Confronting challenges of contingency: using a web-based patient record for ulcer care

Abstract

In the Norwegian authorities' "Coordination Reform" , insufficient coordination is considered the main reason that people with chronic diseases lose out in health care. Thus, the purpose of the web-based ulcer record at the University Hospital of North Norway is to optimise treatment and care for ulcer patients by facilitating interaction. This paper reports from a formative study of experiences, and addresses challenges in ulcer care and possible solutions. Qualitative interviews are conducted with all professionals and patients using the service from its start in 2011 and I present challenges for integrating knowledge, a crucial step for optimising services. The analytical perspectives are the sociology of knowledge, which emphasises the socially contingent character of knowledge, and science and technology studies, which emphasises the potential for mediation of social life through electronic media. Challenges related to differences in knowledge, procedures, values and goals, and transparency, are discussed in order to contribute to an understanding of how the use of the ulcer record may improve services.