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When patient empowerment encounters professional autonomy: The conflict and negotiation process of inscribing an eHealth service

Erlingsdottir, Gudbjörg LU and Lindholm, Cecilia (2015) In Scandinavian Journal of Public Administration (SJPA) 2(19).
Abstract
In Sweden, as in many other European countries, government and public agencies have

promoted the expansion of eHealth over the past years, arguing that this development

enhances patient participation, empowerment and cost efficiency. This paper presents a

longitudinal study of the deployment of My medical records on the Internet, a civic service

originally inspired by the home banking concept. The study illustrates how the technology is

developed and inscribed with new norms, dictating access and use. These norms are in turn

shaped by both social and legal norms as well as values and beliefs of several different actors

involved in the development process. Supported by the... (More)
In Sweden, as in many other European countries, government and public agencies have

promoted the expansion of eHealth over the past years, arguing that this development

enhances patient participation, empowerment and cost efficiency. This paper presents a

longitudinal study of the deployment of My medical records on the Internet, a civic service

originally inspired by the home banking concept. The study illustrates how the technology is

developed and inscribed with new norms, dictating access and use. These norms are in turn

shaped by both social and legal norms as well as values and beliefs of several different actors

involved in the development process. Supported by the study, we conclude 1) that the new

technology challenges the medical professionals, thus causing resistance as the institutional

boundaries are changed when patients are given digital access to their medical record, 2) that

the technology changes or inscribes the law, 3) that a pilot project of this type is dependent on

an enthusiast, seeing the project through until it becomes accepted on a larger scale and 4) that

increased patient participation requires improved access to information which differs from the

NPM rhetoric advocating more service to customers. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Patient empowerment, information technology (IT), medical records, New Public Management (NPM), inscriptions
in
Scandinavian Journal of Public Administration (SJPA)
volume
2
issue
19
publisher
Göteborg : School of Public Administration, University of Gothenburg
ISSN
2001-7413
language
English
LU publication?
yes
id
68b42e5d-a4c0-4b8f-b3cb-234573a72dad (old id 4275901)
date added to LUP
2014-02-12 10:13:30
date last changed
2016-04-15 23:42:40
@article{68b42e5d-a4c0-4b8f-b3cb-234573a72dad,
  abstract     = {In Sweden, as in many other European countries, government and public agencies have<br/><br>
promoted the expansion of eHealth over the past years, arguing that this development<br/><br>
enhances patient participation, empowerment and cost efficiency. This paper presents a<br/><br>
longitudinal study of the deployment of My medical records on the Internet, a civic service<br/><br>
originally inspired by the home banking concept. The study illustrates how the technology is<br/><br>
developed and inscribed with new norms, dictating access and use. These norms are in turn<br/><br>
shaped by both social and legal norms as well as values and beliefs of several different actors<br/><br>
involved in the development process. Supported by the study, we conclude 1) that the new<br/><br>
technology challenges the medical professionals, thus causing resistance as the institutional<br/><br>
boundaries are changed when patients are given digital access to their medical record, 2) that<br/><br>
the technology changes or inscribes the law, 3) that a pilot project of this type is dependent on<br/><br>
an enthusiast, seeing the project through until it becomes accepted on a larger scale and 4) that<br/><br>
increased patient participation requires improved access to information which differs from the<br/><br>
NPM rhetoric advocating more service to customers.},
  author       = {Erlingsdottir, Gudbjörg and Lindholm, Cecilia},
  issn         = {2001-7413},
  keyword      = {Patient empowerment,information technology (IT),medical records,New Public Management (NPM),inscriptions},
  language     = {eng},
  number       = {19},
  publisher    = {Göteborg : School of Public Administration, University of Gothenburg},
  series       = {Scandinavian Journal of Public Administration (SJPA)},
  title        = {When patient empowerment encounters professional autonomy: The conflict and negotiation process of inscribing an eHealth service},
  volume       = {2},
  year         = {2015},
}