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Electronic patient records in action: Transforming information into professionally relevant knowledge
University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology. (LINA)ORCID iD: 0000-0002-1908-4940
University of Gothenburg.
2011 (English)In: Health Informatics Journal, ISSN 1460-4582, Vol. 17, no 1, p. 51-62Article in journal (Refereed) Published
Abstract [en]

The implementation of generic models for organizing information in complex institutions like those in healthcare creates a gap between standardization and the need for locally relevant knowledge. The present study addresses how this gap can be bridged by focusing on the practical work of healthcare staff in transforming information in EPRs into knowledge that is useful for everyday work. Video recording of shift handovers on a rehabilitation ward serves as the empirical case. The results show how extensive selections and reorganizations of information in EPRs are carried out in order to transform information into professionally relevant accounts. We argue that knowledge about the institutional obligations and professional ways of construing information are fundamental for these transitions. The findings point to the need to consider the role of professional knowledge inherent in unpacking information in efforts to develop information systems intended to bridge between institutional and professional boundaries in healthcare.

Place, publisher, year, edition, pages
2011. Vol. 17, no 1, p. 51-62
Keywords [en]
communication, electronic patient records, professional knowledge, shift handovers, workplace studies
National Category
Pedagogy
Research subject
SOCIAL SCIENCE, Pedagogics
Identifiers
URN: urn:nbn:se:hv:diva-3342DOI: 10.1177/1460458210396330OAI: oai:DiVA.org:hv-3342DiVA, id: diva2:418309
Available from: 2011-05-21 Created: 2011-05-21 Last updated: 2015-01-16Bibliographically approved
In thesis
1. Transforming information into practical actions: A study of professional knowledge in the use of electronic patient records
Open this publication in new window or tab >>Transforming information into practical actions: A study of professional knowledge in the use of electronic patient records
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today, technologies are being introduced into historically established settings, which change the conditions for work as well as for work-integrated learning. In health care, electronic patient records (EPRs) has been implemented during the last decades to serve as a tool for planning, decision making and evaluation of care work. The overall aim of the research presented in this thesis is to analyse the complex actions and interactions that occur when EPRs are used in health care practice. Analytically, such an interest is pursued employing a socio-cultural perspective on workplace studies, where the use of technology is studied in action. Through three separate studies, practical actions and practical use of EPRs have been examined and the empirical data draws on observations, video-recordings, audio-recordings and documents from a hospital ward in Sweden. The result shows that technologies such as EPRs both offer and presuppose standardization of terminologies and information structures. This, however, does not mean that EPRs completely format and structure information, or that it is driven by its own logic. When staffs comply with a set of standards, transformations of those standards will gradually occur. Those transformations are collective achievements and since each professional involved act in a conscious and active manner, this affects the use of standards as well as the development of collective proficiency. The results also demonstrate that meaning making in(through) the use of EPRs presupposes extensive knowledge of the indexicality of categories, something that originates in the participants‘ shared institutional history. It is in the process of reliving, creating and exposing the meaning of information, that health care professionals actually bring information in EPRs to life. In further development of EPRs that exceeds institutional and even national boundaries it is important to see this development not as solely technical or organizational questions. To develop systems that enhance the possibilities for professionals in different institutions with different professional domains to make sense of standardized information may be a much more  demanding task than it seems to be. Such boundary-crossing systems are nevertheless of great importance for the further development of health care practice.

Place, publisher, year, edition, pages
Trollhättan: University West, 2012. p. 207
Series
PhD Thesis: University West ; 2012:1
Keywords
Electronic patient records, professional knowledge, decision making, work integrated learning, standardization
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pedagogy
Research subject
SOCIAL SCIENCE, Pedagogics; Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-4779 (URN)978-91-977943-3-6 (ISBN)
Public defence
2012-09-21, Albertsalen, Högskolan Väst, Trollhättan, 13:00
Opponent
Supervisors
Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2015-03-26Bibliographically approved

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