Institut for Kommunikation og Kultur

This paper investigates how physicians create overview of patient cases through a comparative analysis of physicians’ work practices. Based on observations of physicians and interviews with physicians on overview, we analyse what overview is to physicians and how they create it by the use of different socio-technical systems (paper-based and electronic patient records). We propose to conceptualise the creating of overview as ‘distributed plot-making’ drawing on the theory of distributed cognition and narrative theory: Distributed cognition focuses on the role of artefacts, humans and their interaction in information processing, while narrative theory focuses on how humans create narratives through the construction of plots. Hence, the concept of distributed plot-making highlights the distribution of information processing between different social actors and artefacts, as well as the filtering, sorting and ordering of information into a narrative made coherent by a plot. The comparative analysis shows that paper-based and electronic patient records enable the creation of overview in different ways and that both have disadvantageous and beneficial characteristics. In the light of the current move towards electronic patient records, we point to the ways in which benefits of paper can be carried over into the electronic patient record as well as ways in which the possibilities of digital artefacts can be explored more