Implementation of an Electronic Medical Record in Light of the Actor-Network Theory

Abstract

Objective: to describe the human and non-human actors network involved in the implementation of an electronic medical record in Primary Health Care in Minas Gerais. Method: this is a study with a qualitative approach, with the Actor-Network Theory as a theoretical framework and Controversy Cartography as a methodological framework. We interviewed 20 health professionals, managers and other spokespersons involved with the implementation of an electronic medical record in a city in Minas Gerais State. We conducted observation and collection of 30 documents when following the participants from September 2018 to August 2019. For analysis, we used the following scales to visualize the mapped social dynamics: Minor Scale (brief and chronological description of the main events); Intermediate Scale (identification of humans and non-humans, their relationships and controversies); Major Scale (detailed description of the main controversies). Results: the network of actants involved in the electronic medical record implementation is woven from controversies: multiple actants and their translations influencing the electronic medical record implementation; contributions and weaknesses shaping the electronic medical record as an open controversy. Such controversies emerged from the mobilization of actors from various spheres of government, in addition to the place of implementation. Despite the weaknesses found, the electronic medical record contributed to: support decision-making; monitor patients’ health history; integrate information between the assistance network points. Conclusion: the success of the technology implementation was influenced by the relationships established between humans and non-humans from different management spheres, which, by mobilizing, strengthen or weaken computerization.

Technosociality in health professionals’ daily lives and interaction with users in the covid-19 pandemic

“…8 The use of teledermatology is also satisfactory among health professionals and patients in Santiago, Chile. 32 The electronic medical record has optimized the FHS teams' work, by favoring the simultaneous registration in the Primary Care Health Information System (SISAB -Sistema de Informação em Saúde da Atenção Básica), 33 with the power to represent the population's health, proving to be useful to calculate the prevalence of chronic diseases. 34 Protocols have been considered relevant instruments to organize health work, in a systematic way, and to face various care problems.…”

Tecnossocialidade no quotidiano de profissionais da saúde e interação com usuários na pandemia de covid-19

“…8 A utilização da teledermatologia, também, mostra-se satisfatória entre profissionais de saúde e pacientes em Santiago, Chile. 32 O prontuário eletrônico tem otimizado o trabalho das equipes da ESF, ao favorecer o registro simultâneo no Sistema de Informação em Saúde da Atenção Básica (SISAB), 33 com o poder de representar o estado de saúde da população, demostrando ser útil para calcular a prevalência de doenças crônicas. 34 Os protocolos vêm sendo considerados instrumentos relevantes para organizar o trabalho em saúde, de forma sistematizada, e enfrentar diversos problemas assistenciais.…”