Ellen Balka - Academia.edu (original) (raw)
Papers by Ellen Balka
Studies in Health Technology and Informatics, 2010
Ghost charts, sometimes referred to as shadow charts, are duplicate medical records. Governance d... more Ghost charts, sometimes referred to as shadow charts, are duplicate medical records. Governance documents in several countries suggest that ghost charts present a risk to patient safety, to the extent that they contain information which may not appear in an official hospital record. Although most would agree ghost charts should not exist, their existence is widespread. This paper reports on an in depth multi-method qualitative study of ghost charts undertaken in two ambulatory care settings in a Canadian hospital. The study was undertaken in order to inform the design and implementation of a clinical information system which it is hoped will eliminate the need for duplicate charts. Our research demonstrated that ghost charts filled a variety of needs only some of which are typically accounted for in electronic record design. We suggest that if the functions ghost charts fill are not addressed, their existence will persist. This work is significant in that few studies of ghost charts have been undertaken, and in the in-depth understanding it contributes to design requirements for electronic record systems.
Canadian Woman Studies, Sep 1, 2004
Canadian Woman Studies, 1993
After working under Maggie's supervision as a Master's student, sociaux spkcifques comme les rkse... more After working under Maggie's supervision as a Master's student, sociaux spkcifques comme les rkseau informatisb pour les and as a doctoral student until her ill health prohibited it, her groupes fkministes.
Http Dx Doi Org 10 1080 13216597 1996 9751824, Apr 4, 2012
Studies in Health Technology and Informatics, Feb 1, 2009
Remote and rural regions in Canada are faced with unique challenges in the delivery of primary he... more Remote and rural regions in Canada are faced with unique challenges in the delivery of primary health services. The purpose of this study was to understand how patients and healthcare professionals in northern British Columbia might make use of the Internet to manage cardiovascular diseases. The study used a qualitative methodology. Eighteen health professionals and 6 patients were recruited for a semi-structured interview that explored their experience in managing patients with cardiovascular disease and their opinions and preferences about the use of the Internet in chronic disease management. Key findings from the data suggest that a) use of the Internet helps to maintain continuity of care while a patient moves through various stages of care, b) the Internet may possibly be used as an educational tool in chronic disease self-management, c) there is a need for policy development to support Internet-based consultation processes, and d) while health providers endorse the notion of electronic advancement in their practice, the need for secure and stable electronic systems is essential.
Is it feasible for middle school students to use component-oriented software t o ols to construct... more Is it feasible for middle school students to use component-oriented software t o ols to construct their own mathematical explorations and experiments? In order to explore the potential of a new constructive educational technology for mathemat-ics, a program of guided c ollaboration between middle school students on Bowen Island near Vancouver Canada and researchers at Simon Fraser University was established. Novel and recently developed bridging methodologies were introduced to overcome the lack of maturity in the software. The goal was to predict its feasibility as an in-class resource for learning mathematics and to engage the students in the software design process.
Canadian Medical Association Journal, 2015
Journal of Communication in Healthcare, 2011
ABSTRACT
This volume contains selected papers from the Seventh International Conference on Women, Work and... more This volume contains selected papers from the Seventh International Conference on Women, Work and Computerization (WWC 2000), which provides an interdisciplinary forum for researchers, practitioners and users in the field of information technology. The conference was sponsored by the International Federation for Information Processing (IFIP) and was held in Vancouver, British Columbia, Canada, in June 2000. Generous support for the publication of the proceedings was provided by the Social Sciences and Humanities ...
Electronic Journal of Health Informatics, Aug 22, 2011
In this paper the use of an electronic medical record (EMR) system in a general practice setting ... more In this paper the use of an electronic medical record (EMR) system in a general practice setting is analyzed. The concept of infrastructure helps shed light on its supposed role of invisibly supporting the work practices of medical and administrative personnel. An ethnographic case study at a Canadian Community Health Center has been conducted following an action research approach. The researcher assumed the role of IT support in a situation where the EMR system was displaying technical problems after an update of the software. Her role developed from troubleshooting IT issues to EMR training and IT education, and finally she was also increasingly involved in EMR optimization. Our research provides in depth insights into the researcher's role as a mediator between the medical work and the technical tool within the larger context of system design, which, we suggest, has implications for design of programs to support the introduction of EMRs. Although those trained in health and medical informatics are aware of this need, research findings presented here suggest that this is often overlooked in funding programs and project implementation.
