Abstract

A recent trend in health care is patient-centred e-health, but are health care organizations ready to cope with that change? Changes at the patient level are one aspect but there is a need for reshaping the organization of health care. There is a need to focus much more on prevention care, helping patients to cope and become better self-managers, focusing on the patient process, working together and empowering patients. The aim of this paper is to gain a better understanding of the lack of sustainability over time in two patient-centred care (PCC) projects by using actor network theory (ANT) as an analytical framework. We use case studies from heart fibrillation and heart failure care organization in a Swedish county council. The cases concern initiatives to achieve better interactions for these patients and organize care to become more patient-centred. Both initiatives have now been partly abandoned in the organization, although research and guidelines recommend such care organizations. The analysis of the different actors dominating the translation process towards a PCC network and the way they come together in networks reveal that this is a time-consuming process, taking place long after the initial training and PCC implementation activities. We discuss the temporality of stability, the reversible process with chimerical enrolments and how a complex and changing environment demands constant re-problematization of PCC. We also include how the understanding of the translation and negotiation process can influence decisions on allocating sufficient time and resources to the process. We shed light on the importance of understanding and managing the organizational change in a PCC project and thus also of when to implement patient-centred e-health solutions.

Download

Share

COinS