Weaving Discourses and Changing Organizations: The Role of ICT in the Transformation of Healthcare Towards Patient-Centered Model

This paper illustrates ways in which ICT are implicated in transforming healthcare from an organization-centered model of delivery to a patient-centered model. Building on the literature on discourse analysis and organizational change it analyzes ICT-led organizational transformation and patient-centered healthcare discourses constructed in the UK’s policy papers and enacted in healthcare organizations. It suggests that ICT discourse performs different roles in relation to patient-centered healthcare discourse, and theorizes them as opening of possibilities, amplifying and re-focusing. The research reveals that Electronic Health Records both facilitate and obstruct the transformation of healthcare towards a patient-centered model. This contradiction arises from a number of contingent, interacting factors including different organizational characteristics, implementation strategies and work practice, as well as different conceptualizations of patient-centered care. Organizational transformation takes time and is characterized by detours and setbacks