The politics of healthcare informatics: knowledge management using an electronic medical record system.

The design and implementation of an electronic medical record system pose significant epistemological and practical complexities. Despite optimistic assessments of their potential contribution to the quality of care, their implementation has been problematic, and their actual employment in various clinical settings remains controversial. Little is known about how their use actually mediates knowing. Employing a variety of qualitative research methods, this article attempts an answer by illustrating how omitting, editing and excessive reporting were employed as part of nurses' and physicians' political efforts to shape knowledge production and knowledge sharing in a technologically mediated healthcare setting.

Corona hotels in Israel: Care and abandonment under the auspices of digital medicine.

Following the onset of the COVID-19 pandemic, Israel established a number of 'corona hotels' - hybrid spaces that were neither fully treatment-oriented nor fully incarcerational, in which people known or suspected to be infected with the coronavirus were confined, sometimes for prolonged and indefinite periods. This paper describes the experience of 25 people who were confined in corona recovery and isolation hotels between March and July 2020. The corona hotels exemplify how remote medical technology and digital medicine together enable a new 'technogeography of care', where care and abandonment are inextricably linked. The paper adds to the growing number of critical studies on digital health by showing how the employed technologies impact the concepts of human embodiment, subjectivity and social relations, as well as how the occupants negotiated the meaning of these technologies and resisted their effects.

Prediction of vaccine hesitancy based on social media traffic among Israeli parents using machine learning strategies.

INTRODUCTION: Vaccines have contributed to substantial reductions of morbidity and mortality from vaccine-preventable diseases, mainly in children. However, vaccine hesitancy was listed by the World Health Organization (WHO) in 2019 as one of the top ten threats to world health. AIM: To employ machine-learning strategies to assess how on-line content regarding vaccination affects vaccine hesitancy. METHODS: We collected social media posts and responses from vaccination discussion groups and forums on leading social platforms, including Facebook and Tapuz (A user content website that contains blogs and forums). We investigated 65,603 records of children aged 0-6 years who are insured in Maccabi's Health Maintenance Organization (HMO). We applied three machine learning algorithms (Logistic regression, Random forest and Neural networks) to predict vaccination among Israeli children, based on demographic and social media traffic. RESULTS: Higher hesitancy was associated with more social media traffic, for most of the vaccinations. The addition of the social media traffic features improved the performances of most of the models. However, for Rota virus, Hepatitis A and hepatitis B, the performances of all algorithms (with and without the social media features) were close to random (accuracy up to 0.63 and F1 up to 0.65). We found a negative association between on-line discussions and vaccination. CONCLUSIONS: There is an association between social media traffic and vaccine hesitancy. Policy makers are encouraged to perceive social media as a main channel of communication during health crises. Health officials and experts are encouraged to take part in social media discussions, and be equipped to readily provide the information, support and advice that the public is looking for, in order to optimize vaccination actions and to improve public health.

Numbers, graphs and words - do we really understand the lab test results accessible via the patient portals?

BACKGROUND: The heavy reliance on remote patient care (RPC) during the COVID-19 health crisis may have expedited the emergence of digital health tools that can contribute to safely and effectively moving the locus of care from the hospital to the community. Understanding how laypersons interpret the personal health information accessible to them via electronic patient records (EPRs) is crucial to healthcare planning and the design of services. Yet we still know little about how the format in which personal medical information is presented in the EPR (numerically, verbally, or graphically) affects individuals' understanding of the information, their assessment of its gravity, and the course of action they choose in response. METHODS: We employed an online questionnaire to assess respondents' reactions to 10 medical decision-making scenarios, where the same information was presented using different formats. In each scenario, respondents were presented with real (anonymized) patient lab results using either numeric expressions, graphs, or verbal expressions. Participants were asked to assess the gravity of the hypothetical patient's condition and the course of action they would follow if they were that patient. The questionnaire was distributed to more than 300 participants, of whom 225 submitted usable responses. RESULTS: Laypersons were more likely to overestimate the gravity of the information when it was presented either numerically or graphically compared to the narrative format. High perceived gravity was most likely to produce an inclination to actively seek medical attention, even when unwarranted. "Don't know" responses were most likely to produce an inclination to either search the Internet or wait for the doctor to call. POLICY RECOMMENDATIONS: We discuss the study's implications for the effective design of lab results in the patient portals. We suggest (1) that graphs, tables, and charts would be easier to interpret if coupled with a brief verbal explanation; (2) that highlighting an overall level of urgency may be more helpful than indicating a diversion from the norm; and (3) that statements of results should include the type of follow-up required.

"We are here to give you emotional support": performing emotions in an online HIV/AIDS support group.

Since the advent of the Internet, social critics have debated its effects on intimacy and social relationships. I show how, by writing detailed descriptions of their illness experiences, participants in online support groups create emotionally vibrant, empathic communities in which emotional rhetoric frames various moral dilemmas. I illustrate my argument with a detailed analysis of "emotion talk" among members of an HIV/AIDS support group over a 2-year period. My findings add to current debates by encouraging sociologists to consider the emotional dynamics within the online support group as a moral, rather than just psychological or therapeutic, component of interaction.

Unintended consequences of information technologies in health care--an interactive sociotechnical analysis.

Many unintended and undesired consequences of Healthcare Information Technologies (HIT) flow from interactions between the HIT and the healthcare organization's sociotechnical system-its workflows, culture, social interactions, and technologies. This paper develops and illustrates a conceptual model of these processes that we call Interactive Sociotechnical Analysis (ISTA). ISTA captures common types of interaction with special emphasis on recursive processes, i.e., feedback loops that alter the newly introduced HIT and promote second-level changes in the social system. ISTA draws on prior studies of unintended consequences, along with research in sociotechnical systems, ergonomics, social informatics, technology-in-practice, and social construction of technology. We present five types of sociotechnical interaction and illustrate each with cases from published research. The ISTA model should further research on emergent and recursive processes in HIT implementation and their unintended consequences. Familiarity with the model can also foster practitioners' awareness of unanticipated consequences that only become evident during HIT implementation.

'Do you feel sorry for him?': gift relations in an HIV/AIDS on-line support forum.

Sociologists have debated whether meaningful emotional relationships can be formed on-line. Drawing on Mauss' concept of the gift, I explore how caregivers who participate in Hope, an on-line support forum dedicated to HIV/AIDS, incorporate moral percepts and understandings about ethics into their caregiving experiences. Their intense discussions on the essence of familial loyalties give rise to emotionally vibrant, empathic communities in which a socio-emotional economy is formulated. Can the Internet act as a moral space? How are concepts such as reciprocity, obligation, and commitment talked about and practiced in an on-line forum that exists in the ever present?

Negotiating time scripts during implementation of an electronic medical record.

Practitioners renegotiated time use requirements in an electronic medical record (EMR), thereby improving fit between health information technology (HIT) and clinical practices. The study contains important implications for managing HIT implementation.