AI Article Synopsis
- The transition from paper records to electronic health records (EHR) represents a shift in documentation focus from individual patient monitoring to data that supports Institutional Priorities (IPs) like finances, risk management, and quality improvement.
- The authors provide a brief history of this transition and discuss its unintended consequences, including changes in clinician workload and the clinician-patient relationship.
- The paper is based on institutional ethnography from a large urban hospital and incorporates philosophical insights from thinkers like Jacques Ellul and Langdon Winner.
Article Abstract
One of the most significant changes in modern healthcare delivery has been the evolution of the paper record to the electronic health record (EHR). In this paper we argue that the primary change has been a shift in the focus of documentation from monitoring individual patient progress to recording data pertinent to Institutional Priorities (IPs). The specific IPs to which we refer include: finance/reimbursement; risk management/legal considerations; quality improvement/safety initiatives; meeting regulatory and accreditation standards; and patient care delivery/evidence based practice. Following a brief history of the transition from the paper record to the EHR, the authors discuss unintended or contested consequences resulting from this change. These changes primarily reflect changes in the organization and amount of clinician work and clinician-patient relationships. The paper is not a research report but was informed by an institutional ethnography the aim of which was to understand how the EHR impacted clinicians and administrators in a large, urban hospital in the United States. The paper was also informed by other sources, including the philosophies of Jacques Ellul, Don Idhe, and Langdon Winner.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/nup.12112 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Stimulant-involved overdose deaths: Constructing dynamic hypotheses.
Int J Drug Policy
January 2025
MGH Institute for Technology Assessment, Harvard Medical School, Boston, MA, 02144, USA. Electronic address:
The overdose epidemic in the United States is evolving, with a rise in stimulant (cocaine and/or methamphetamine)-only and opioid and stimulant-involved overdose deaths for reasons that remain unclear. We conducted interviews and group model building workshops in Massachusetts and South Dakota. Building on these data and extant research, we identified six dynamic hypotheses, explaining changes in stimulant-involved overdose trends, visualized using causal loop diagrams.
View Article and Find Full Text PDFEnhancing farmer awareness: Vertical transmission of Neospora caninum in aborting cattle and the value of diagnostics tools.
Vet Parasitol
January 2025
Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, Bern 3012, Switzerland. Electronic address:
The protozoan parasite Neospora caninum is an important cause of abortion in cattle. Infection occurs horizontally by ingestion of oocysts shed by canids or vertically, from an infected dam to the foetus, and may result in abortion, stillbirth, or the birth of subclinically infected offspring. We estimated the occurrence of N.
View Article and Find Full Text PDFPerspectives on Swedish Regulations for Online Record Access Among Adolescents With Serious Health Issues and Their Parents: Mixed Methods Study.
JMIR Pediatr Parent
January 2025
Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Background: With the increasing implementation of patient online record access (ORA), various approaches to access to minors' electronic health records have been adopted globally. In Sweden, the current regulatory framework restricts ORA for minors and their guardians when the minor is aged between 13 and 15 years. Families of adolescents with complex health care needs often desire health information to manage their child's care and involve them in their care.
View Article and Find Full Text PDFExploring the Psychological and Physiological Insights Through Digital Phenotyping by Analyzing the Discrepancies Between Subjective Insomnia Severity and Activity-Based Objective Sleep Measures: Observational Cohort Study.
JMIR Ment Health
January 2025
Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
Background: Insomnia is a prevalent sleep disorder affecting millions worldwide, with significant impacts on daily functioning and quality of life. While traditionally assessed through subjective measures such as the Insomnia Severity Index (ISI), the advent of wearable technology has enabled continuous, objective sleep monitoring in natural environments. However, the relationship between subjective insomnia severity and objective sleep parameters remains unclear.
View Article and Find Full Text PDFExplore barriers to using the internet for health information access in African countries: A systematic review.
PLOS Digit Health
January 2025
Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia.
Background: The Internet is a crucial source of health information, providing access to vast volumes of high-quality, up-to-date, and relevant healthcare information. Its impact extends beyond information access, influencing medical practice through the widespread adoption of telemedicine and evidence-based medicine. Despite the significant global increase in internet usage, Africa lags in internet penetration, particularly in utilizing the internet for health information.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!