Persistent institutional breaches: Technology use in healthcare work

Athanasia Daskalopoulou, Mark Palmer

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Various mobile phone applications (thereafter apps) including, Doctor on Demand, Epocrates, Medscape, MedPageToday, Read by QxMD, UpToDate, challenge instituted ways of working in healthcare. This study explores the institutional breaches arising from the use of apps in doctor-patient interactions. This paper argues that institutional breaches, however small, are important occasions for observing the contextual intersections between healthcare, regulation and technology in a hospital setting. Based on healthcare professionals’ normative judgements, the paper offers an empirically grounded understanding of institutional legitimacy-claiming; safeguarding responses deployed by the instituted regime, and the case-building responses deployed by the instituting persuaders. Institutional breach persistence arises from the moral dimension of legitimacy and is grounded in asymmetrical dynamics between two virtuous healthcare narratives. The paper concludes with a discussion of the contextual intersections between healthcare, regulation and technology, paying particular attention to institutional breaches as experimentation, the contestation of normativity and patterns of technology indulgency in healthcare work.

Keywords: institutional breaches, technology, legitimacy, healthcare, institutions.
Original languageEnglish
Article number114399
Number of pages8
JournalSocial Science & Medicine
Early online date25 Sep 2021
Publication statusPublished - Nov 2021


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