Відмінності між версіями «Generalization (as with experiments) nor theoretical generalization (as with multisite case»

Версія за 06:22, 15 січня 2018

Russell, R.E. Ashcroft, and W. ParsonseHealth system is very best conceptualized not as a blueprint and implementation strategy for a state-of-the-art technical program but as a series of overlapping, conflicting, and mutually misunderstood language games that combine to produce a scenario of ambiguity, paradox, incompleteness, and confusion. But going beyond technical "solutions" and engaging with these language games would clash with the bounded rationality that policymakers ordinarily employ to produce their eHealth programs manageable. This may clarify their limited and contained response towards the nuanced messages of in-depth case study reports. Conclusion: The complexity of modern wellness care, combined together with the multiple stakeholders in large technologies initiatives, implies that national eHealth applications require significantly a lot more pondering via than has at times occurred. We will need fewer grand plans and much more finding out communities. The onus, as a result, is on academics to develop methods of drawing judiciously on the richness of case studies to inform and influence eHealth policy, which necessarily occurs within a simplified decision atmosphere. Keywords: eHealth, policymaking, case study, ethnography, evaluation, Wittgenstein, sensemaking, mastering community.eHealth Policy: The Canon of HistoryThose who ignore history are doomed to repeat it. --George APD356 manufacturer Santayana (1863?952)National eHealth programs rarely unfold as predicted, especially when very carefully planned out in title= f1000research.9271.1 advance. Obviously, that is definitely since they're complex and title= s12916-016-0650-2 unpredictable. But policymakers typically persist in considering that issues will go far better subsequent time. Their hubris has reached a level that deserves to be researched in its own right. To that finish, this article argues that lessons are hardly ever learned from national eHealth programs for the reason that insufficient value is placed on in-depth case research, and it makes this case on philosophical as opposed to methodological grounds. We propose that national eHealth programs and, by extension, other complex technology projects with a number of stakeholders and interdependencies could usefully be reconceptualized as Wittgensteinian language games.Why National eHealth Programs Have to have Dead PhilosophersThe United States' 2009 Well being Facts Technologies for Financial and Clinical Health (HITECH) Act allocated up to 27 billion for the adoption and "meaningful use" of electronic well being records by physicians and hospitals involving 2011 and 2015 (Blumenthal and Tavenner 2010). Australia's federal price range for 2010/2011 included A 466.7 million (US 473 million) for the design, building, and title= JVI.00458-16 national rollout of a personally controlled electronic wellness record (PCEHR) (Westbrook and Braithwaite 2010). By 2010, Canada's Overall health Infoway implementation plan had been allocated C two.13 billion (US 2.16 billion) (Whitt 2010). In some ways, Engl.Generalization (as with experiments) nor theoretical generalization (as with multisite case comparisons or realist evaluations). But they do deliver the facility for heuristic generalization (i.e., to achieve a clearer understanding of what is going on), thereby enabling additional productive debate about eHealth programs' complex, interdependent social practices. A national Address correspondence to: Trisha Greenhalgh, Yvonne Carter Constructing, 58 Turner Street, London E1 2AB (e-mail: p.greenhalgh@qmul.ac.uk).The Milbank Quarterly, Vol. 89, No. four, 2011 (pp. 533?63) c 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.T.