Between representation, reorganization and control: the informal technification of intensive care units and the consequences

Abstract

"Relying upon an ethnographical study in the field of intensive care medicine, the paper shows how economic requirements are restructuring medical knowledge and practice on intensive care units (ICUs). As such, emphasis is placed on the special role that the IT network plays in this reorganizing process. The digitalization process allows linking the monitoring system, not only with the electronic patient record, but also with the management information system beyond the ward. Thereby, the former socially and ethically closed sphere of the ICU is opened up to organisational and economical requirements. Presenting two examples from the case-study, the paper illustrates how the IT network allows the accounting department to control the organization of work on the ICU as well as displaying the way in which medical classification systems are transformed into economic indicators. Furthermore, the paper explicitly shows how the medical and nursing stuff deal with the conflict of objectives that result from this digitalization and economization process." [author's abstract]