Digital healthcare management as organisational scripting: doctors making sense of how screen-level workflow management is transforming medical work

Sirpa Wrede

Chapter 13 in Research Handbook on the Sociology of the Professions, 2025, pp 188-203 from Edward Elgar Publishing

Abstract: This chapter explores the Janus-like character of Patient Information (PI) Systems within digital healthcare management systems (HCMS). While prior research acknowledges that HCMS reinforce managerialist logics in clinical practice, this study delves into the dual role of PI Systems, not only as tools for archiving and accessing medical records but also as pivotal resources for healthcare management's key planning functions. PI Systems thus standardize medical workflows by scripting clinical encounters. Examining the accounts of early-career and late-career Finnish doctors (N = 38), the study reveals doctors’ frustrations with their limited power to organize clinical encounters according to valued practice patterns, impacting doctor-patient relationships and discretion. The HCMS emerge as a pervasive source of professional and personal frustration, segregating doctors concerning workflow autonomy. Amid doctor shortages, the allure of ‘foot voting’—opting out from strictly regulated practice environments—becomes a tempting solution for many physicians.

Keywords: Digitalisation; Doctoring; Healthcare management; Medical workflows; Workflow autonomy (search for similar items in EconPapers)
Date: 2025
ISBN: 9781035323074
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