide managerial recipes for how to conduct optimal
innovation processes. It is descriptive rather than prescriptive. Still, the findings do
provide insights on issues that managers should recognize in their decisions about how
to plan for and support the innovation process. To start with, this paper reports about
how a service innovation process can unfold in the absence of a clear strategy,
i.e. without much managerial planning. In the case studied the managers simply made
a new technological resource available to front-line personnel and their idea was to see
JOSM what new care services could emerge as a result. This is contrary to innovation
20,1 processes beginning with the managerial definition of a “service objective” and
proceeding with the formal allocation of the resources necessary to achieve this
objective, as has been proposed (Alam and Perry, 2002; Cooper et al., 1994; Edgett,
1994; Kelly and Storey, 2000). In the case studied the new technology was the only
resource formally allocated to the service development project. There was no
114 “development team” or “development budget” devoted to the service innovation as is
often recommended in the service innovation literature (de Jong and Vermulen, 2003;
Edvardsson and Olsson, 1996; Johne and Storey, 1998; Kelly and Storey, 2000; Stevens
and Dimitriadis, 2004; Syson and Perks, 2004). The present study, however, shows that
this did not prevent innovation from happening. It rather forced front-line personnel to
make do with the resources at hand, i.e. to engage in bricolage (Lévy-Strauss, 1966).
In creating the prerequisites for employing the new technology, i.e. creating space for
service innovation, they reallocated time from activities that could wait and repurposed
available resources, such as abandoned facilities, social relationships and private
experiences. The absence of any formal allocation of resources to the innovation
process studied may have had positive implications. For example, hidden and
seemingly unrelated resources had perhaps not been put to any productive application
if a development budget had been available. As it were, bricolage sometime created
value without withdrawing resources from any current use. Further, as the operational
personnel could not delegate tasks to some “development team,” they were forced to
infuse the new technology into their work life without disrupting their day-to-day
work. As a result, the technology was fairly integrated in the organization.
However, the lack of “new” development resources in terms not only of time, but
also of authority and competence among participants, and the reliance on obtainable
resources most likely made the personnel strive for a workable rather than a
breakthrough solution. The absence of an innovation strategy led to ad hoc choices that
tended toward the option requiring the least cognitive effort and time (Douglas, 1987).
As a result, the personnel were inclined to choose paths that avoided dramatic changes.
These factors contribute to the fact that incremental rather than radical or disruptive
(Christensen, 1997) innovations were produced. In general, the creative use of bits and
pieces has produced a “bits and pieces” innovation, i.e. a half-realized innovation.
Elements that are vital to the development of a sustainable service are still lacking.
As noted by Baker and Nelson (2005), “coaxing,” a large degree of ad hoc responses and
improvisation can be anathema to the establishment of reliable impersonal routines.
The provision of the new service is dependent on the employees’ capability to create
space to use the new technology as no formal roles or responsibilities have been
created. Further, the vendor will not provide “free” support forever. It needs to be noted
though that the process is far from finished. More formalized processes and roles will
most likely emerge over time.
In general, the findings presented here are relevant to managers not only in the care
setting but also in service settings in general. This study emphasizes the complexity
related to the innovation of technology-based service systems and the many forces that
managers need to take into account before and during such innovation processes.
Although it is difficult for managers to control the mechanisms involved, such as
individual care workers improvisations, pragmatic acts of “making do,” institutional
constraints and reactions among consumers, managers need to be aware of the
significance of such forces. They should establish support systems (in terms of, Technology-
e.g. rewards or other incentives) to support and encourage care workers’ tinkering with based service
the available resources. They should also engage in continuous follow-up meetings to
catch up emergent ideas. Finally, they should try to reflect on how institutional systems
regulations and cultural values may influence the innovation process.
In summary, the present study suggests that although innovation processes may be
difficult to predict and control, it is nevertheless possible to distinguish patterns and to 115
“prepare for” certain interactions in advance. The findings elucidate how individuals’
engagement in bricolage is not merely a matter of arbitrarily departing from the means
available; it is also shaped by attenuating and reducing feedback mechanisms.
Outcomes do not drift randomly but as a result of structural and cultural factors.
Institutional constraints had particular significance in the context studied. The
personnel could not introduce new services merely on the basis of what was technically
afforded and what could produce values to their senior caretakers. Rather, they had to
keep their public commitment in mind, i.e. what needs they are and are not officially
responsible and reimbursed for responding to. Deeply rooted values (such as
maintaining privacy, autonomy and the prevailing healthcare culture where care is
seen as a matter of human (face-to-face) contact) also influenced the emergence of new
services by disallowing more radical uses of the new technology.

5.3 Limitations and future research directions


The present exploratory study is based on a single case. As noted, the public
home-help setting studied is idiosyncratic in many ways. However, the purpose was
to develop theory rather than to test theory (Eisenhardt and Graebner, 2007). Of
course, further research needs to validate and refine the proposed framework
(Figure 1) in other settings. Explorations of how organizations can make use of new
technologies (e.g. digital and nanotechnologies) to provide new services in complex
settings (such as healthcare) are particularly warranted. Such innovations occur in
interfirm modularity settings (Staudenmeyer et al., 2005), where it is difficult for a
single actor to develop all parts of the final offering as this requires deep insight
into what is technologically feasible as well as insight into the specific service
delivery processes in question. Longitudinal studies, using multiple cases and
covering various actors (not only the service provider but also technology vendors,
etc.) as well as combining qualitative and quantitative data generation methods,
would benefit the development of the framework suggested here. This paper also
studied the early stage of a single service innovation process. Research focusing on
later phases in such emergent processes would further our understanding of how
new services are integrated into existing service systems (Tax and Stuart, 1997),
legitimized and actually become available to consumers. In general, there is reason
to believe that many new service development processes include formal as well as
informal elements. The proposed framework could be used to analyze how forces at
individual and societal level shape well-planned and strictly managed processes.
Finally, this study indicates that the lack of resources in terms of authority and
competence can hamper innovation outcomes. Although this could be expected
(Vargo and Lusch, 2004) further research about how such pre-requisites can be
created in the public sector is needed.
JOSM Notes
20,1 1. Innovation can broadly be described as an idea, artifact, or behavior that is new to or
perceived as new by the organization adopting it (Daft, 1978; Zaltman et al., 1973).
This paper deals with the process that generates such “outcomes.”
2. Barlow et al. (2006) write about “implementing” a technological innovation, but I believe that
it is more appropriate to talk about service innovation. The overall discourse needs to shift
116 focus from technology implementation to service innovation.
3. This version of the dissipative structures model is simplified to suit the purpose of this paper
(see Prigogine and Stengers (1984) for a more detailed account).
4. This study is part of an ongoing research program investigating the infusion of IT into
elderly care.
5. There were also a large number of “false” alarms that were triggered by seniors sleeping
unusually deep during the study period.

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Appendix
Interview guide (many of these questions were asked (in one way or another) at several times, at
informal/formal meetings and during interviews).
To managers:
How did you choose to invest in this particular technology?
(Often, follow-up questions were asked, such as: was there any other aspect that
influenced your decision, you think?)
Who did you engage in the decision phase?
Why?
What was problematic in this first stage?
What was your intention at this stage? Vision? (What benefits did you foresee at this
stage?)
How did the project proceed?
Has your vision been realized?
What have you learned?
If it would be up to you to decide, would you recommend a continued use of the
technology?
Why?

To home-helpers:
What do you think of the new technology?
How many times per week have you used it, and for how long?
How have you used it? Technology-
Why have you used it in this way? based service
Has it been difficult?
systems
Did you use all functions/features possible in the application?
Why did you not/use certain features?
If it would be up to you to decide, would you recommend a continued use of the 121
technology?
Why?
What benefits can the technology produce from your viewpoint?

Corresponding author
Anna Essén can be contacted at: [email protected]

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