# From safety to efficiency: How drivers of technology adoption changed during the COVID-19 pandemic in municipal home care

## TL;DR

This study explores how digital technologies were adopted in Swedish home care during the pandemic, shifting from safety to efficiency over time.

## Contribution

The study reveals how motivations for technology adoption in home care evolved from safety to efficiency during the pandemic.

## Key findings

- Digital technologies were initially adopted to ensure safety but later used for efficiency.
- Digital meetings and faxing continued post-pandemic due to efficiency and lack of alternatives.
- Theoretical models like TAM and TTF fail to capture the dynamic context of technology use in home care.

## Abstract

Home care underwent abrupt adaptations to handle the COVID-19 pandemic including an accelerated digitalization. While some research exists regarding the working conditions for home care personnel during the COVID-19 pandemic, few studies exist on the effect of everyday technology use in home care during the pandemic. The aim of this study was to investigate how digital technologies, introduced in Swedish municipal home care during the COVID-19 pandemic, were adopted and used by home care nurses and how well they fitted the context of use over time.

An ethnographic approach was employed where qualitative data were gathered via semi-structured interviews and field observations. The data were subjected to thematic analysis. The Technology Acceptance Model (TAM) and the Task-Technology Fit (TTF) model were used as theoretical frameworks to identify and discuss factors associated with technology acceptance, use, and fit with the work.

Three new technologies were implemented: digital infection status lists, digital faxing, and digital meetings. Around these three technologies, two main themes related to the adoption and acceptance of technology were constructed: Ensuring safety and Striving for efficiency. Initially, the implementation of the technologies was solely driven by a need to ensure safety. However, benefits promoting efficiency were progressively discovered. After the pandemic, the perceived usefulness of the technologies was solely related to efficiency. Digital meetings continued to be in use also after the pandemic since they improved efficiency. Digital faxing continued to be in use despite being associated with usability problems, as the previous solution, the analogue fax, had been decommissioned. Thus, adoption was not only a matter of perceived usefulness but also a matter of other organizational factors and decisions.

Technology had a central role in home care during the pandemic as it was used to ensure safety. Contextual conditions changed over time, and with them motivations to use the new technologies. The dynamic nature that dictates technology use in practice is not captured well in the TAM and TTF theoretical frameworks. A more holistic discussion is needed where context, feedback, agency, and control at work are given greater consideration and space.

Not applicable.