SSE/EFI Working Paper Series in Business Administration,
Stockholm School of Economics

Abstract: In this paper I theorize about how transforming the interpretative scheme for what a patient record is might restructure a health care setting. The observations presented here were obtained when I during three years followed implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed and interpreted within a framework combining theories about knowledge management with concepts from structuration theory and cognitive theories about schema-use, representations and sense-making. The findings indicate that thinking about the patient record as a knowledge management system might start a horizontal and vertical movement, a movement of coordination and enhancement. I propose that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.

Keywords: interpretative schemes; anesthesia patient record; knowledge management system; knowledge management; structuration theory

19 pages, First version: March 14, 2007. Revised: August 11, 2007. Earlier revisions: April 14, 2007, April 14, 2007, April 14, 2007, April 17, 2007, April 19, 2007, April 24, 2007, May 7, 2007, May 8, 2007, May 17, 2007, August 1, 2007, August 3, 2007.

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