When patient empowerment encounters professional autonomy

The conflict and negotiation process of inscribing an eHealth service

Authors

  • Gudbjörg Erlingsdóttir Department of Design Sciences, Lund University
  • Cecilia Lindholm Department of Business Studies, Uppsala University

DOI:

https://doi.org/10.58235/sjpa.v19i2.15607

Keywords:

Patient empowerment, Medical records, Information technology (IT), New Public Management (NPM), Inscriptions

Abstract

In Sweden, as in many other European countries, government and public agencies have promoted the expansion of eHealth in recent years, arguing that this development enhanc- es patient participation, empowerment and cost efficiency. This article presents a study of the development of My medical record 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 technical norms, dictating access and use. These norms are in turn shaped by negotiations between social and legal norms as well as the 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.

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Author Biographies

Gudbjörg Erlingsdóttir, Department of Design Sciences, Lund University

Gudbjörg Erlingsdóttir is an associate professor at the Department of Design Sciences at Lund University, Sweden. Her background is in organizational theory and she is currently engaged in research on the deployment of medical records and other eHealth services, the impact of teamwork on doctors’ work environment, health and leadership and how deployment of eHealth services affects the work environment in healthcare organizations.

Cecilia Lindholm, Department of Business Studies, Uppsala University

Cecilia Lindholm is assistant professor at the Department of Business Studies at Uppsala Universi- ty, Sweden. Her research is mainly focused on management accounting in the public sector, with a specialization in inter-organizational cooperation between healthcare organizations. She also studies management auditing and the association between legal and professional accountability in public sector organizations.

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Published

2015-06-15

How to Cite

Erlingsdóttir, G., & Lindholm, C. (2015). When patient empowerment encounters professional autonomy: The conflict and negotiation process of inscribing an eHealth service. Scandinavian Journal of Public Administration, 19(2), 27–48. https://doi.org/10.58235/sjpa.v19i2.15607

Issue

Section

Original Articles

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