Health Information Management: Integrating Information Technology ...

Chapter 2
Waiting for Godot
Episodes from the history of patient records
Marc Berg and Brit Ross Winthereik
The electronic medical record has been pursued as an ideal by so
many, for so long, that some suggest that it has become the Holy Grail
of Medical Informatics.
(Kay and Purves 1996)
KEY POINTS OF THIS CHAPTER
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The patient record has been at the centre of health care innovation for
at least a century.
Since its early conception, the history of the patient record is
intertwined with the standardization of health care work.
The development (the construction and implementation) of new
record systems (and information technologies in general) implies a
transformation of the practice in which it functions. Similarly, during
this development process, the technology is transformed as well.
The still prevailing standard view of technology tends to reduce the
complicated and socially relevant concerns involved in the
development of (health care) ICT to mere ‘technical’ problems.
Bringing the interrelations between technological, organizational and
political aspects into the light is a precondition for the development of
health care ICT applications that may actually work.
Although the need for patient care information systems has only
grown more acute, the actual track record of ICT in health care is in
stark contrast with the golden futures that are often promised.