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Related Experiment Video

Updated: May 16, 2026

A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts

A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts

Published on: September 20, 2018

Computer templates in chronic disease management: ethnographic case study in general practice.

Deborah Swinglehurst¹, Trisha Greenhalgh, Celia Roberts

¹Centre for Primary Care and Public Health, Blizard Institute, Queen Mary, University of London, London, UK.

|November 30, 2012

Summary

Electronic templates significantly alter chronic disease consultations, shifting focus from patient narratives to data entry. Creative clinical work is essential to maintain patient-centered care amidst template-driven bureaucracy.

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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts

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Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

Published on: July 27, 2018

Area of Science:

Health Services Research
Sociology of Health and Illness
Digital Health

Background:

Electronic templates are widely implemented in chronic disease management.
Their impact on the practicalities of consultations remains underexplored.

Purpose of the Study:

To investigate how electronic templates shape, enable, and constrain consultations for chronic diseases.
To understand the influence of templates on the nature of chronic disease care.

Main Methods:

Linguistic ethnography using ethnographic observation, video recording, and screen capture.
Microanalysis of talk, body language, and data entry in 36 nurse-led consultations.
Discourse analysis informed by sociotechnical theory.

Main Results:

Consultations became centered on evidence-based protocols within templates, transforming patient stories into data.
Templates defined disease, care delivery, and professional roles, often resembling bureaucratic encounters.
A tension emerged between 'patient-as-individual' and 'patient-as-population' framings, with some clinicians navigating this creatively.

Conclusions:

Electronic templates profoundly change chronic disease management, contributing to bureaucratization.
They may marginalize quality aspects not captured by the template's focus.
Creative adaptation is needed to balance institution-centered and patient-centered care.