striving for seamlessly integrated care l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Striving for seamlessly integrated care PowerPoint Presentation
Download Presentation
Striving for seamlessly integrated care

Loading in 2 Seconds...

play fullscreen
1 / 11

Striving for seamlessly integrated care - PowerPoint PPT Presentation


  • 213 Views
  • Uploaded on

Striving for seamlessly integrated care . Eric Monteiro Norwegian Univ. of Science & Technology and Univ. of Oslo www.idi.ntnu.no/~ericm. Local solutions . Artefacts in use workplace studies ethnographies contingencies, glitches, situated action small commuties of practice.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Striving for seamlessly integrated care' - Sophia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
striving for seamlessly integrated care
Striving for seamlessly integrated care

Eric Monteiro

Norwegian Univ. of Science & Technology

and

Univ. of Oslo

www.idi.ntnu.no/~ericm

local solutions
Local solutions
  • Artefacts in use
    • workplace studies
    • ethnographies
    • contingencies, glitches, situated action
    • small commuties of practice
  • Artefacts in context
    • prototyping
    • users, participation

Pelle Ehn & Scandinavia

beyond the local vertical horizontal
Beyond the local: vertical & horizontal

How similar ?

- granularity

Standardisation !

Dependencies with Others ?

- scope

Integration !

standardisation example
Standardisation: Example
  • Portal Rikshospital
  • 556 systems, 160 clinical
  • Role-based, in principle
  • ex.: order entry
  • ”Too much details”

(Rikshospitalet, GK Bruun)

standardisation example5
Standardisation: Example

“… but for us it is not helpful …. Just consider that

you have to scroll the listbox [the list of analyses codes].

This also means that there are too many available

options for the physician ordering a test….

Mixing everything together in a big chunk on the working

lists has caused a problem for several departments

because they want Microbiology results separated from the

mass produced blood results ”

standardisation analytical perspective
Standardisation: Analytical perspective
  • Standards as co-constructed practice
    • top-down enforced but also …
    • improvised locally
  • Relocate – not remove - work-arounds
    • J Grudin, revisited
    • benefits for whom? additonal work ?
  • Inherent, immanent ??

“The order and its disorder…. need and embody each other…

The orders … produce the very disorder they attempt to eradicate”

(Timmermans and Berg, 2000)

integration example
Integration: Example

Pharmacy

GP

prescription

identifier

Record sys.

inventory sys.

list of products

Vendor

Catalogue

NMD

Fabritius

integration example8
Integration: Example
  • data standards
  • reporting
  • indicators

DHIS

GIS

ART/HIV

Morbidity & Mortality

Scheduler/FMHIS

(www.hispindia.org)

Adm/budgetting

analytic i change to remain the same
Analytic (I): ”Change, to remain the same”
  • change contents
    • different parts
    • different versions
    • different configurations
  • change context
    • community based
    • drilling equipment
  • Is Z Bush Pump an artefact ??
  • Fluid

Zimbabwe bush pump

analytical perspective ii
Analytical perspective (II)
  • Integration = add dependencies
    • integration ALSO multiplication & propagation of unintended consequences
    • removing slack (delay, quality ensurance, double check)
  • Complex + tightly coupled (C Perrow)
    • difficult to recognise outcomes (risks)
    • effects interact, travel
  • Integration
    • part of the solution or …
    • part of the problem ?
from artefacts to infrastructures
From Artefacts to Infrastructures

Standardisation

  • Architecture vs Urban planning
    • houses vs neigherhood
    • blend in = ... ?
  • Heterogenous integration
    • oppose idealisations/abstractions
    • curb totalizing inclination/ambitions
  • ”Complexify concepts in response to complex phenomena” (Tsoukas)

Integration