Communicating the Implementation of Open Notes to Health Care Professionals: Mixed Methods Study.

Karin Jonnergård,Lena Petersson,Gudbjörg Erlingsdóttir

doi:10.2196/22391

Abstract

BackgroundThe literature on how to communicate reform in organizations has mainly focused on levels of hierarchy and has largely ignored the variety of professions that may be found within an organization. In this study, we focus on the relationship between media type and professional responses.ObjectiveThe objective of this study was to investigate whether and how belonging to a profession influences the choice of communication media and the perception of information when a technical innovation is implemented in a health care setting.MethodsThis study followed a mixed methods design based on observations and participant studies, as well as a survey of professionals in psychiatric health care in Sweden. The χ2 test was used to detect differences in perceptions between professional groups.ResultsThe use of available communication media differed among professions. These differences seem to be related to the status attached to each profession. The sense-making of the information appears to be similar among the professions, but is based on their traditional professional norms rather than on reflection on the reform at hand.ConclusionsWhen communicating about the implementation of a new technology, the choice of media and the message need to be attuned to the employees in both hierarchical and professional terms. This also applies to situations where professional employees are only indirectly affected by the implementation. A differentiated communication strategy is preferred over a downward cascade of information.

Highlights

BackgroundSince 2017, all residents of Sweden have been able to access their nonpsychiatric electronic health records (EHRs) through the internet, and have been able to read clinical notes
When communicating about the implementation of a new technology, the choice of media and the message need to be attuned to the employees in both hierarchical and professional terms
This applies to situations where professional employees are only indirectly affected by the implementation

Summary

Introduction

Since 2017, all residents of Sweden have been able to access their nonpsychiatric electronic health records (EHRs) through the internet, and have been able to read clinical notes. This “Open Notes” policy was first introduced in November 2012 by Region Uppsala, followed by Region Skåne in March 2014. Implementing new technical systems such as Open Notes in the public sector is often depicted as a complex process [4,5] This is partly because activities in the public sector are affected by political and operational considerations, and are performed by both managers and street-level bureaucrats. We focus on the relationship between media type and professional responses

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Results

Discussion

Conclusion