Ethnographic study of ICT-supported collaborative work routines in general practice

Area of Science:

• Sociology of organizations
• Health informatics
• Qualitative research methods

Background:

• Traditional health informatics research relies on experimental designs.
• Routinisation, the process of making collaborative work routine, is an emerging area in organizational sociology.
• Ethnography and qualitative methods are increasingly used to study electronic patient records (EPRs) in healthcare settings.

Purpose of the Study:

• To analyze how collaborative work routines are enacted and evolve over time.
• To investigate the role of EPRs in supporting collaborative work practices.
• To generate insights into routinisation in healthcare organizations.

Main Methods:

• Utilizing 'the organizational routine' as the unit of analysis.
• Collecting data through narratives, ethnographic observations, and multi-modal recordings in four UK general practices.
• Conducting a detailed qualitative analysis informed by sociological theory.

Main Results:

• Mapping and comparing the enactment of three common routines: repeat prescribing, coding/summarizing, and chronic disease surveillance.
• Identifying how front-line staff workarounds bridge the gap between EPR design and real-world application.
• Highlighting the impact of "automated" safety features in practice through staff's hidden work.

Conclusions:

• The study can identify quality failures in collaborative work routines.
• It reveals hidden work and workarounds by staff that influence EPR effectiveness.
• Insights into routinisation can improve the integration and safety of EPR technologies.