‘Drilling down’ and ‘breaking glass’ – Evolving notions of public service ‘quality’ in the Norwegian health data space

Abstract

The datafication of healthcare and its implications for patients and practitioners are a topic of ongoing study. We suggest that analytic benefit can be gained by (a) unpacking the sometimes ordinary origins of the promissory claims, investments, and shifts in organizations and practices that often precede large-scale health data integration projects, and (b) centring analyses on how such projects relate to institutional shifts in normative concepts such as quality in healthcare and the increasingly institutionalized vocabulary of benefit. We illustrate these features’ relevance through an in-depth empirical case study of ‘the Health Platform’ (HP, Epic) as exemplifying that of what Klaus Hoeyer terms a ‘data space’ – an interface intended to unlock potential for analytics and efficiency across the healthcare sector. To date, this process has been marked by promissory dynamics as well as delays, problems, and ultimately fierce protests. In this context, we ask how might the notion of data spaces help explain evolving notions of quality in healthcare? In response we attempt an early application of Hoeyer et al.’s framework for data-intensive health environments as an interplay of formative and experiential dimensions. Based on our findings, we propose a broadening of Hoeyer et al.'s notion of promises in relation to data spaces, to acknowledge how starting points of constraint, need, and limited choice can cascade into promissory territory.

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