My Research: How Did I Get There?
Today I planned to give you an overview of my research project but it occurred to me: before I get there, I should tell you how I got there. One of the first questions people ask when I tell them about my dissertation is how I became interested in electronic health records. Unlike many people who have studied health IT or work with informatics, I didn’t come through healthcare.
I’ve always had an interest in how technology informs, shapes and changes social interactions (and by extension, culture). My first professional experience — writing an advice column for teen-aged boys with a passion for videogaming — was actually an excellent test bed for these interests. My column existed as part of media entity that was oriented around entertainment and would seem to have no interest in social good. But because I was passionate about my work, serious about helping my readers, and willing to embrace the technology available both as a writer and as someone nurturing a community, I truly believe my successes reflected the best potential of technology: positively impacting individual lives while also hopefully informing and entertaining wider audiences.
I addressed questions of love, sexual health, emotional growth — and the potentially contraceptive effects of Mountain Dew — with honesty, respect and fact, all of which were and sadly still can be in short supply for your average teen male.
After my tenure as an advice columnist, I moved back into academic work. I pursued a Master’s degree at Georgetown where I became interested in some of the more theoretical underpinnings of cultural representations of technology. I also continued to explore the ways in which technology impacts people and culture itself, specifically in organizational and business contexts, both nationally and internationally.
At UC Irvine, I followed these threads by studying three main areas of interest: organizations, social networks, and culture. In 2007 I began work on my dissertation research. By that time, I was trained in qualitative research methods and knew I wanted to conduct an ethnography. My combined and ongoing interest in organizational change, technology, social networks, and culture pointed to the healthcare field and specifically to EHR.
But why clinicians? Why focus on physicians and other healthcare providers? Healthcare is a complicated industry with — as everyone knows — an ever-growing number of problems. Even if every solution we can come up with is oriented around patient care, the clinician should somehow be involved in those solutions in a positive, collaborative way. All I could think of was that, ultimately, happier physicians able to do their jobs more effectively might lead to better patient care. It’s simple and perhaps to some, too simple, but why not see if we could solve some problems at the physician level to see if there would be a ripple effect?
As the mandate for EHR grows, the contested landscape of healthcare will not likely calm, and there is a palpable lack of knowledge about how massive technological shifts will affect everyone along the chain of wellness. The outcome of this research is not a unified solution for how or why EHR is useful (or not), or the best way to design or implement it. Rather, it’s another milestone in a long term interest in observing and questioning how people make use of technology. I believe there are answers in those questions that can shape both the technology and ways people use it so that we can realize the best hopes of a technology-infused culture: health, happiness and security for everyone who engages. Even those lonely teen boys, looking for an answer.
So, in order to begin looking for these answers, I set out in late 2007/early 2008 to examine a networked group of ambulatory care clinics that, as a recently formed and unified organization, was poised to transition from an entirely paper record system to an electronic system. In my next post, I’ll tell you more about how I conducted my research.
