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From e-Health Policies to the 2.0 Doctor-Patient Relationship
Slomian, Cynthia
2015International Conference on Public Policy
 

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Keywords :
general practitioners; electronic health record; e-health
Abstract :
[en] Europe has a Digital Agenda set until 2020 that encompasses several actions related to health as well as an e-Health Action Plan 2013-2018. Belgium has followed the same path and decided to write down its own e-Health Action Plan 2013-2018. The Belgian financial and political context is quite challenging. On the one hand, health budgets are constantly decreasing and, on the other hand, a 6th State Reform is changing the political organisation, including the health system. The Action Plan is a political document negotiated by the government, insurances, care providers and service user groups in order to develop or integrate existing e-Health initiatives designed to increase financial effectiveness and quality of health care. Since it is conceived as an adequate response to the financial and quality of care challenges, health data sharing is included in that political agenda as a cornerstone of the evolution of the health system. This paper first reports negotiations involved in the making-up of e-Health policies, with a particular focus on policy instruments (Lascoumes & Le Galès, 2005; Halpern, Lascoumes & Le Galès, 2014). Then, by combining public action approaches to policy instruments with the strategic approach to collective action, such as defined by Crozier and Friedberg (1977), this paper analyses the implementation of e-health policies. In that respect, it particularly stresses the development of new organisation and instruments of work by health care providers, especially general practitioners. It focuses on the implementation of the e-Health platform. That initiative was launched in 2008 with the intent of integrating local health networks that developed separately due to the sharing of decision-making power between the federal, regional and community levels of the Belgian State. It had been opposed by medical doctors’ union, which argued that the management of health data registration and communication systems by the state threatened professional obligations as medical confidentiality. In spite of those oppositions between public health authorities and the representatives of the medical profession, general practitioners were required to use digital instruments to share medical data with their professional colleagues and other actors involved in health care delivery. Thus, this paper finally raises the question of the impact of e-Health policies decided by the government on members of the medical profession requested to put them into practice. More specifically, it will wonder about the concrete changes it implies in the doctor-patient relationship specific to the practice of medicine. Key concepts borrowed from sociological approaches to profession, for instance Freidson (1984), Bucher & Strauss (1992) Abbott (2005), will be used in examining that question. On the whole, this paper proposes a comprehensive and multi-level approach to the analysis of the development and implementation of e-Health policies. Methodologically, it is based on detailed analysis of professional, organisational and policy documents as well as 30 semi-structured interviews with representatives of federal and regional institutions, GPs or medical doctor trade union, e-Health experts and GPs of the Province of Liège.
Research center :
Centre de Recherche et d'Interventions Sociologiques
Disciplines :
Sociology & social sciences
Author, co-author :
Slomian, Cynthia ;  Université de Liège > Faculté des sciences sociales > Sociologie des ress. hum. et des systèmes institutionnels
Language :
English
Title :
From e-Health Policies to the 2.0 Doctor-Patient Relationship
Publication date :
July 2015
Event name :
International Conference on Public Policy
Event place :
Milan, Italy
Event date :
du 1 juillet 2015 au 4 juillet 2015
Audience :
International
Available on ORBi :
since 29 April 2016

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