Methods of Information in Medicine
While recognized that global actors influence health information system design, studies of health... more While recognized that global actors influence health information system design, studies of health informatics have largely focused on micro politics of technology design and implementation. Here a problematic patient care information system (PCIS) is discussed in relation to federal and provincial policies and corporate strategies to demonstrate that our understanding of health informatics can be enhanced by linking micro studies of health informatics to larger macro contexts. Interviews and document study. Although the extent to which federal initiatives influenced (or failed to influence) provincial and hospital initiatives remains debateable, events initiated at one level (the hospital's decision to implement software, initiated at the organizational level) are influenced (perhaps indirectly) by developments in other contexts (federal/macro changes gave an initiative more weight; provincial initiatives such as the Labour Accord altered the industrial relations environment in which system development occurred). Micro-studies of work practice, invaluable in addressing interactions between technologies, users and work practices, often fail to account for the historic reach of global actors, although it is often these historic circumstances that contribute to present-day interactions between user, information system and organization, and that find expression - often indirectly - in daily work practices.
Here discourse about information technology in Canada's health sector is examined. After an overv... more Here discourse about information technology in Canada's health sector is examined. After an overview of the emergence of the Canadian Health Information Infrastructure, discourse within the Romanow Report is discussed in relation to three key themes: standardization, empowerment, and time/space compression. While an instrumental view of technology in the health care sector is the predominant discourse articulated in the report, we argue that, by emphasizing technology assessment, the Romanow Report makes room for a more nuanced analysis of technology implementations than is common to government reports. We conclude by suggesting how investigations of information and communication technology in the health sector, such as this, may offer opportunities to raise critical questions about technology and health policy from a communications perspective.
Preliminary work 2 yielded the following findings and recommendations:
This paper focuses on how gender has been addressed in the health information highway. I examine ... more This paper focuses on how gender has been addressed in the health information highway. I examine the accessibility of online health information to wo men and the question of hip replacements and gender. I conclude that the health information highway obscures the social relations surrounding women's health. Résumé
Studies in Health Technology and Informatics, 2010
Ghost charts, sometimes referred to as shadow charts, are duplicate medical records. Governance d... more Ghost charts, sometimes referred to as shadow charts, are duplicate medical records. Governance documents in several countries suggest that ghost charts present a risk to patient safety, to the extent that they contain information which may not appear in an official hospital record. Although most would agree ghost charts should not exist, their existence is widespread. This paper reports on an in depth multi-method qualitative study of ghost charts undertaken in two ambulatory care settings in a Canadian hospital. The study was undertaken in order to inform the design and implementation of a clinical information system which it is hoped will eliminate the need for duplicate charts. Our research demonstrated that ghost charts filled a variety of needs only some of which are typically accounted for in electronic record design. We suggest that if the functions ghost charts fill are not addressed, their existence will persist. This work is significant in that few studies of ghost charts have been undertaken, and in the in-depth understanding it contributes to design requirements for electronic record systems.
Canadian Woman Studies, Sep 1, 2004
Canadian Woman Studies, 1993
After working under Maggie's supervision as a Master's student, sociaux spkcifques comme les rkse... more After working under Maggie's supervision as a Master's student, sociaux spkcifques comme les rkseau informatisb pour les and as a doctoral student until her ill health prohibited it, her groupes fkministes.
Http Dx Doi Org 10 1080 13216597 1996 9751824, Apr 4, 2012
Studies in Health Technology and Informatics, Feb 1, 2009
Remote and rural regions in Canada are faced with unique challenges in the delivery of primary he... more Remote and rural regions in Canada are faced with unique challenges in the delivery of primary health services. The purpose of this study was to understand how patients and healthcare professionals in northern British Columbia might make use of the Internet to manage cardiovascular diseases. The study used a qualitative methodology. Eighteen health professionals and 6 patients were recruited for a semi-structured interview that explored their experience in managing patients with cardiovascular disease and their opinions and preferences about the use of the Internet in chronic disease management. Key findings from the data suggest that a) use of the Internet helps to maintain continuity of care while a patient moves through various stages of care, b) the Internet may possibly be used as an educational tool in chronic disease self-management, c) there is a need for policy development to support Internet-based consultation processes, and d) while health providers endorse the notion of electronic advancement in their practice, the need for secure and stable electronic systems is essential.
