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A contemporary ontology of continuity in general practice: Capturing its multiple essences in a digital age

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  • Ladds, Emma
  • Greenhalgh, Trisha
  • Byng, Richard
  • Rybczynska-Bunt, Sarah
  • Kalin, Asli
  • Shaw, Sara

Abstract

Continuity is a long-established and fiercely-defended value in primary care. Traditional continuity, based on a one-to-one doctor-patient relationship, has declined in recent years. Contemporary general practice is organisationally and technically complex, with multiple staff roles and technologies supporting patient access (e.g. electronic and telephone triage) and clinical encounters (e.g. telephone, video and electronic consultations). Re-evaluation of continuity's relational, organisational, socio-technical and professional characteristics is therefore timely. We developed theory in parallel with collecting and analysing data from case studies of 11 UK general practices followed from 2021 to 2023 as they introduced (or chose not to introduce) remote and digital services. We used strategic, immersive ethnography, interviews, and material analysis of technologies (e.g. digital walk-throughs).

Suggested Citation

  • Ladds, Emma & Greenhalgh, Trisha & Byng, Richard & Rybczynska-Bunt, Sarah & Kalin, Asli & Shaw, Sara, 2023. "A contemporary ontology of continuity in general practice: Capturing its multiple essences in a digital age," Social Science & Medicine, Elsevier, vol. 332(C).
    • Handle: RePEc:eee:socmed:v:332:y:2023:i:c:s0277953623004690
    DOI: 10.1016/j.socscimed.2023.116112
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    References listed on IDEAS

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    1. Wanda J Orlikowski, 2006. "Material knowing: the scaffolding of human knowledgeability," European Journal of Information Systems, Taylor & Francis Journals, vol. 15(5), pages 460-466, October.
    2. Wanda J. Orlikowski, 2002. "Knowing in Practice: Enacting a Collective Capability in Distributed Organizing," Organization Science, INFORMS, vol. 13(3), pages 249-273, June.
    3. Hassane Alami & Pascale Lehoux & Sara E. Shaw & Chrysanthi Papoutsi & Sarah Rybczynska-Bunt & Jean-Paul Fortin, 2022. "Virtual Care and the Inverse Care Law: Implications for Policy, Practice, Research, Public and Patients," IJERPH, MDPI, vol. 19(17), pages 1-16, August.
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    1. Dakin, Francesca H. & Rybczynska-Bunt, Sarah & Rosen, Rebecca & Clarke, Aileen & Greenhalgh, Trisha, 2024. "Access and triage in contemporary general practice: A novel theory of digital candidacy," Social Science & Medicine, Elsevier, vol. 349(C).

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