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Electronic Health Records and Clinical Routines: Convergence and Divergenc

Author

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  • Andrei M. Korbut

    (National Research University Higher School of Economics)

Abstract

The article is based on the preliminary results of author’s current study of the implementation of electronic health records in one of Russian outpatient clinics. Interviews with doctors, developers, managers of the State Department of Healthcare, IT-specialists, and clinic’s head, as well as observations of doctors’ everyday work, show that one of the key problems in the transition from paper to electronic record-keeping is how new information system transforms (or fails to transform) doctors’ routine, habitual activities. The article suggests that the widespread view of habitual action as an action in accordance with a preliminary scheme – a view that forms a basis for the majority of medical information systems – does not describe the actual structure of healthcare activities. The analysis of how doctors perceive and use electronic health records in their daily practice demonstrates that a situational approach to routine actions is more adequate. For example, the use of so-called “templates” that are created by doctors within the electronic health records cannot be understood without reference to the situational context of professional activities. Doctors, creating and using various “templates,” do this in such ways that allow them to make these health records circumstantially understandable. The view of routine activities as situated, concerted achievements not only proves the possibility of a new approach to the description of habitual actions’ role and place in the structure of social action, but can be important for the design and evaluation of professional information systems.

Suggested Citation

  • Andrei M. Korbut, 2016. "Electronic Health Records and Clinical Routines: Convergence and Divergenc," HSE Working papers WP BRP 130/HUM/2016, National Research University Higher School of Economics.
  • Handle: RePEc:hig:wpaper:130/hum/2016
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    References listed on IDEAS

    as
    1. Reich, Adam, 2012. "Disciplined doctors: The electronic medical record and physicians' changing relationship to medical knowledge," Social Science & Medicine, Elsevier, vol. 74(7), pages 1021-1028.
    2. Brian T. Pentland & Martha S. Feldman, 2005. "Organizational routines as a unit of analysis," Industrial and Corporate Change, Oxford University Press and the Associazione ICC, vol. 14(5), pages 793-815, October.
    3. Markus C. Becker, 2005. "The concept of routines: some clarifications," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 29(2), pages 249-262, March.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    electronic health records; habits; situated action; templates; routine medical practice.;
    All these keywords.

    JEL classification:

    • Z - Other Special Topics

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