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When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic

When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic
When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic
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).
telemedicine, social construction, medical knowledge, evaluation, uk
0277-9536
989-1002
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Ellis, Nicola T.
5440bfed-93d5-4ed3-bde5-3d036085ee93
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Ellis, Nicola T.
5440bfed-93d5-4ed3-bde5-3d036085ee93

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).

Record type: Article

Abstract

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).

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More information

Published date: October 2001
Keywords: telemedicine, social construction, medical knowledge, evaluation, uk

Identifiers

Local EPrints ID: 163429
URI: http://eprints.soton.ac.uk/id/eprint/163429
ISSN: 0277-9536
PURE UUID: 5b5648b7-7082-431a-b685-912fe5854cd9
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 09 Sep 2010 08:55
Last modified: 14 Mar 2024 02:04

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Contributors

Author: Carl May ORCID iD
Author: Nicola T. Ellis

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