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Infrastructuring and Ordering Devices in Health Care: Medication Plans and Practices on a Hospital Ward

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Infrastructuring and Ordering Devices in Health Care : Medication Plans and Practices on a Hospital Ward . / Bossen, Claus; Markussen, Randi.

I: Computer Supported Cooperative Work, Bind 19, Nr. 6, 2010, s. 615-637.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Bossen, Claus ; Markussen, Randi. / Infrastructuring and Ordering Devices in Health Care : Medication Plans and Practices on a Hospital Ward . I: Computer Supported Cooperative Work. 2010 ; Bind 19, Nr. 6. s. 615-637.

Bibtex

@article{dc68e360e8cf11dfa891000ea68e967b,
title = "Infrastructuring and Ordering Devices in Health Care: Medication Plans and Practices on a Hospital Ward",
abstract = "In this paper, we analyse physicians' and nurses' practices of prescribing and administering medication through the use of paper-based, and digitalized medication plans. Our point of departure is an ethnographic study of the implications of upgrading an electronic medication module (EMM) that is part of an electronic health record (EHR), carried out at an endocrinology department. The upgrade led to a temporary breakdown of the EMM, and a return to paper-based medication plans. The breakdown made visible and noticeable the taken-for-granted capabilities of medication plans in their paper-based and digital versions, and the distribution of functionalities between medication plans and clinicians. We see the case as an opportunity to analyse infrastructuring in health care, the process by which medical practices and artefacts become parts of social and technological networks with longer reaches and more channels through which coordination among distributed actors is enabled and formed. In this case, infrastructuring means an extended scope and intensity of the coordinative capabilities of medication plans, and an increased vulnerability to, and dependency on events outside the immediate loci of interaction. We particularly note the capacity of the EMM to facilitate different kinds of ordering of information and practices, and propose the conceptualizing of such digitalized artefacts as ‘ordering devices'. Ordering devices order information, stipulate action, and coordinate interaction across and within social worlds, and achieve this through the flexible support of different kinds of ordering.",
keywords = "Computerized physician order entry, electronic patient records, electronic medication module, ethnography, health care, hospitals, information infrastructures, infrastructuring, ordering, ordering devices",
author = "Claus Bossen and Randi Markussen",
note = "Paper id:: 10.1007/s10606-010-9131-x",
year = "2010",
doi = "10.1007/s10606-010-9131-x",
language = "English",
volume = "19",
pages = "615--637",
journal = "Computer Supported Cooperative Work",
issn = "0925-9724",
publisher = "Springer",
number = "6",

}

RIS

TY - JOUR

T1 - Infrastructuring and Ordering Devices in Health Care

T2 - Medication Plans and Practices on a Hospital Ward

AU - Bossen, Claus

AU - Markussen, Randi

N1 - Paper id:: 10.1007/s10606-010-9131-x

PY - 2010

Y1 - 2010

N2 - In this paper, we analyse physicians' and nurses' practices of prescribing and administering medication through the use of paper-based, and digitalized medication plans. Our point of departure is an ethnographic study of the implications of upgrading an electronic medication module (EMM) that is part of an electronic health record (EHR), carried out at an endocrinology department. The upgrade led to a temporary breakdown of the EMM, and a return to paper-based medication plans. The breakdown made visible and noticeable the taken-for-granted capabilities of medication plans in their paper-based and digital versions, and the distribution of functionalities between medication plans and clinicians. We see the case as an opportunity to analyse infrastructuring in health care, the process by which medical practices and artefacts become parts of social and technological networks with longer reaches and more channels through which coordination among distributed actors is enabled and formed. In this case, infrastructuring means an extended scope and intensity of the coordinative capabilities of medication plans, and an increased vulnerability to, and dependency on events outside the immediate loci of interaction. We particularly note the capacity of the EMM to facilitate different kinds of ordering of information and practices, and propose the conceptualizing of such digitalized artefacts as ‘ordering devices'. Ordering devices order information, stipulate action, and coordinate interaction across and within social worlds, and achieve this through the flexible support of different kinds of ordering.

AB - In this paper, we analyse physicians' and nurses' practices of prescribing and administering medication through the use of paper-based, and digitalized medication plans. Our point of departure is an ethnographic study of the implications of upgrading an electronic medication module (EMM) that is part of an electronic health record (EHR), carried out at an endocrinology department. The upgrade led to a temporary breakdown of the EMM, and a return to paper-based medication plans. The breakdown made visible and noticeable the taken-for-granted capabilities of medication plans in their paper-based and digital versions, and the distribution of functionalities between medication plans and clinicians. We see the case as an opportunity to analyse infrastructuring in health care, the process by which medical practices and artefacts become parts of social and technological networks with longer reaches and more channels through which coordination among distributed actors is enabled and formed. In this case, infrastructuring means an extended scope and intensity of the coordinative capabilities of medication plans, and an increased vulnerability to, and dependency on events outside the immediate loci of interaction. We particularly note the capacity of the EMM to facilitate different kinds of ordering of information and practices, and propose the conceptualizing of such digitalized artefacts as ‘ordering devices'. Ordering devices order information, stipulate action, and coordinate interaction across and within social worlds, and achieve this through the flexible support of different kinds of ordering.

KW - Computerized physician order entry, electronic patient records, electronic medication module, ethnography, health care, hospitals, information infrastructures, infrastructuring, ordering, ordering devices

U2 - 10.1007/s10606-010-9131-x

DO - 10.1007/s10606-010-9131-x

M3 - Journal article

VL - 19

SP - 615

EP - 637

JO - Computer Supported Cooperative Work

JF - Computer Supported Cooperative Work

SN - 0925-9724

IS - 6

ER -