Practical Affordance: EMR Use Within Outpatient Consulting on Women’s Health
Abstract
We have seen increased adoption of electronic medical records (EMR) to facilitate the monitoring and recording patient trajectories. Information systems and allied discipline researchers have argued that paper persistence post EMR implementation is pervasive because: limitations in the system design and institutional policies lack an understanding of the clinical workflow. I question the doctor focused and clinical workflow-oriented understanding of medical record-keeping that ideates EMR as having a role only within the hospital boundaries. By providing empirical data from two settings: a rural secondary care hospital, and a metropolitan multinational hospital, I unpack situations when patients’ healthcare needs were central to the doctor’s work, instead of using information technologies, i.e., EMR. The projection of EMRs as artefact limited to the hospital setting and only for clinical purposes discounts the role of patients’ life world in clinical interactions, and runs the risk of devaluing the experiential and affective knowledge of both patients and doctors. EMR, I argue, cannot support doctors’ work unless the patient’s role is recognized. I propose that EMR systems be flexible, situated in the patient’s practical context, rather than administrative and clinical work-oriented only.
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