Healthcare’s fragmented ICT systems - how can qualitative research contribute?, Margunn Aanestad, UiO
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The document summarizes qualitative research on healthcare's fragmented ICT systems in Norway. Researchers studied several ICT integration projects and found huge expectations but modest results. The research examines experiences with electronic health records, mobile technologies, and other projects. It focuses on the socio-technical complexity where technological and organizational issues intersect. The research questions common views of seamless integration, implementation, and information flow. It provides examples of studies that offer realistic perspectives on complex work practices and information sharing challenges.
Healthcare’s fragmented ICT systems - how can qualitative research contribute?, Margunn Aanestad, UiO
- 1. HEALTHCARE’S FRAGMENTED ICT SYSTEMS - HOW CAN QUALITATIVE RESEARCH CONTRIBUTE? Margunn Aanestad, Irene Olaussen, Miria Grisot, Espen The FIPP project Skorve (IFI, UiO) and Gro A. Hamre (IDI, NTNU)
- 2. FIPP project (Flexible Integration Processes in the Public Sector) no. 176856 Researchers have studied the attempts at integration of care processes through the use of ICT in the Norwegian healthcare sector Motivation: Huge expectations vs. modest results Participants: UiO: Margunn Aanestad, Miria Grisot, Irene Olaussen, Ole Hanseth, Espen Skorve, Synnøve Thomassen Andersen (Ingunn Moser, Fredrik Thele) NTNU: Eric Monteiro, Gro Alice Hamre (Knut Rolland)
- 3. Approach We examine the actual experiences, conditions and consequences of a number of Norwegian healthcare ICT projects EPR, mobile technology, telemedicine, patient charts, automatic medication etc. Focus on “socio-technical complexity” (the way in which technological, organizational and social issues are intertwined) Utilises a cross-disciplinary approach Information Systems field, Computer-Supported Collaborative Work, Science and Technology Studies
- 4. Recent anthology: Aim: contributing to a better understanding of socio- technical complexity We critically question a number of widespread conceptualizations and understandings within the sector: Seamless integration Implementation, pilot projects User participation Information flow Patient trajectory
- 7. 1 book 2 editors 11 chapters 12 authors 178 pages 73.601 words 432.601 characters
- 10. Qualitative studies Context-specific and particular stories rather than validation of models/propositions ”Anectdotal evidence”? We offer realistic exemplifications Generate awareness of socio-technical complexity … and we question and criticize conceptualizations Metaphors, models, understandings, beliefs
- 11. Example 1: Gro A. Hamre, Kirsti Berntsen & Eric Monteiro (NTNU): Chapter8: ”Kvalitetssikring av legemiddelhåndtering i et samhandlingsperspektiv” Automatic packaging of (some) medication Multidose in Trondheim municipality Home care, pharmacy and GP Study of work practices, information tools and information flow (processes of collaboration/information transfer between parties)
- 12. Pharmacy’s list versus GP’s list – differences
- 13. Example 2: Ingunn Moser (Diakonhjemmet Høyskole): Chapter 3: ”Fra flyt til fluiditet: om metaforer for og modeller av informasjon i helsefaglige praksiser og e-helseplaner” Does information flow? Studies of work with information: Information is often tentative, incomplete and materially heterogeneous. It is shaped and exchanged within a collective, and its relevancy is context dependent. Comparison with concept of information and information flow in ICT strategies and programs
- 14. Example 3: Ann Therese Lotherington (NORUT Tromsø) & Beate Nyheim (NST) Chapter 9: ”Å se, og se sammen. Produksjon av klinisk kunnskap gjennom nettbasert sårveiledning” Cooperation between hospital and municipal care teams on wounds Projectdefined package of tools: Digital camera, standardised report form and web interaction Variable configurations of package and usage pattern What does implementation mean? Not ”roll-out”…
- 15. Example 4: Miria Grisot (IFI, UiO): Chapter 4. ”Ordningslogikker i informasjonspraksiser – en case fra hjertetransplantasjon” Patient trajectory – principle to guide improvement and re-organisation (e.g. standardised care paths) New (extended) conceptualizations: Multiple ordering logics: Patient focused Treatment focused Activity focused Result focused
- 16. Remaining questions: Description and awareness of complexity is only the first step. The challenge remains: How to govern complex socio-technical systems? We need to identify governance models, i.e. Actor constellations Solution architectures and Development strategies that can deal with collective action dilemmas
- 17. … and finally: VERDIKT and IFI welcomes you to further discussions: 13.00-16.00 Friday 26th November in Oslo Presentation of book, panel debate: Anders Grimsmo (NTNU/NSEP) Frode Lærum (UIO/AHUS) Anne Moen (UiO) Bjørn Afstad (Helse&Omsorgdept) Hans Nielsen Hauge (Helse Sør-Øst) Ole Hanseth (UiO) Free participation (but please register) See VERDIKT’s calender: http://tinyurl.com/36mjyca Thank you for your attention!