Rob Procter

The impact of eHealth on the quality and safety of health care: a systematic overview.

Aziz Sheikh and colleagues report the findings of their systematic overview that assessed the impact of eHealth solutions on the quality and safety of health care.

Making a Case in Medical Work: Implications forthe Electronic Medical Record

The introduction of theelectronic medical record (EMR) is widely seenby healthcare policy makers and servicemanagers alike as a key step in the achievementof more efficient and integrated healthcareservices. However, our study of inter-servicework practices reveals important discrepanciesbetween the presumptions of the role of the EMRin achieving service integration and the waysin which medical workers actually use andcommunicate patient information. These lead usto doubt that technologies like the EMR candeliver their promised benefits unless there isa better understanding of the work they areintended to support and the processes used inits development and deployment becomesignificantly more user-led.

Adoption and use of Web 2.0 in scholarly communications

Sharing research resources of different kinds, in new ways, and on an increasing scale, is a central element of the unfolding e-Research vision. Web 2.0 is seen as providing the technical platform to enable these new forms of scholarly communications. We report findings from a study of the use of Web 2.0 services by UK researchers and their use in novel forms of scholarly communication. We document the contours of adoption, the barriers and enablers, and the dynamics of innovation in Web services and scholarly practices. We conclude by considering the steps that different stakeholders might take to encourage greater experimentation and uptake.

Reading the riots on Twitter: methodological innovation for the analysis of big data

For social scientists, the widespread adoption of social media presents both an opportunity and a challenge. Data that can shed light on people’s habits, opinions and behaviour is available now on a scale never seen before, but this also means that it is impossible to analyse using conventional methodologies and tools. This article represents an experiment in applying a computationally assisted methodology to the analysis of a large corpus of tweets sent during the August 2011 riots in England.

Collaboration and Trust in Healthcare Innovation: The eDiaMoND Case Study

This paper presents findings from an investigation into requirements for collaboration in e-Science in the context of eDiaMoND, a Grid-enabled prototype system intended in part to support breast cancer screening. Detailed studies based on ethnographic fieldwork reveal the importance of accountability and visibility of work for trust and for the various forms of ‘practical ethical action’ in which clinicians are seen to routinely engage in this setting. We discuss the implications of our findings, specifically for the prospect of using distributed screening to make more effective use of scarce clinical skills and, more generally, for realising the Grid’s potential for sharing data within and across institutions. Understanding how to afford trust and to provide adequate support for ethical concerns relating to the handling of sensitive data is a particular challenge for e-Health systems and for e-Science in general. Future e-Health and e-Science systems will need to be compatible with the ways in which trust is achieved, and practical ethical actions are realised and embedded within work practices.

The organising vision for telehealth and telecare : discourse analysis

Objective To (1) map how different stakeholders understand telehealth and telecare technologies and (2) explore the implications for development and implementation of telehealth and telecare services. Design Discourse analysis. Sample 68 publications representing diverse perspectives (academic, policy, service, commercial and lay) on telehealth and telecare plus field notes from 10 knowledge-sharing events. Method Following a familiarisation phase (browsing and informal interviews), we studied a systematic sample of texts in detail. Through repeated close reading, we identified assumptions, metaphors, storylines, scenarios, practices and rhetorical positions. We added successive findings to an emerging picture of the whole. Main findings Telehealth and telecare technologies featured prominently in texts on chronic illness and ageing. There was no coherent organising vision. Rather, four conflicting discourses were evident and engaged only minimally with one anothers arguments. Modernist discourse presented a futuristic utopian vision in which assistive technologies, implemented at scale, would enable society to meet its moral obligations to older people by creating a safe ‘smart’ home environment where help was always at hand, while generating efficiency savings. Humanist discourse emphasised the uniqueness and moral worth of the individual and tailoring to personal and family context; it considered that technologies were only sometimes fit for purpose and could create as well as solve problems. Political economy discourse envisaged a techno-economic complex of powerful vested interests driving commodification of healthcare and diversion of public funds into private business. Change management discourse recognised the complicatedness of large-scale technology programmes and emphasised good project management and organisational processes. Conclusion Introduction of telehealth and telecare is hampered because different stakeholders hold different assumptions, values and world views, ‘talk past’ each other and compete for recognition and resources. If investments in these technologies are to bear fruit, more effective inter-stakeholder dialogue must occur to establish an organising vision that better accommodates competing discourses.

