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Electronic patient records in interprofessional decision making: Standardized categories and local use
University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology. (LINA)ORCID iD: 0000-0002-1908-4940
Department of Education, University of Gothenburg.
2012 (English)In: Human Technology, ISSN 1795-6889, Vol. 8, no 1, 46-64 p.Article in journal (Refereed) Published
Abstract [en]

Electronic patient records (EPRs) are a constitutive element of medical practice and are expected to improve interprofessional communication and support decision making. The aim of the current study is to explore the ways in which access to structured information from multiple professions within EPRs enters into the phases involved in arriving at final agreements about patients' future care. The results show that decision making in interprofessional team rounds involves a prestructuring of a pathological reality. Further, the results demonstrate how information in EPRs is deconstructed and recast into patterns that presuppose knowledge about the EPR's structural organization. This means that EPRs are highly flexible technologies and that their design does not determine their usefulness. A major conclusion is that the members' knowledge on how to bridge between standardized categories in EPRs and their local meanings is decisive for understanding the basic conditions necessary for how EPRs could support interprofessional collaboration.

Place, publisher, year, edition, pages
Finland: Agora Center, University of Jyväskylä , 2012. Vol. 8, no 1, 46-64 p.
Keyword [en]
Electronic patient records, decision making, categories, standardization, communication, information technologies
National Category
Pedagogy Public Health, Global Health, Social Medicine and Epidemiology
Research subject
SOCIAL SCIENCE, Pedagogics; Work Integrated Learning
Identifiers
URN: urn:nbn:se:hv:diva-4777OAI: oai:DiVA.org:hv-4777DiVA: diva2:563990
Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2015-03-26Bibliographically 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. 207 p.
Series
PhD Thesis: University West, 2012:1
Keyword
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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