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Square pegs in round holes: Information systems, hospitals and the significance of contextual awareness

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  • Tjora, Aksel Hagen
  • Scambler, Graham

Abstract

The considerable emphasis in the development and implementation of clinical information systems in hospitals internationally seems to have had a limited effect. In particular, the implementation of electronic patient record (EPR) systems has been slower and more difficult than anticipated and with little change in efficiency and security. This paper suggests why this might be the case. Well established research findings within the field of computer supported cooperative work (CSCW - an interdisciplinary research field between informatics and the social sciences) are cited to construct a case for greater awareness of (1) inter- and intra-professional interests, and (2) broader social and health policy contexts. We draw on Gouldner's work [(1957). Cosmopolitans and locals: toward an analysis of latent social roles - I. Administrative Science Quarterly, 2(3), 281-306; (1958). Cosmopolitans and locals: toward an analysis of latent social roles - II. Administrative Science Quarterly, 2 (4), 444-480] on organisational roles to develop a discussion of professional awareness; a pivotal notion is also the interactionist one of the hospital as a 'negotiated order'. Drawing for illustrative purposes on the Norwegian experience (that is, reviewing research on hospital information systems in Norway), we contend that enhanced awareness of the hospital itself as a social system may be a precondition of cost-effective hospital information and communication technologies.

Suggested Citation

  • Tjora, Aksel Hagen & Scambler, Graham, 2009. "Square pegs in round holes: Information systems, hospitals and the significance of contextual awareness," Social Science & Medicine, Elsevier, vol. 68(3), pages 519-525, February.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:3:p:519-525
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    References listed on IDEAS

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    1. Smith, Harold E., 1982. "Doctors and society: A Northern Thailand study," Social Science & Medicine, Elsevier, vol. 16(5), pages 515-526, January.
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    Cited by:

    1. Andreassen, Hege K. & Kjekshus, Lars Erik & Tjora, Aksel, 2015. "Survival of the project: A case study of ICT innovation in health care," Social Science & Medicine, Elsevier, vol. 132(C), pages 62-69.
    2. Trondsen, Marianne V. & Tjora, Aksel & Broom, Alex & Scambler, Graham, 2018. "The symbolic affordances of a video-mediated gaze in emergency psychiatry," Social Science & Medicine, Elsevier, vol. 197(C), pages 87-94.
    3. Mackintosh, Nicola & Sandall, Jane, 2010. "Overcoming gendered and professional hierarchies in order to facilitate escalation of care in emergency situations: The role of standardised communication protocols," Social Science & Medicine, Elsevier, vol. 71(9), pages 1683-1686, November.

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