Berg M, Goorman E
Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
Int J Med Inform. 1999 Dec;56(1-3):51-60. doi: 10.1016/s1386-5056(99)00041-6.
Successful design of information systems in health care starts with a thorough understanding of the practices in which the systems are to function. In this paper, we discuss the nature of 'medical information' from a sociological perspective. We focus on the (im)possibilities of the utilization of primary health care data for secondary purposes such as research and administration. In much of the literature on EPRs, this secondary utilization is only seen to depend on the question whether the IT connections are in place. It is then simply a matter of selecting which information to transport and to where. In this article, we argue that this view of medical information is mistaken. Information should be conceptualized as always entangled with the context of its production. The disentangling of information from its production context is possible, but that entails work. We propose the following 'law of medical information': the further information has to be able to circulate (i.e. the more diverse contexts it has to be usable in), the more work is required to disentangle the information from the context of its production. The question that then becomes pertinent is; who has to do this work, and who reaps the benefits?
医疗保健领域信息系统的成功设计始于对系统运行所涉及实践的透彻理解。在本文中，我们从社会学角度探讨“医疗信息”的本质。我们关注将初级卫生保健数据用于研究和管理等次要目的的（不）可能性。在许多关于电子病历的文献中，这种二次利用仅被视为取决于信息技术连接是否到位。那么，这仅仅是选择传输哪些信息以及传输到何处的问题。在本文中，我们认为这种对医疗信息的看法是错误的。信息应被概念化为始终与其产生的背景相互交织。将信息与其产生背景分离是可能的，但这需要付出努力。我们提出以下“医疗信息定律”：信息必须能够流通得越远（即它必须能够在越多样化的背景中使用），将信息与其产生背景分离所需的工作量就越大。随之而来的相关问题是：谁必须做这项工作，谁能从中受益？
