Integration as interdependent workaround

Ellingsen, Gunnar; Monteiro, Eric; Røed, Kristoffer

doi:10.1016/j.ijmedinf.2012.09.004

Cited by 33 publications

(26 citation statements)

References 38 publications

(45 reference statements)

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“…It is clear that work of design and implementation of a new set of systems-on top of existing emergent socio-technical infrastructure(s)-is greatly underestimated in healthcare ICT projects (McLoughlin et al, , 2017Wilson et al, 2012;Ellingsen et al, 2013). The project examined in this article was characterised by full commitment of the municipality to ICT-based support for its older population, dedicated funding resources, strong political support, committed clinical championing and a mature civil society environment.…”

Section: Discussionmentioning

confidence: 99%

Who is telecaring whom? Exploring the total social organisation of care work in an Italian municipality

Wilson¹,

Baines²,

Martin³

et al. 2017

New Technol Work Employ

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Telecare’ refers to the use of digital or information and communication technologies (ICTs) to facilitate health and social care delivery to individuals in their homes. This article explores the phenomenon by foregrounding its interconnections with work activities, paid and unpaid. It draws on research as a part of the design and deployment of a set of telecare innovations for older people in an Italian municipality. The project was conceived at the outset in terms of formal inter‐ relationships between functions and components of technical systems. Technical setbacks, however, were resolved only by enrolling the active support of groups and individuals (including civil society organisations and older people). By situating a telecare intervention conceptually within the ‘total social organisation of labour’ (TSOL), we provide an analysis that contributes to understanding how a socio‐technical infrastructural approach to telecare reveals ways to improve our understanding of how formal and informal care systems interact.

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Section: Discussionmentioning

confidence: 99%

Who is telecaring whom? Exploring the total social organisation of care work in an Italian municipality

Wilson¹,

Baines²,

Martin³

et al. 2017

New Technol Work Employ

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“…With numerous post-implementation issues to resolve it became clear that knowing ‘when’ the system would bring a change to practice and who within the broader renal clinical team would enact that change would be vital [22,23]. A ‘watch list’ of benefits that were ‘on the horizon but not here yet’ was constructed.…”

Section: Methods: Developing a Participative Practice-centred Approachmentioning

confidence: 99%

Practice-centred evaluation and the privileging of care in health information technology evaluation

Darking

Anson

Bravo

et al. 2014

BMC Health Serv Res

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BackgroundElectronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts – can complement and in some instances offer advantages over, outcome-centric evaluation models.MethodsWe carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An ‘action learning’ approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies?DiscussionOrganising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of ‘when’ and ‘under what conditions’ technology-enabled service improvements are realised, and crucially, how such innovation improves care.SummaryOur contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context ‘practice-centred’ evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes.

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“…Healthcare IT and collaboration have been of continued interest to CSCW (For overviews, see [16] and [18]). However, there are few studies of the collaborative challenges of working across organizational settings.…”

Section: Related Work and Theorymentioning

confidence: 99%

Collaboration in-between

Bossen

Grönvall

2015

Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work &Amp; Social Computing

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In this paper, we analyse the challenges of working between organizations and established information infrastructures. The Care Hotel is a municipal healthcare facility where persons, typically following a hospital stay, undergo rehabilitation to enable them to live independently at home. Admission, stay, and discharge from the Care Hotel entail numerous coordination activities with a variety of frequent and sporadic, heterogeneous, external collaborators, including general practitioners, relatives, and hospitals, some of which are already part of large information infrastructures, whereas others are too small or shifting to allow for stable arrangements. Hence, work at the Care Hotel may be characterized as 'collaboration in-between'. We propose a design solution for flexible use to further stimulate reflection on design implications, and how to meet the challenges of collaboration in-between. As large infrastructures continue to develop, we posit that many 'inbetween settings' will encounter similar challenges to collaboration. Healthcare providers in contexts of fragmented healthcare are also likely to face such challenges.

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Integration as interdependent workaround

Cited by 33 publications

References 38 publications

Who is telecaring whom? Exploring the total social organisation of care work in an Italian municipality

Who is telecaring whom? Exploring the total social organisation of care work in an Italian municipality

Practice-centred evaluation and the privileging of care in health information technology evaluation

Collaboration in-between

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