The Digitalization of Health Care : Electronic Records and the Disruption of Moral Orders (1ST)

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The Digitalization of Health Care : Electronic Records and the Disruption of Moral Orders (1ST)

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  • 製本 Hardcover:ハードカバー版/ページ数 196 p.
  • 言語 ENG
  • 商品コード 9780198744139
  • DDC分類 610.285

Full Description

Electronic health records are widely regarded as the 'connective tissue' of any modern healthcare system. For some they represent a 'dangerous enthusiasm' and for others a key enabler of 'disruptive innovation'. Many governments have made major policy and financial investments in digitalizing health records but their implementation has frequently run into opposition from doctors, had lukewarm responses from patients, and raised considerable concerns for privacyadvocates and others worried by the security of sensitive health data and the risks of national data-bases.This book draws upon the concept of 'orders of worth' to reveal the moral dimensions of the medical division of labour and to delve deeper into understanding why electronic records have been so difficult to implement and the sources of opposition to them. The authors argue that digitalization disrupts the moral orders which define rights and responsibilities for the sharing and exchanging of patient medical data. This is illustrated through longitudinal studies of two of the most controversialattempts to introduce national systems - a patient controlled electronic record in Australia and a national summary care record that was part of the ill-fated NHS national program for IT in England. The authors conclude by using the lessons from these national experiences and insights from tworegional projects in each country to suggest how the idea of electronic records might be re-thought. It is a must read for anyone concerned about health information and the implications of how it is shared and exchanged in a digital world.

Table of Contents

List of Figures                            ix
List of Tables xi
List of Abbreviations xiii
Introduction 1 (9)
1 Digitalizing Healthcare: `Dangerous 10 (13)
Enthusiasm' or `Disruptive Innovation'?
2 The Troubled History of Implementing EHRs 23 (18)
3 Moral Orders and Justification in the 41 (17)
Division of Medical Labour
4 The Development of a National EHR in 58 (20)
Australia I: Trials, Tribulations, and
5 The Development of a National EHR in 78 (20)
Australia II: The Struggle over `Personal
6 The Development of a National EHR in 98 (21)
England: The Summary Care Record
7 Boundary Objects: Building EHRs at 119 (21)
National and Local Level
8 Conclusion: Moral (Re)Ordering and 140 (17)
Rethinking the Electronic Record
Appendix 1 Research Design and Methods 157 (4)
Appendix 2 Other Sources Not Cited in Text 161 (4)
References 165 (22)
Index of Names 187 (4)
Subject Index 191