Multilevel structures and human agency in relation to email consultations

A strong structuration theory analysis of the Danish general practice setting

Dados Bibliográficos

ID5010184
AutoresElisabeth Assing Hvidt (0000-0003-3762-8478, University of Southern Denmark, autor correspondente), Anette Grønning (0000-0002-5782-9739, University of Southern Denmark), Matilde Nisbeth Brøgger (0000-0001-5133-1529, Aarhus University), Jane Ege Møller (0000-0003-2661-0256, Aarhus University), Antoinette Fage-Butler (0000-0002-4849-0227, Aarhus University)
Ano2021
Volume282
Páginas114155
Data de publicação2021-08-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSocial Science & Medicine (JOURNAL)
Identificadores do periódicoISSN: 0277-9536 • E-ISSN: 1873-5347
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2021.114155
PMID34174578
OpenAlexW3173408607
IdiomaEN
Citações recebidas7
Referências citadas32

In recent years and throughout the developed world, policymakers have encouraged the implementation of digital patient-clinician interaction. Our focus is on the Danish general practice setting where email consultations were implemented as a mandatory service in 2009 and now constitute 21% of all consultations in general practice. Drawing upon strong structuration theory (SST), our analysis sets out to explore how email consultations are represented in structures on macro, meso and micro-levels and how the interplay between structures and agents plays out with respect to possible alignments, tensions and adjustments. We analyze data from policy documents on the macro and meso-levels, data from clinics' websites (meso-level) and data from interviews with GPs and patients (micro-level) (n = 53). Our findings show that the introduction of email consultation as a new health technology is a key site for development in email consultation practice, professional boundary setting and adjustments within the doctor-patient relationship. Our findings thus demonstrate that email consultation can be considered a dynamic component of a socio-technical network rather than a static medium for simple health transactions or information delivery. Based on these findings, we recommend that, for future implementation of patient-clinician digital communication it is important to investigate the multiple sources of influence on telecare practices and to see its intended users as agents who actively shape their own care motivated by opinions, relationships and values

Agency (philosophy · Business · Danish · Digital health · Health care · Political science · Public relations · Relation (database · Service (business · Sociology · Telecare · Telemedicine · Computer Science · Focus Groups and Qualitative Methods · Healthcare Systems and Technology · Medicine · Mental Health and Patient Involvement · Psychology