Collective expectations--individual action implementing electronic booking systems in Norwegian health care

We draw on an ongoing study of an electronic booking project at the University Hospital North Norway where general practitioners are given the opportunity to book appointments at the hospital for their patients. Electronic booking offers well-defined and standardised services as well as standardised procedures for preparing the patient for the appointment at the hospital. We examine how the standards inscribed in the booking system shape medical work and how they bring to the surface a social dilemma between collective and individual interests in how the key actors reflect on the consequences of the system. We combine two social theories, namely Actor Network Theory and the theory of collective action. As a conclusion, we argue that simple and well-defined cases of patients' problems and willingness among the general practitioners to undertake work traditionally conducted at the hospital are conditions for making electronic booking successful. However, when the patients' problems are unclear the booking system needs to be combined with traditional referrals. We also point to how the general practitioners' attitude towards the system is time-dependent. Their initial positive attitude towards the potential public goods produced by booking transforms into putting more weight on the individual interests.