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

这项评价性社会技术研究的主要目的是调查作为合作伙伴参与扩展选择网络（ECN）的公共和私人医疗保健提供者之间的信息流管理。生态网络是一项真正综合的社会技术政策方案，受到其运作的技术和组织环境的影响。ECN支持选择和预订应用程序，并使用技术和组织机制来管理信息流，因此具有技术和社会依赖性以及综合含义。ECN是一种指定机制，通过该机制，公共和独立医疗机构的一系列医疗服务提供者可以“委托”服务，以扩大患者的选择范围，并实现更大的物有所值。自从ECN成立以来，医疗界一直关注成为ECN成员所涉及的费用。隐私和同意管理是这些成本的重要组成部分。该研究旨在引起人们对患者信息流临床管理中组织背景理解的重要性的注意，特别是在涉及其隐私和安全方面。利用案例研究方法部署一系列定性和定量的数据收集方法，它侧重于患者信息的临床管理在一个私营部门供应商。该研究将追踪患者信息流，因为它穿越参与ECN的不同组织，并将利用综合社会技术方法来评估宏观组织背景对患者信息流隐私管理的影响。虽然信息系统设计的一个特点是它们具有形成良好的技术研究方法，但为研究选择了一个跨学科的研究框架，以便实现信息流的社会技术层面的整合。隐私管理是一项社会技术活动，它既依赖于用于交付ECN的技术，也依赖于与该技术交互的组织结构。这种对生态网络信息流的综合社会技术评价审查了以下关键领域：信息系统兼容性；国家方案合规性与地方组织部署要求；以及影响知识转移的制度文化复杂性。在评价西非国家网络对一个独立部门伙伴的影响时，采用了一种现实主义的方法，能够提请注意该方案的具体情况-机制-结果结构。也就是说，信息系统流、医疗保健专业角色和组织结构的哪一种配置可能从该计划中受益最大，以及哪种社会、技术和文化资源是维持ECN计划所必需的，同时满足确保患者隐私、同意和安全的要求。

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.