A phenomenological perspective on clinical communication and interaction. The case of electronic health records
| Published date | 22 August 2007 |
| Date | 22 August 2007 |
| DOI | https://doi.org/10.1108/14779960710822665 |
| Pages | 20-32 |
| Author | Lars Botin |
| Subject Matter | Information & knowledge management |
A phenomenological perspective
on clinical communication
and interaction
The case of electronic health records
Lars Botin
Aalborg University, Aalborg, Denmark
Abstract
Purpose – The purpose of this paper is to investigate how people communicate in organisations.
Design/methodology/approach – The approach in doing this is based on two pillars. One being a
philosophical phenomenological approach dealing mainly ethical questio ns concerning
communication and interaction in designing and implementing electronic health records (EHR). The
other is videoobservation of work procedures in hospitals because appropriate for unveiling tacit
knowledge in an organisation.
Findings – The paper discusses the inappropriate design and implementation of actual EHR’s in the
Danish hospital system. Where the technology is based on hierarchical and economic structured
managerialist thinking and doing, that eliminates the everyday knowledge of nursing staff and the
patient.
Originality/value – The value of this paper that it lays forward the inappropriate paradigmatic
thinking of hospital systems concernin g communication and interaction in design ing and
implementing EHRs.
Keywords Communication,Phenomenology, Ethics, Customerrecords, Hospitals, Denmark
Paper type Research paper
Introduction
As scientists we observe the world in order to gain knowledge concerning a particular
field of investigation. This knowledge has to be sufficiently communicable for
scientific validation; and then applied in a more pragmatic and ethical way, for the
common good. This process of observation can be conducted in a variety of ways.
The involvement and entanglement of the observer in the process varies as we choose
different mental “lenses” through which we observe the world. I follow the approach of
Latour (1999) and others that total objectivity is impossible in modern science, since the
empirical and natural world is in itself affected by purposes and values of people who
interact with it, hence eliminating the concept of pure objectivity. Each field of
observation is constructed by human beings who interact with other human subjects
and with technologies, all of which have an impact on the choice of lens. This applies to
the activity of creating new knowledge in the field of clinical interaction and
communication in the health care system. In this paper, I focus on the development and
implementation of electronic health records (EHR) in the Danish healthcare system.
To help sharpen the focus on the problem, the paper first addresses the significance
of choosing to study clinical communication and interaction. Secondly, the method
used for observation, grounded in ethnography and phenomenological phi losophy and
methodology will be described. Thirdly the particular observations are described.
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/1477-996X.htm
JICES
5,1
20
Journal of Information,
Communication & Ethics in Society
Vol. 5 No. 1, 2007
pp. 20-32
qEmerald Group Publishing Limited
1477-996X
DOI 10.1108/14779960710822665
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