When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic
May, Carl and Ellis, Nicola T. (2001) When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic. Social Science & Medicine, 53, (8), 989-1002. (doi:10.1016/S0277-9536(00)00394-4).
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Telecommunications systems seem to offer health care providers, professionals and patients a plethora of opportunities to respond to social and geographical inequalities in health care provision, and a new field of health care endeavor has emerged — ‘telemedicine’. This paper presents results from a three year ethnographic study of the development and implementation of telemedicine systems in a British region. We explore how attempts to put into service one ‘telemedicine’ system failed to get beyond the draft of a written protocol. Our analysis focuses on the contests between clinicians, technical experts and external evaluators over what kinds of knowledge and practice count in developing a protocol and evaluating a clinical intervention. We show how the introduction and implementation of ‘hard’ technologies (systems hardware) can be undermined in practice by ‘soft’ technologies (the practices through which evaluative knowledge is produced).
|Keywords:||telemedicine, social construction, medical knowledge, evaluation, uk|
|Subjects:||R Medicine > RZ Other systems of medicine
H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
H Social Sciences > HE Transportation and Communications
|Divisions:||University Structure - Pre August 2011 > School of Health Sciences
|Date Deposited:||09 Sep 2010 08:55|
|Last Modified:||27 Mar 2014 19:17|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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