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Title: Professional hybrids and perspectives on electronic health records as boundary objects : the case of the National Programme for IT organising vision
Author: Koshy, Miria A.
ISNI:       0000 0004 5355 9860
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2014
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This thesis examines the uses of Electronic Health Records (EHRs) and challenges faced in their implementation in the context of England’s National Programme for IT (NPfIT), the biggest civil IT programme in the world (Brennan, 2007). Despite the huge investments and high visibility that characterised the NPfIT, its aim of national level EHRs was not achieved and the programme was dismantled after being in operation for nearly a decade. The concepts of ‘organising visions’ (Swanson and Ramiller, 1997), ‘boundary objects’ (Star and Griesemer, 1989), ‘technology frames’ (Orlikowski and Gash, 1994) and ‘professional hybridisation’ (Noordegraaf, 2007) are employed to explain findings from this research. The study uses qualitative research methods, drawing on documentary sources and 51 semi-structured interviews. Responding to the limitations of using solely organising visions (Swanson and Ramiller, 1997), this thesis studies the NPfIT using a dual lens combining organising visions and boundary objects to understand the dynamics between stakeholders of the NPfIT organising vision. This thesis presents the EHR itself as a boundary object, and illustrates the knowledge sharing capacity of EHRs across clinical boundaries. A key emergent finding is the presence of clinician-IT hybrid professionals - a group that has neither been subject to empirical research nor been given sufficient attention in critical projects such as the NPfIT despite their unique position that bridges the clinical and IT domains. This study presents key findings discussing the factors that support and discourage the emergence of clinician-IT professional hybrids.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General)