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Professional culture, information security and healthcare quality—an interview study of physicians’ and nurses’ perspectives on value conflicts in the use of electronic medical records

Journal article
Authors Maria Skyvell Nilsson
Marianne Törner
Anders Pousette
Published in Safety in health (BMC)
Volume 4
Issue 11
ISSN 2056-5917
Publication year 2018
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Language en
Keywords Healthcare quality, Organisational culture, Value conflicts, Information security, Rule compliance, Information management
Subject categories Applied Psychology


Background: Digital healthcare information systems impose new demands on healthcare professionals, and information security rules may induce stressful value conflicts, which the professional culture may help professionals to handle. The aim of the study was to elucidate physicians’ and registered nurses’ shared professional assumptions and values, grounded in their professional cultures, and how these assumptions and values explain and guide healthcare professionals’ handling of value conflicts involving rules regulating the use of electronic medical records. Methods: Healthcare professionals in five organisations in two Swedish healthcare regions were interviewed. Results: The study identified ensuring the patients’ physical health and well-being as the overarching value and a shared basic assumption among physicians and registered nurses. A range of essential professional and organisational values were identified to help attain this goal. In value conflicts, different values were weighted in relation to each other and to the electronic information security rules. Conclusions: The results can be used to guide effective design and implementation of electronic medical records and information security regulations in healthcare.

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