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Electronic health records are widely regarded as the 'connective
tissue' of any modern healthcare system. For some they represent a
'dangerous enthusiasm' and for others a key enabler of 'disruptive
innovation'. Many governments have made major policy and financial
investments in digitalizing health records but their implementation
has frequently run into opposition from doctors, had lukewarm
responses from patients, and raised considerable concerns for
privacy advocates and others worried by the security of sensitive
health data and the risks of national data-bases. This book draws
upon the concept of 'orders of worth' to reveal the moral
dimensions of the medical division of labour and to delve deeper
into understanding why electronic records have been so difficult to
implement and the sources of opposition to them. The authors argue
that digitalization disrupts the moral orders which define rights
and responsibilities for the sharing and exchanging of patient
medical data. This is illustrated through longitudinal studies of
two of the most controversial attempts to introduce national
systems - a patient controlled electronic record in Australia and a
national summary care record that was part of the ill-fated NHS
national program for IT in England. The authors conclude by using
the lessons from these national experiences and insights from two
regional projects in each country to suggest how the idea of
electronic records might be re-thought. It is a must read for
anyone concerned about health information and the implications of
how it is shared and exchanged in a digital world.
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