Off the record: The invisibility work of doctors in a patient-accessible electronic health record information service.

• In this article, we draw on Michael Lipsky's work on street-level bureaucrats and discretion to analyse a real case setting comprising an interview study of 30 Swedish doctors regarding their experiences of changes in clinical work following patients being given access to medical records information online. We introduce the notion of invisibility work to capture how doctors exercise discretion to preserve the invisibility of their work, in contrast to the well-established notion of invisible work, which denotes work made invisible by parties other than those performing it. We discuss three main forms of invisibility work in relation to records: omitting information, cryptic writing and parallel note writing. We argue that invisibility work is a way for doctors to resolve professional tensions arising from the political decision to provide patients with online access to record information. Although invisibility work is understood by doctors as a solution to government-initiated visibility, we highlight how it can create difficulties for doctors concerning accountability towards patients, peers and authorities.

Ämnesord

SAMHÄLLSVETENSKAP  -- Sociologi (hsv//swe)

SOCIAL SCIENCES  -- Sociology (hsv//eng)

NATURVETENSKAP  -- Data- och informationsvetenskap (hsv//swe)

NATURAL SCIENCES  -- Computer and Information Sciences (hsv//eng)

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Övrig annan samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Other Social Sciences not elsewhere specified (hsv//eng)

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Arbetslivsstudier (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Work Sciences (hsv//eng)

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Tvärvetenskapliga studier inom samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Social Sciences Interdisciplinary (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Annan hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Other Health Sciences (hsv//eng)

TEKNIK OCH TEKNOLOGIER  -- Medicinteknik -- Annan medicinteknik (hsv//swe)

ENGINEERING AND TECHNOLOGY  -- Medical Engineering -- Other Medical Engineering (hsv//eng)

TEKNIK OCH TEKNOLOGIER  -- Elektroteknik och elektronik -- Kommunikationssystem (hsv//swe)

ENGINEERING AND TECHNOLOGY  -- Electrical Engineering, Electronic Engineering, Information Engineering -- Communication Systems (hsv//eng)

NATURVETENSKAP  -- Data- och informationsvetenskap -- Annan data- och informationsvetenskap (hsv//swe)

NATURAL SCIENCES  -- Computer and Information Sciences -- Other Computer and Information Science (hsv//eng)

NATURVETENSKAP  -- Data- och informationsvetenskap -- Människa-datorinteraktion (hsv//swe)

NATURAL SCIENCES  -- Computer and Information Sciences -- Human Computer Interaction (hsv//eng)

NATURVETENSKAP  -- Data- och informationsvetenskap -- Systemvetenskap, informationssystem och informatik (hsv//swe)

NATURAL SCIENCES  -- Computer and Information Sciences -- Information Systems (hsv//eng)

Nyckelord

discretion; invisibility work; invisible work; medical professionals; online medical records

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)