Data work: A condition for integrations in health care

Abstract

Integration and interoperability between different information and communication technology (ICT) systems are crucial for efficient treatment and care in hospitals. In this article, we are particularly interested in the daily local work conducted by health-care personnel to maintain integrations. A principal aim of our article is, therefore, to contribute to a sociotechnical understanding of the “data work” that is embedded in the integration of health-care systems. Theoretically, we draw on the concepts of “information infrastructures” and “articulation work,” and we discuss how social status may influence the invisible articulation work. Furthermore, we show how historical decisions and existing systems both nationally and regionally have impacts on the daily work of local actors. Empirically, we have studied the formative stages of a large-scale electronic medication management system project in the Northern Norway Regional Health Authority.

Good organizational reasons for better medical records: The data work of clinical documentation integrity specialists

“…For example, birth certificate clerks in the U.S. have come under increasing pressure to improve their data entry, because birth certificate data have recently become an important source for research and data-driven accountability of obstetric practices (Pine et al, 2016). Clinicians are also tasked with performing new kinds of data work, for example, to maintain integrations between data in various information systems (Bjørnstad and Ellingsen, 2019) and to interpret patient-generated data (Grisot et al, 2019;Langstrup, 2019).…”

“…For example, since medical records are the major source of data extraction, clinicians are facing new demands for documentation in patient records to be accurate and comprehensive (Kuhn et al, 2015), so that other data workers such as medical coders can extract highquality data for usages such as data-driven accountability. Subsequently, a new line of research has begun to examine the on-the-ground work required to produce, manage, analyze, and deploy data in healthcare carried out by healthcare workers, including both clinicians and non-clinicians (Bjørnstad and Ellingsen, 2019;Bonde et al, 2019;Grisot et al, 2019;Islind et al, 2019;Pine, 2019).…”

Data work in healthcare: An Introduction

“…29,30 Finally, there is work to produce data itself, including skillfully assessing messy charts to create structured datasets, 22 to sanitizing and validating data, 31 and building data integrations between various information systems. 32…”

“…Further, the number and diversity of individuals and occupational groups involved in healthcare data work is vast and includes clinicians, non-clinical healthcare workers, managers, administrators, patients, caregivers, and external organizations and workers (quality improvement organizations, researchers, IT companies, consultants, and others). For example, Langstrup 30 describes the collection of PROM (Patient-Reported Outcome Measures) data by patients; Hult et al 26 describe the work of nurses adapting to different patient literacies; Chorev 24 chronicles the work of clinicians to make sense of ambiguous data; and Bjørnstad and Ellingsen 32 call attention to the invisible work of creating meaningful integration of information systems. Widespread adoption of digital Information Infrastructures for healthcare increases the capacity to produce, store, and analyze data, 43 and widespread availability of data tools mean that increasing expectations are developing for the types and depth of biomedical and organizational research that can be done using second-order data.…”

Patient data work: filtering and sensing patient‐reported outcomes

“…2019a). Particular focus is directed towards the data work carried out by professionals within clinical settings (Bjørnstad and Ellingsen 2019, Bonde et al . 2019, Cabitza et al .…”