Introduction to the Special Issue on ‘Information Infrastructures in Healthcare: Governance, Quality Improvement and Service Efficiency’ (original) (raw)

Computer Supported Cooperative Work (CSCW)

From the beginning, information infrastructures in healthcare have had at least two purposes: First, the coordination and exchange of information across professions, organizational units and time in order to treat and care for patients, and second, the accumulation and analysis of data in order to improve quality and efficiency of services provided. The duality goes back to Zuboff's call for digitization to not just be used for automation, but also for informating workers, management and organisations (Zuboff 1988): IT would provide information that could be used to 'informate work' by making some activities visible. Such informating can concern workers as part of their ongoing activities (Kristiansen et al. 2018), or management as part of organizing and monitoring organisational work processes (Evans and Kitchin 2018), or state authorities. The deployment of healthcare infrastructures has been relatively late compared to other domains in the sense that despite numerous stand-alone IT systems one of the core infrastructures, the patient record, has only become digital at scale during the last two decades: In Europe, development of electronic health records took off around the turn of the millennium (Häyrinen et al. 2008), in the USA a couple of years later (Berner et al. 2005; Simborg et al. 2013). However, since then information infrastructures in healthcare have developed rapidly (Fitzpatrick and Ellingsen 2012) and the above mentioned duality of coordinating and informating has become evermore relevant. In the USA, the HITECH act of 2010 launched to spur the adoption of Electronic Health Record (EHR) also aimed at generating data on patients and healthcare service on large scale (Blumenthal and Tavenner 2010) (Sholler, This issue). In Europe, the European Institute for Innovation through Health Data was launched in 2016 to promote semantic interoperability, quality and governance through healthcare data (i~HD.eu). The duality of aims was found to create tensions in and obstacles for the development information healthcare infrastructures, because the wish to generate data for