Assemblages of Health Information in the United States: Engineering the Future Patient
Based on 5 years of research at community hospitals and academic medical centers, teleradiology providers, and regional and federal agencies, this study invites reflection healthcare information automation in the US during a period of when 47 million people are under or uninsured. The notion of assemblages of health information brings attention to a multiplicity of computer-based networks, systems, agencies, and values that can not be reduced to one logic or rationality, and that suggest new ethical problems in restructuring of one of the costliest and most inefficient information enterprises in the world. Recently, the wide adoption of Electronic Health Records (EHR) have been linked to a larger social transformation that frames health information technologies as “essential” and “revolutionizing” within a delivery system arguably in disrepair. Health information technology (HIT) has taken on the role as a primary means to fix deep social and political problems underlying chronic disease in the US through establishing "interoperable" systems, providing greater broadband "connectivity", and improving "patient safety" through electronic continuity of care records that are more widely available to clinicians at the point of care. This study investigates the clinical, social and political dimensions of adoption of Electronic Health Records, but more importantly, it examines a new conception of the patient and perceptions that health information technologies can do for patients what our healthcare institutions have failed to do. The shaping of the future patient within this larger social-political framework of health information delivery invites reflections on the limits and possibilities of EHR adoption, the historic promise of health information, and how the future shapes the present of health information planning and policy in the US.
Keywords: Automation, Electronic Health Records, Patient, Future, Diagnotic, Interoperability, Network Society, Risk Society, Patient Safety, Medical Error
Researcher, Krieger School of Arts and Sciences