IKT-arbeid i helse- og omsorgssektoren

Abstract

This chapter reports from three studies of implementation and use of electronic patient records and systems for health information exchange. In contemporary health care such large ICT systems are implemented on all levels. Nevertheless, there is a growing awareness that the potential for cross-institutional communication and quality improvements of the health- and care services that these systems offer rarely are fully exploited. Through combining empirical material form three separate qualitative studies, all aimed at detecting the nature of ICT work in Norwegian health care services, we aim to illuminate the complexity of ICT implementation and operation in health care, and point to some gaps in current understandings and efforts to organize ICT work in this sector. The studies highlight how it is crucial to take into account both structural tensions and microlevel characteristics of health and care work when deconstructing ICT documentation and communication practices in professional health care work. Our analysis challenges the timeline proposed in traditional studies of technology deployment, where successful implementation is to be followed by well-established routine operation of ICT systems. Rather, in our material, it is the continuous, invisible negotiation work involving a multitude of actors through all phases of use that is striking. Hence our findings allow us to pose the question if such a thing as a successful implementation of ICT systems in health care really exists, or if there are other more relevant questions to pursue when aiming for service improvement through, and with, ICT.