Inquiring into the conceptual framework of actor-network theory through the case of electronic medical records

The spread of Information Communication Technologies (ICT) can currently be observed in multiple domains including in the healthcare sector, where there are various discussions concerning the increasing need for “IT injection” in the healthcare system, and the transformation to a so-called “e-Health Government”. These debates has been accompanied by the inevitably promise that such technologies will provide overall enhancement and sustainability of healthcare services. Information Technology (IT) in general, and Electronic Medical Records (EMRs) in particular, have been viewed as magic formulas to be applied to achieve increase efficiency, coordination and planning, with the effect of decreasing waiting times for patients not to mention costs. However, contrary to expectations, a number of studies have shown that the transition to EMRs is a long and highly challenging process, in which many goals have not yet been met. The complexity arising from the transition to EMRs, encourages broader investigation of whether technologies that are implemented in the healthcare sector are meeting their goals and envisioned potential. The complexities mentioned above, and their relationship with the existing fragmented health care information infrastructure (which now comprises both paper and electronic records), is the focal point of my research. In this paper, I will discuss an empirical case study of the initial phases of the implementation of EMRs in the Primary Health Care (PHC) sector. I will use this case as entry point for a critical discussion of the capacities of Actor Network Theory (ANT) to account for my empirical findings. The motivation behind this paper is neither to advocate ANT, nor to develop ideological objections against it. My aim is rather to examine if ANT privileges or neglects certain aspects of the empirical material, and to explore the theoretical and practical reasons and implications of doing so.