Normalisation of electronic medical records in routine healthcare work amidst ongoing digitalisation of the Philippine health system.

Autor: Macabasag RLA; National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Padre Faura St., Ermita, Manila, 1000, Philippines. Electronic address: ramacabasag@up.edu.ph., Mallari EU; National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Padre Faura St., Ermita, Manila, 1000, Philippines. Electronic address: eumallari@up.edu.ph., Pascual PJC; National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Padre Faura St., Ermita, Manila, 1000, Philippines. Electronic address: pcpascual@up.edu.ph., Fernandez-Marcelo PGH; Department of Family and Community Medicine, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Taft Ave, Ermita, Manila, 1000, Philippines. Electronic address: phfernandezmarcelo@up.edu.ph.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2022 Aug; Vol. 307, pp. 115182. Date of Electronic Publication: 2022 Jul 01.
DOI: 10.1016/j.socscimed.2022.115182
Abstrakt: By drawing perspectives from the multi-level perspectives in sociotechnical transition and the normalisation process theory, this article explores how ongoing (i.e., incomplete) national level reforms in health information management (HIM) shape the normalisation of electronic medical records (EMRs) in Philippine rural health work. Based on document review, interviews, and observations, we argue that an ongoing HIM regime transition-transitioning from paper-based to an electronic HIM regime-may exert ambivalent institutional pressures on health workers through their institutions' implementation context. The ambivalence of the implementation context-one that accommodates both EMR and paper-based medical records-offers conflicting social, cognitive, and material resources for normalising EMRs. In such a context, we find that health workers performed selective participation and partial implementation in normalising EMRs in their routine healthcare work. In selective participation, select health workers-often, the technologically savvy-could actively participate in the EMR implementation while others focused on their clinical work. At the same time, since only a few could use the EMR in routine work, EMRs were implemented partially in particular instances where it is deemed more valuable and applicable. We emphasised in this article how complementing the idea of normalisation with sociotechnical transition may reveal the emergence of pressures from various institutions and stakeholders that advances (or impede) the normalisation of healthcare innovations.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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