Transforming healthcare: policy discourses of IT and patient-centred care

Abstract

Information Technology (IT) is increasingly seen in policy and academic literature as key to the modernization of healthcare provision and to making healthcare patient-centred. However, the concept of Patient-Centred Care (PCC) and the role of IT in the transformation of healthcare are not straightforward. Their meanings need unpacking in order to reveal assumptions behind different visions and their implications for IT-enabled healthcare transformation. To this end, this paper reviews literature on PCC and IT and analyses England's health policy between 1989 and 2013. English policy has set out to transform healthcare from organization-centric to patient-centred and has placed IT as central to this process. This policy vision is based on contested conceptualizations of PCC. IT implementation is problematic and this is at least partly because of the underpinning goals and visions of healthcare policy. If this misalignment is not addressed then producing technologically superior systems, or better IT implementation strategies, is unlikely to result in widespread and substantial changes to the way healthcare is delivered and experienced. For IT to support a healthcare service that is truly patient-centred, patients' needs and wants need to be identified and designed into IT-enabled services rather than simply added on afterwards.

Ideologies implicated in IT innovation in government: A critical discourse analysis of Mexico's international trade administration

“…Also, explanations of the difficulties faced in the development of effective IT infrastructures in the NHS have pointed to the ambivalence of health care policy. Klecun (2016) argues that problems of IT implementation are partly explained by the controversies about the "Patient-Centred…”

“…We showed how, in our case study, apparently straightforward meanings of IT as enablers of efficiency in government organizations implicated political positions of socio-economic development. Similarly, innocuous IT innovation objectives and effects in other areas of public services, such as improvement of health outcomes (Klecun, 2016) or reducing poverty (Thompson, 2004), are likely to be associated with ideological positions and involve political contestations.…”

Information Infrastructures for eHealth

“…Many health strategies and policies contain visions of more patient-centric healthcare systems (Klecun 2016). Several countries initiated the development of patient-oriented eHealth solutions seeking to realize visions for patient-centeredness.…”

Clinical managers' identity at the crossroad of multiple institutional logics in it innovation: The case study of a health care organization in England

“…To date, very few studies have analysed PCC as an institutional logic (Shaw et al, 2017). After realizing the pitfalls of acute care in the management of complex and long-term chronic conditions, policy-makers in various countries have promoted the diffusion of this logic through policies that drive the transition from hospital care to home-based care for improved patient satisfaction and cost-efficiencies (Klecun, 2015). Whereas medical professionalism only recognizes the authority of clinicians in the provision of patient care, PCC requires health care organizations and professionals to reorient their thinking and processes and encourages patients to participate actively in their care (Kitson et al, 2013;Shaw et al, 2017).…”