Abstract:
OBJECTIVE:The introduction of health information technologies (HIT) can lead to unintended consequences. We studied a newly introduced electronic messaging (e-messaging) system for communication between homecare providers and general practitioners (GPs) in Norway. The objective of this paper is to identify and discuss unintended consequences of the introduction of e-messaging, particularly how it affected collaboration between the groups. METHODS:Qualitative data from interviews with homecare staff (23), GPs (11), medical secretaries (5) and project managers (4), lasting in average 45min. Data was analysed using an interpretative approach. RESULTS:We highlight three unintended consequences, which broadly led to changes in work practices for homecare nurses and GPs. (1) Communicating via e-messaging led to less face-to-face contact between homecare nurses and GPs. Even though e-messaging meant the opportunity to communicate more efficiently both groups emphasised the need for sustaining interpersonal relations via face-to-face communication to collaborate efficiently. (2) E-messaging made it easy to be proactive and send information. Consequently, tasks and responsibilities were sometimes reconfigured in unexpected ways. (3) Nurses said that the fact that e-messages were automatically documented in the patient's electronic patient record (EPR) system gave more weight to their requests. Nurses experienced e-messages as a more powerful means of communication vis-à-vis GPs than other means of communication, thus making e-messaging a tool for empowering them in their collaboration with GPs. CONCLUSION:Unintended consequences of HIT affect collaboration between healthcare workers. The consequences may be both desirable and undesirable. Previous research has mostly focused on the undesirable unintended consequences. We show that the introduction of e-messaging led to both desirable and undesirable unintended consequences for interprofessional collaboration. More insight into positive unintended consequences can be a resource in the reorganisation of work that often accompanies the implementation of HIT.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Melby L,Hellesø Rdoi
10.1016/j.ijmedinf.2014.02.001subject
Has Abstractpub_date
2014-05-01 00:00:00pages
343-53issue
5eissn
1386-5056issn
1872-8243pii
S1386-5056(14)00027-6journal_volume
83pub_type
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
pub_type: 杂志文章,随机对照试验
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
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pub_type: 杂志文章,评审
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journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
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更新日期:1998-02-01 00:00:00
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journal_title:International journal of medical informatics
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更新日期:2018-04-01 00:00:00
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journal_title:International journal of medical informatics
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更新日期:2011-09-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2006.07.011
更新日期:2007-10-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.05.002
更新日期:2005-08-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.07.019
更新日期:2006-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2016.12.007
更新日期:2017-03-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2004.05.002
更新日期:2004-08-01 00:00:00
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journal_title:International journal of medical informatics
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更新日期:2009-10-01 00:00:00
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journal_title:International journal of medical informatics
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doi:10.1016/j.ijmedinf.2017.04.007
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.04.002
更新日期:2005-07-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.02.007
更新日期:2012-08-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2014.11.001
更新日期:2015-02-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2016.10.001
更新日期:2017-01-01 00:00:00
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journal_title:International journal of medical informatics
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更新日期:2013-08-01 00:00:00
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