Supporting informality: team working and integrated care records

This paper reports findings from an ethnographic study of the work of Adult and Care of the Elderly Community Mental Health Teams in the context of the deployment of an Electronic Medical Record. Our findings highlight the importance of informal discussions and provisional judgments as part of the process by which teams achieve consensual clinical management decisions over time. We show how paper-based documentation supports this collaborative work by affording both the revision of preliminary clinical management options and the accretion of contributions by team members with different clinical perspectives and expertise. Finally, we consider the implications both for teamwork and the Integrated Care Record (ICR) as clinical documentation becomes increasingly held and distributed electronically.

Fitting Standard Software Packages to Non-Standard Organisations: The 'Biography' of an Enterprise-Wide System

Abstract This paper investigates the development and implementation of a generic off-the-shelf computer package and the competing pressures for standardization and differentiation as this package is made to fit new organizational settings. The particular focus is on an Enterprise Resource Planning (ERP) system and its application within universities. In order for the ERP system to fit this setting a new module called ‘Campus’ is being developed. We followed the module as the current ‘generic user’ embodied in the software was translated to a more ‘specific user’ (a number of universities piloting the module) and back once again to a generic form of university user (the potential ‘global university marketplace’). We develop the notion that these systems have a ‘biography’, which helps us to analyse the evolution of software along its life cycle and provides insights into the different dynamics at play as Campus is translated for use in a number of institutions and countries. The study draws on over three years of ethnographic research conducted in a British University and a major ERP Supplier.

Analysing How People Orient to and Spread Rumours in Social Media by Looking at Conversational Threads

As breaking news unfolds people increasingly rely on social media to stay abreast of the latest updates. The use of social media in such situations comes with the caveat that new information being released piecemeal may encourage rumours, many of which remain unverified long after their point of release. Little is known, however, about the dynamics of the life cycle of a social media rumour. In this paper we present a methodology that has enabled us to collect, identify and annotate a dataset of 330 rumour threads (4,842 tweets) associated with 9 newsworthy events. We analyse this dataset to understand how users spread, support, or deny rumours that are later proven true or false, by distinguishing two levels of status in a rumour life cycle i.e., before and after its veracity status is resolved. The identification of rumours associated with each event, as well as the tweet that resolved each rumour as true or false, was performed by journalist members of the research team who tracked the events in real time. Our study shows that rumours that are ultimately proven true tend to be resolved faster than those that turn out to be false. Whilst one can readily see users denying rumours once they have been debunked, users appear to be less capable of distinguishing true from false rumours when their veracity remains in question. In fact, we show that the prevalent tendency for users is to support every unverified rumour. We also analyse the role of different types of users, finding that highly reputable users such as news organisations endeavour to post well-grounded statements, which appear to be certain and accompanied by evidence. Nevertheless, these often prove to be unverified pieces of information that give rise to false rumours. Our study reinforces the need for developing robust machine learning techniques that can provide assistance in real time for assessing the veracity of rumours. The findings of our study provide useful insights for achieving this aim.

Reading the riots : what were the police doing on Twitter?

The widespread adoption of new forms of digital communication platforms such as micro-blogging sites presents both an opportunity and a challenge for researchers interested in understanding peoples attitudes and behaviours, especially in the context of unfolding crises and the need for government agencies such as the police to inform the public and act swiftly to ensure public order and safety. In this paper, we use a study of a recent public order crisis in England to explore how the police, other organisations and individuals used Twitter as they responded to this event.