The Digitalization of Healthcare: Electronic Records and the Disruption of Moral Orders

Hardcover | March 2, 2017

byIan P. McLoughlin, Karin Garrety, Rob Wilson

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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 digitalizinghealth records but their implementation has frequently run into opposition from doctors, had lukewarm responses from patients, and raised considerable concerns for privacy advocates 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 digitalizationdisrupts 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 controversial attempts to introduce national systems - a patient controlled electronic record in Australiaand 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 two regional projects in each country to suggest how the idea of electronic records might bere-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.

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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 digitalizinghealth records but their implementation has ...

Ian McLoughlin is Professor of Management at Monash University, in Melbourne, Australia. He has conducted research on organizational change and innovation in the UK, Europe and Australasia with a particular focus on the digitalization of public services, including healthcare. He is currently leading a major Australian research project ...

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Format:HardcoverDimensions:240 pages, 9.21 × 6.02 × 0.98 inPublished:March 2, 2017Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0198744137

ISBN - 13:9780198744139

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Table of Contents

Introduction1. Digitalizing Healthcare: 'Dangerous Enthusiasm' or 'Disruptive Innovation'?2. The Troubled History of Implementing EHRs3. Moral Orders and the Justification in the Medical Division of Labour4. The Development of a National EHR in Australia I: Trials, Tribulations and Uncertainty5. The Development of a National EHR in Australia II: The Struggle over 'Personal Control'6. The Development of a National EHR in England: The Summary Care Record7. Boundary Objects: Building EHRs at National and Local Level8. Conclusion: Moral (re-) Ordering and Rethinking the Electronic RecordAppendix 1: Research Design and MethodsAppendix 2: Other Sources not Cited in Text