JMIR Publications

ABSTRACT

As technology is integrated into healthcare delivery, questions related to the adoption and acceptance of these new technologies become increasingly urgent. Current models of technology adoption/acceptance of health technologies leave large gaps in practice and provide limited explanation of how and why certain technologies are adopted and others are not. In these discussions, the concept of legitimacy is omnipresent but often implicit and underdeveloped. There is no cohesive agreement about what legitimacy is or how it works across social science disciplines, despite a prolific volume of literature centering legitimacy. Through a Critical Interpretive Synthesis literature review using the disciplinary constructs of Organization & Management Studies, Science & Technology Studies, and Medical Anthropology & Sociology, we explore the meaning of legitimacy in health and technology, how it is produced, and how it is used. We synthesize these bodies of literature to produce a novel conceptualization of legitimacy as a form of social infrastructure. Legitimacy as social infrastructure allows us to bring relational, material, semiotic, and network-based aspects of legitimacy into focus, conceptualizing legitimacy as an assemblage. Social infrastructure is a flexible and adaptable framework for working with legitimacy that can aid both academics and decision-makers by providing more coherent and holistic explanations for how and why embedding new technologies in healthcare practice does or does not happen.