Accepted papers will be published in the EUSSET digital library. Authors will retain all copyrights.
Selected papers from the workshop will be invited to submit an extended version to a special issue of the International Journal of Computer Supported Cooperative Work.
The workshop is the 6th of a series where the first three workshops took place in Denmark (Danish Technical University, Copenhagen University, IT University of Copenhagen), Norway (University of Tromsø), Italy (Fondazione Bruno Kessler, University of Trento). Each of the workshops has resulted in a special issue:
The use of information infrastructures in healthcare to monitor and govern the provision of healthcare services and quality has become prominent as the digitization of healthcare has intensified. The overall goals of infrastructures and information systems have allegedly always been to increase the efficiency and quality of the healthcare sector. However, previous efforts have mainly focused on the challenges of design, development, implementation and use of information systems in clinicians’ daily work. This has led to the identification of crucial socio-technical challenges confronting clinicians and system developers in these processes, and has highlighted how different practices are interconnected and interdependent, which in turn has demanded a broad approach to the field.
Less attention has been dedicated to the use of information infrastructures to monitor and govern the healthcare sector, and this workshop intends to contribute to filling this gap by focusing on the analysis of infrastructures for governance, quality improvement and service efficiency. This includes practices and systems dedicated to such governance only, as well as the re-purposing of systems dedicated to supporting healthcare staff in their core activities. Dedicated infrastructures for governance may, for instance, be systems monitoring overall performance or output from healthcare such as quality databases or reimbursement infrastructures based on diagnoses-related groups. Re-purposing of systems for governance may include the use of electronic health records (EHRs), not only for the support of clinical work, but also to serve managerial ambitions of increased efficiency and patient throughput. Other related systems along the same lines may be computerized provider order entry (CPOE), picture archiving and communication system (PACS), patient reported output measures (PROM), patient portals or, more broadly, any other systems used in the clinical practice.
Previously, dedicated healthcare information infrastructures for governance and quality improvement purposes used by healthcare economists and hospital management have been able to generate data from administrative systems without interfering much into to healthcare staff’s practices, as have quality data bases for research purposes. At the same time, IT systems developed for laboratories, X-ray and MR scans, and drug administration have operated without much attention from management. This has changed dramatically the recent years and health as information infrastructures such as EHRs are increasingly expected to provide policymakers and healthcare managers with data that may be used for policy decisions and governance. There are growing expectations that the data generated by healthcare infrastructures and systems used by healthcare professionals or even patients can be re-purposed and re-used.
While this may sound promising, questions arise as to whether data generated for one set of purposes can be meaningfully re-purposed, as well as to what the costs in terms of additional workload and consequences for healthcare staff will be. The re-purposing of existing systems, for instance, calls into question a major issue regarding the main beneficiary of these systems and data. For example, a recurring challenge in the development and implementation of EHRs is that they tend to benefit ‘secondary use’ to the detriment of healthcare professionals: Whereas ‘primary use’ is the use of healthcare staff of healthcare information systems when conducting their core activities such as diagnosing, treatment and caring for patients, ‘secondary use’ is the use of the same systems for administrative, legal, managerial or governance purposes. Similar issues may arise with the re-purposing of PROMs or other patient-oriented systems.
The use of healthcare infrastructures for governance, quality improvement and service efficiency raises a number of questions regarding both the design and implantation of such infrastructures and the feasibility, costs, and organizational effects of their use.
We wish to bring international researchers, healthcare professionals, information systems professionals, administrators, and vendors together to discuss these issues. We particularly invite contributions which methodologically are based on ethnographic/case/field studies.
Topics of particular interest include, but are not limited to: