A Template in the Structure of Action: Electronic Health Records and the Routinization of Clinical Practice

Abstract

The article deals with the problem of the habitual action and routinization of work. Based on the data collected during the study of the implementation of electronic health records in medical practices, the article shows that the widespread view of habitual action as an action in accordance with a preliminary scheme does not describe the actual structure of healthcare activities, a view that forms a basis for the majority of medical information systems. The analysis of how doctors perceive and use electronic health records in their daily practice shows that a situational approach to routine actions is more adequate. For example, the use of so-called “templates” that are created by doctors within the electronic health records system demonstrates the importance of a situational context of professional activities. Doctors, creating and using various “templates,” do this in such ways that allows them to make these health records circumstantially understandable. This work of producing a situational recognizability that does not consist in the use of pre-established schemes can and should be the subject of sociological analysis. The understanding of routine activities as situationally-oriented, concerted achievements not only proves the possibility of a new approach to the desсription of the habitual actions’ role and place in the structure of social action, but can be important for the design and evaluation of professional information systems.