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This article looks at the Electronic Health Record (EHR), a core module of the healthcare information system (HIS), to understand how the affordances of the technological tool emerge and can evolve to meet user needs. The case study data is collected from change agents in a university hospital using grounded theory and then coded. Our results analyze the design choices made for the EHR (its structure) to describe the potentialities offered by these design choices (affordances) and the actual use made of these potentialities by users (affordance actualizations). Our contribution to the literature on affordances distinguishes three types of structure within the tool (resulting from technical, legal or organizational design factors). The structure provides a new understanding of how affordances evolve and are updated. From a managerial point of view, these contributions enable the project team to better analyze its interventions on the tool's structure, leading to changes in the potentialities offered to users.

The proliferation of digital tools in the activities of middle managers (MM) exacerbates tensions between the historic mandate for rationalization and an emerging injunction for individual and collective autonomy. By interrogating the concept of appropriation through the lens of activity theory, our article aims to address the following question: How do middle managers handle the tensions introduced by digital tools in their activities? We conducted an ethnographic study based on shadowing within transport equipment repair factories and their central management. Our findings indicate that digital tools continuously reshape managerial activities. Indeed, they introduce new tensions that render managerial activity systems temporary and adaptive. Our results demonstrate that managers transform these digital-induced tensions through pragmatic, epistemic, socio-political, and reflective mediations. Specifically, they reinterpret the uses of these tools to rethink their entire managerial practices, encompassing the exploration of possibilities in action, knowledge sharing, collaboration with teams, and self-representation as a manager.

At the time of the first confinement in March 2020, teleworking had developed rapidly and on a large scale. This new context changed the usual modes of coordination and called for the use of digital technologies to mediate working relationships. Our focus lies on the emergence of new operating rules during this period. Our research therefore aims to answer the following question: what role do digital tools play in the social regulations at work at the time of the transition to teleworking? A qualitative methodology, based on 44 semi-structured interviews conducted in two organizations, was used to gather data from the first days of the confinement. These were a departmental council (Val de Seine) and a company producing neurosurgical equipment (Neurochir). Our methodology was adapted to the health circumstances, as we repeated a series of interviews on two occasions, resulting in a total of three phases of investigation, spread over a year. Our findings underscore the pivotal role of telecommuting tools and a regulatory process predominantly driven by individual initiative, thus limiting broader discussions beyond local contexts. In the course of this research, we have highlighted changes in regulations and their effects. These range from a feeling of trust in the organization, to a feeling of increased control, to a perception that work is being intensified and dehumanised. Digital tools contribute in each case, in the absence of organized discussion at an institutional level. Our study advocates for deliberation on telecommuting regulations, particularly those concerning telecommuting tools, and proposes ideas for establishing discussion platforms. We offer some ideas for engineering discussion forums.