Making Qualitative Studies Talk back: the Poetics of User-reception of EPR

The oral paper presents the poetics of the e-text, as a methodology for analysing ICT-reception and use, with the prospect on continuous development of ICT in relation to clinical praxis. Background: Information technologies are playing a growing role in the organization and enactment of health care services. Visions of shared use of (electronic) data for administrative purposes, for research purposes and for performing daily health care services push the IT-development and challenges the understanding of what health care work actually is. The Achilles of ICT-mediated health care is the clinician. They feed the systems by entering data as well as clinical tasks increasively depend on retrieving data from IT-systems. Aim: Critical hermeneutical insights on communication and sense-making are suggested for understanding and explaining IT in health care practices. The presentation advocates that qualitative studies of user-reception can inform system design and IT-development in health care. Method: The framework of analysing user-reception of IT-systems was developed on the background of an evaluation study of ICT-implementation in primary health care (Wentzer, Bygholm 2001). High standardisation of clinical language for IT-development of clinical documents is a well-known challenge to health care authorities and to clinical users. The theoretical foundation of the method is the critical hermeneutic of Paul Ricoeur (1978, 1981, 1988, 2002), Don Ihde (1996) Inger Lytje (2000), and Joseph Dunne (1993). The textual paradigm of the critical hermeneutic is applied to technology and software development from a neo-aristotelian understanding of health care as techniques serving praxis and ‘the good life’. Results: The poetics of the e-text offers ‘a way in’ to understand why health care praxis is difficult to communicate with IT. A proper articulation of users experiences can explain problems of continuity of work practice with ICT - and inform further system design from a user-centred perspective.