Collective expectations--individual action implementing electronic booking systems in Norwegian health care.
ABSTRACT We draw on an ongoing study of an electronic booking project at the University Hospital North Norway where general practitioners are given the opportunity to book appointments at the hospital for their patients. Electronic booking offers well-defined and standardised services as well as standardised procedures for preparing the patient for the appointment at the hospital. We examine how the standards inscribed in the booking system shape medical work and how they bring to the surface a social dilemma between collective and individual interests in how the key actors reflect on the consequences of the system. We combine two social theories, namely Actor Network Theory and the theory of collective action. As a conclusion, we argue that simple and well-defined cases of patients' problems and willingness among the general practitioners to undertake work traditionally conducted at the hospital are conditions for making electronic booking successful. However, when the patients' problems are unclear the booking system needs to be combined with traditional referrals. We also point to how the general practitioners' attitude towards the system is time-dependent. Their initial positive attitude towards the potential public goods produced by booking transforms into putting more weight on the individual interests.
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ABSTRACT: Healthcare reform has emphasized coordinated and integrated care — patient-centered care — for a decade. To that end, policymakers have invested in integration of healthcare providers’ information flows. Research to date has studied healthcare actors’ information needs but overlooked communicative exchanges among all participants in coordinating treatment plan decisions. Consequently, while medical literature asserts that patients should depend on information from healthcare providers to enable patients’ participation in treatment plan decisions, the assertion has not been tested. To ameliorate this oversight, we conducted an empirical study of a patient-centered healthcare environment. Our study draws on dependency network diagramming (DND) and social network analysis (SNA) to elucidate the nature and structure of actors’ communications in support of their information dependencies. The findings illustrate that although patients are well supported by personal communications with healthcare providers, they are disenfranchised from the integrated information technology within and between healthcare providers and its potential to support patients’ participation in coordinated “patient-centered care” decisions. Furthermore, knowledge asymmetry between patients and healthcare providers should be considered in the selection and tailoring of healthcare information systems (IS).Proceedings of the 15th Americas Conference on Information Systems, AMCIS 2009, San Francisco, California, USA, August 6-9, 2009; 01/2009
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ABSTRACT: For more than a decade, healthcare reform has emphasized coordinated ''patient-centered care". To that end, policymakers have invested in integration of healthcare providers' information flows. Research has studied healthcare providers' information needs but overlooked communicative exchanges among participants in coordinating treatment plan decisions. Consequently, although medical literature asserts that patients should depend on information exchange with healthcare providers to enable participation in treatment plan decisions, the assertion has not been tested. In this paper, the authors conduct an empirical study to elucidate the structure of actors 'communications in support of their information dependencies. The findings illustrate that although patients are well connected through personal contact with healthcare providers, patients are disenfranchised from integrated healthcare information systems (IS) and the potential of IS to support patients ' participation in coordinated ''patient-centered care" decisions. Furthermore, knowledge asymmetry between patients and healthcare providers should be considered in the selection and design of healthcare IS.
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ABSTRACT: The main idea behind the paper is to try to find out what the main socio-technical obstacles and enablers for high volume use of collaboration systems in the health sector are. The paper also focuses how the results can be used in design, implementation and deployment of collaborative systems in health care, with electronic referrals used as a case.Collaborative Technologies and Systems (CTS), 2010 International Symposium on; 06/2010