Is it feasible for middle school students to use component-oriented software t o ols to construct... more Is it feasible for middle school students to use component-oriented software t o ols to construct their own mathematical explorations and experiments? In order to explore the potential of a new constructive educational technology for mathemat-ics, a program of guided c ollaboration between middle school students on Bowen Island near Vancouver Canada and researchers at Simon Fraser University was established. Novel and recently developed bridging methodologies were introduced to overcome the lack of maturity in the software. The goal was to predict its feasibility as an in-class resource for learning mathematics and to engage the students in the software design process.
Canadian Medical Association Journal, 2015
Journal of Communication in Healthcare, 2011
ABSTRACT
This volume contains selected papers from the Seventh International Conference on Women, Work and... more This volume contains selected papers from the Seventh International Conference on Women, Work and Computerization (WWC 2000), which provides an interdisciplinary forum for researchers, practitioners and users in the field of information technology. The conference was sponsored by the International Federation for Information Processing (IFIP) and was held in Vancouver, British Columbia, Canada, in June 2000. Generous support for the publication of the proceedings was provided by the Social Sciences and Humanities ...
Electronic Journal of Health Informatics, Aug 22, 2011
In this paper the use of an electronic medical record (EMR) system in a general practice setting ... more In this paper the use of an electronic medical record (EMR) system in a general practice setting is analyzed. The concept of infrastructure helps shed light on its supposed role of invisibly supporting the work practices of medical and administrative personnel. An ethnographic case study at a Canadian Community Health Center has been conducted following an action research approach. The researcher assumed the role of IT support in a situation where the EMR system was displaying technical problems after an update of the software. Her role developed from troubleshooting IT issues to EMR training and IT education, and finally she was also increasingly involved in EMR optimization. Our research provides in depth insights into the researcher's role as a mediator between the medical work and the technical tool within the larger context of system design, which, we suggest, has implications for design of programs to support the introduction of EMRs. Although those trained in health and medical informatics are aware of this need, research findings presented here suggest that this is often overlooked in funding programs and project implementation.
Methods of Information in Medicine
While recognized that global actors influence health information system design, studies of health... more While recognized that global actors influence health information system design, studies of health informatics have largely focused on micro politics of technology design and implementation. Here a problematic patient care information system (PCIS) is discussed in relation to federal and provincial policies and corporate strategies to demonstrate that our understanding of health informatics can be enhanced by linking micro studies of health informatics to larger macro contexts. Interviews and document study. Although the extent to which federal initiatives influenced (or failed to influence) provincial and hospital initiatives remains debateable, events initiated at one level (the hospital's decision to implement software, initiated at the organizational level) are influenced (perhaps indirectly) by developments in other contexts (federal/macro changes gave an initiative more weight; provincial initiatives such as the Labour Accord altered the industrial relations environment in which system development occurred). Micro-studies of work practice, invaluable in addressing interactions between technologies, users and work practices, often fail to account for the historic reach of global actors, although it is often these historic circumstances that contribute to present-day interactions between user, information system and organization, and that find expression - often indirectly - in daily work practices.
Here discourse about information technology in Canada's health sector is examined. After an overv... more Here discourse about information technology in Canada's health sector is examined. After an overview of the emergence of the Canadian Health Information Infrastructure, discourse within the Romanow Report is discussed in relation to three key themes: standardization, empowerment, and time/space compression. While an instrumental view of technology in the health care sector is the predominant discourse articulated in the report, we argue that, by emphasizing technology assessment, the Romanow Report makes room for a more nuanced analysis of technology implementations than is common to government reports. We conclude by suggesting how investigations of information and communication technology in the health sector, such as this, may offer opportunities to raise critical questions about technology and health policy from a communications perspective.
Preliminary work 2 yielded the following findings and recommendations:
This paper focuses on how gender has been addressed in the health information highway. I examine ... more This paper focuses on how gender has been addressed in the health information highway. I examine the accessibility of online health information to wo men and the question of hip replacements and gender. I conclude that the health information highway obscures the social relations surrounding women's health. Résumé