[Zurück]

M. Tolar:
"Documentation and "ways of knowing" in the healthcare sector: A comparison of electronic and paper-based patient record systems in an oncology setting";
Vortrag: 4S conference (Society for Social Studies of Science), Montreal; 11.10.2007 - 13.10.2007.

Documentation is an important part of the medical practice. In the healthcare sector it serves many purposes: workflow management, reporting and accounting, communicating with external units and services, doing research, ensuring accountability to legal and forensic inquiries, and providing overview of patients´ trajectories. Especially for chronic diseases information about the long-term course of each patient´s condition is crucial. When people receive treatments for many years a lot of data about therapies and examinations is gathered and has to be held accessible. The introduction of electronic patient records changes how information about a patient is stored and retrieved.

The paper presents results from a case study that deals with documentation practices in an oncology setting. In two hospitals in Austria extensive ethnographic fieldwork has been conducted to analyze work processes with special regard to documentation and the corresponding artefacts and procedures. In one of the hospitals they still use paper-based documentation whereas in the other one an electronic patient record system has been used for nearly fifteen years with constant adaptations.
By comparing the two regimes of record keeping the question is answered of how they influence what kind of information is accessible both from the viewpoint of the daily work with individual patients and of statistical analysis in the context of clinical studies or other (e.g. financial) evaluation.

documentation system, healthcare, oncology