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Accounting and Co-constructing: The Development of a Standard for Electronic Health Records

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  • Department of Information and Media Studies
Patient records are central, constitutive parts of health care and hospitals. Presently huge investments are made in order to make patient records electronic to take advantage of the ability of IT to accumulate, compute and propagate data quickly to multiple sites to enhance coordination of health care services, cooperation between staff and make patient records immediately and accessible to distributed actors. Investments also have the aims of making health care services more accountable, integrated and increase quality and efficiency.
This paper analyses a Danish national standard for electronic health records on the basis of an application prototype test build on that standard. The analysis shows that inscribed in the standard is an ambition to make staff and health care services more accountable at the cost of more work, loss of overview and fragmentation of patient cases. Significantly, despite the standard having been conceived and developed in a process of co-construction with clinicians, clinicians did not find it adequate for their work. The analysis argues this was the result of the model of work embedded in the standard coming from a stance from without practice. Subsequently a flip-over effect took place in which the model of work became a model for work. Hence, the paper argues that co-constructing processes should not only include users as representatives of a profession, but strive to produce experiences and knowledge from within practice.
Original languageEnglish
JournalComputer Supported Cooperative Work
Pages (from-to)473-495
Number of pages22
Publication statusPublished - 2011

    Research areas

  • Accountability, clinical work, Co-construction, Electronic Health Records, Health Care Sector, Participatory Design, Representation, User Involvement

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