Privacy management and information flow in the context of the development of the Extended Choice Network: A socio-technical study

点击翻译按钮获取中文摘要

The primary aim of this evaluative socio-technical study is to investigate the management of information flow between public and private healthcare providers participating as partners in the Extended Choice Network (ECN). The ECN is a truly integrated socio-technical policy programme which is affected by both the technological and organisational contexts in which it operates. ECN supports the Choose and Book application and uses both technological and organisational mechanisms to manage information flows and as a result has both technological and social dependencies and combined implications. The ECN is the designated mechanism by through which the process of 'commissioning' services from a range of healthcare providers, public and independent sector, in order to achieve widened patient choice and achieve greater value-for-money can be realised. Since its launch there has been concern in healthcare communities about the costs involved in being a member of ECN. Privacy and consent management are an important part of those costs. The study seeks to draw attention to the importance of an understanding of organisational context in the clinical management of patient information flows, particularly in relation to its privacy and security aspects. Utilising a case study approach deploying a range of qualitative and quantitative data collection methods it focuses upon the clinical management of patient information within one private sector provider. The research will trace patient information flow as it traverses the different organisations participating within the ECN, and will utilize an integrated socio-technical methodology to evaluate the impact of macro-organisational context on the privacy management of patient information flow. While a feature of information systems design is that they have well-formed technological research methodologies, an interdisciplinary research framework has been chosen for the study in order to achieve an integration of the socio-technical dimension of information flows. Privacy management is a socio-technical activity that is dependent both on the technology used to deliver the ECN and upon the organisational structures that interact with the technology. This integrated socio-technical evaluation of ECN information flows examines the following key areas: Information systems compatibility; national programme compliance versus local organisational deployment requirements; and institutional cultural complexities affecting knowledge transfer. In undertaking this evaluation of the ECN as it impacts on an independent sector partner, a realist methodological approach has been adopted which is able to draw attention to the particular context-mechanism-outcome configurations of the programme. That is, which configuration of information system flow, healthcare professional roles, and organisational structure might benefit most from the programme, and which social, technological and cultural resources are necessary to sustain the ECN programme whilst meeting the demands of ensuring patient privacy, consent, and security.