The qualculative dimension of healthcare data interoperability

Area of Science:

• Health Informatics
• Sociology of Work
• Information Science

Background:

• Interoperability and information exchange in health IT systems are crucial for research, quality improvement, and accountability.
• Despite the recognized benefits of secondary data use, practical implementation faces significant challenges.
• Existing research often overlooks the complex 'data work' involved in creating administrative data.

Purpose of the Study:

• To examine the practical challenges in creating administrative data within a hospital system.
• To uncover the situated practices of medical records coders and birth certificate clerks in data creation.
• To identify factors influencing the accuracy and utility of secondary health data.

Main Methods:

• An ethnographic study was conducted within a hospital system.
• Researchers observed and analyzed the data work performed by medical records coders and birth certificate clerks.
• The study focused on the practices involved in creating administrative data, which serves as secondary data.

Main Results:

• Data workers, including coders and clerks, rely on situated, qualitative judgments regarding the accuracy and authority of primary medical information.
• Decisions about data accuracy and the effort to clarify problematic data are influenced by coders' and clerks' understanding of the data's future uses.
• The creation of administrative data involves nuanced 'qualculative' practices rather than purely automated processes.

Conclusions:

• Information technology systems for health data interoperability must be designed to support the 'qualculative' practices of data workers.
• Future IT system designs should clarify the importance of different future data uses for data workers.
• Minimizing conflicting primary data before it reaches data workers is essential for improving the success of secondary data initiatives.