Introducing the electronic patient record (EPR) in a hospital setting: Boundary work and shifting constructions of professional identities
ABSTRACT Today's healthcare sector is being transformed by several ongoing processes, among them the introduction of new technologies, new financial models and new ways of organising work. The introduction of the electronic patient record (EPR) is representative and part of these extensive changes. Based on interviews with health personnel and office staff in a regional hospital in Norway, and with health administrators and information technology service-centre staff in the region, the article examines how the introduction of the EPR, as experienced by the participants, affects the work practices and boundaries between various professional groups in the healthcare system and discusses the implications this has for the understanding of medical practice. The article shows how the EPR has become part of the professionals' boundary work; expressing shifting constructions of professional identities.
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ABSTRACT: Background A territory-wide internet-based electronic patient record allows better patient care in different sectors. This survey measured the adoption level, enabling factors and hindering factors of electronic Medical Record (eMR), among private physicians in Hong Kong. It also evaluated the key functions and the popularity of electronic systems and vendors used by these private practitioners. Methods A central registry consisting of 4,324 private practitioners was set up and invitations for self-administered surveys were sent via fax, emails, postal mails and on-site clinic visits. The questionnaires were returned by any of these means. Current users and non-users of eMR system were compared according to their demographic and practice characteristics. Student’s t-tests and chi-square tests were used for continuous and categorical variables, respectively. Results A total of 524 completed surveys (response rate 12.1%) were collected. The proportion of using eMR in private clinics was 79.6%. When compared with non-users, the eMR users were younger (48.4 years vs. 61.7 years; P<.001); more were female physicians (19.2% vs. 13.1%; P=.03); possessed less clinical experience (> 20 years: 62.6% vs. 86.9%, P<.001); fewer worked under a Health Maintenance Organization (83.2% vs 90.7%; P<.001) and more worked with practice partners (30.2% vs 3.7%; P<.001). Efficiency (90.9%) and reduction of medical errors (54.9%) were the major enabling factors while patient-unfriendliness (54.9%) and limited consultation time (50.5%) were the most commonly reported hindering factors. The key functions of computer software among eMR users consisted of electronic patient registration system (90.2%), drug dispensing system (78.7%) and electronic drug labels (71.0%). Softlink Clinic SolutionTM was the most popular vendor (38.4%). Conclusions These findings identified several physician groups who should be targeted for more assistance on eMR installation and its adoption. Future studies should address the barriers of using internet-based eMR to enhance its adoption.Journal of Medical Internet Research 08/2013; 1(1). DOI:10.2196/medinform.2766 · 4.67 Impact Factor
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ABSTRACT: RFID (Radio Frequency Identification) technology is expected to play a vital role in the healthcare arena, especially in times when cost containments are at the top of the priorities of healthcare management authorities. Medical equipment represents a significant share of yearly healthcare operational costs; hence, ensuring an effective and efficient management of such key assets is critical to promptly and reliably deliver a diversity of clinical services at the patient bedside. Empirical evidence from a phased-out RFID implementation in one European hospital demonstrates that RFID has the potential to transform asset management by improving inventory management, enhancing asset utilization, increasing staff productivity, improving care services, enhancing maintenance compliance, and increasing information visibility. Most importantly, RFID allows the emergence of intelligent asset management processes, which is, undoubtedly, the most important benefit that could be derived from the RFID system. Results show that the added intelligence can be rather basic (auto-status change) or a bit more advanced (personalized automatic triggers). More importantly, adding intelligence improves planning and decision-making processes.Journal of Medical Systems 10/2013; 37(5):9963. DOI:10.1007/s10916-013-9963-2 · 2.21 Impact Factor
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ABSTRACT: Information and communication technologies (ICTs) are often identified by librarians and information professionals as being a driving force behind the way they perform their day-to-day activities and how they interact with their clients. This study considers the role ICTs play in the shaping and constructing of the identities of librarians. Using data gathered from interviews, email discussion lists, and the professional literature, this study employed a discourse analysis to examine the language resources librarians use when constructing their professional identities, with particular attention to the role of ICTs in this construction. ICTs both challenged and enhanced the identities of librarians. While the changes related to ICTs have left librarians feeling insecure about their professional positions, they have also opened up new roles and opportunities for librarians to pursue. Librarians have a service-oriented identity that is influenced by ICT-related changes affecting their work. These changes will challenge and benefit librarians as they engage with ICTs and determine how, if at all, they can be incorporated into their day-to-day practice.Proceedings of the American Society for Information Science and Technology 01/2014; 51(1). DOI:10.1002/meet.2014.14505101049