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Distributed plot-making: creating an overview via paper-based and electronic patient records

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This paper investigates how physicians create an overview of patient cases
through an analysis of physicians’ work practices. Based on observation of and interviews with physicians about how they create overview, we analyse what overview means to physicians and how they establish it by using different socio-technical systems (paper-based and electronic patient records). Drawing on the theory of distributed cognition and narrative theory, primarily inspired by the work done within health care by Cheryl Mattingly, we propose that the creation of overview may be conceptualised as ‘distributed plot-making’. 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 plot construction. 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 such information into a narrative that is made coherent by a plot. The analysis shows that the characteristics of paper-based and electronic patient records support or obstruct the creation of overview in both similar and distinct ways. In the light of the current move towards electronic patient records, we explore the ways in which the benefits of paper records may be carried over into the electronic patient record as well as the ways in which the possibilities afforded by digital artefacts may be exploited more fully than is currently the case.
Original languageEnglish
JournalScandinavian Journal of Information Systems
Pages (from-to)3-27
Number of pages24
Publication statusPublished - Dec 2016

    Research areas

  • comparative analysis, distributed cognition, distributed plot-making, electronic patient recordss, narrative theory, paper-based patient records, Qualitative Methods

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