Disenfranchised patients: A network analysis of IS integration in the context of patient-centered care

摘要

Healthcare reform has emphasized coordinated and integrated care - patient-centered care - for a decade. To that end, policymakers have invested in integration of healthcare providers' information flows. Research to date has studied healthcare actors' information needs but overlooked communicative exchanges among all participants in coordinating treatment plan decisions. Consequently, while medical literature asserts that patients should depend on information from healthcare providers to enable patients' participation in treatment plan decisions, the assertion has not been tested. To ameliorate this oversight, we conducted an empirical study of a patient-centered healthcare environment. Our study draws on dependency network diagramming (DND) and social network analysis (SNA) to elucidate the nature and structure of actors' communications in support of their information dependencies. The findings illustrate that although patients are well supported by personal communications with healthcare providers, they are disenfranchised from the integrated information technology within and between healthcare providers and its potential to support patients' participation in coordinated "patient-centered care" decisions. Furthermore, knowledge asymmetry between patients and healthcare providers should be considered in the selection and tailoring of healthcare information systems (IS).