The Interplay of Digital and Physical Materialities in IT Affordances: A Study of Governance of Controlled Medications in a Hospital

In studies of information technology (IT) in organizations, affordance theory may be used to explain what possibilities for action IT offers, under what conditions they are actualized and how they shape action and outcomes. Affordance theory suggests that materiality matters because it furnishes possibilities for action. However, in studies of IT affordances, the digital and physical materialities of IT are usually in focus, while the physical materiality of non‐IT artefacts is seldom considered. This paper examines how the physical materiality of non‐IT artefacts conditions the action possibilities an IT system offers its users. We base our observations on a study of IT implemented in a hospital to improve visibility and accountability of the use of controlled drugs, such as opioids. We compare how the materiality of both IT and paper‐based systems used for these purposes interplays with the materiality of the medications and other non‐IT artefacts in nurses and pharmacists' accountability work. We found different combinations of technologies and medications, condition visibility for the organization in different ways, with distinct ways of knowing about medication work, and different potential accountability outcomes. Temporal processes of accountability work, such as recurrence, accumulation or temporal lag, also condition different outcomes of affordance actualization. Overall, by illuminating material and temporal influences behind visibility and potential for accountability afforded by IT to organizations we deepen the understanding of the action potential afforded by IT and reveal opportunities for redesign of technology and organizational processes.