The DOT-system as an actor-network
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2016-07-12
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en
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Abstract
Over the last decades, thoughts based on the philosophy of New Public Management (NPM) have been the driver for changes within public sector organizations. In health care, the philosophy that NPM encompasses has been the driver for the introduction of a cost-effective accounting system. This system, based on ‘diagnosis-treatment combinations’ (DTC) helps to codify performed clinical activities in a systematic manner, thereby covering the complete process of care into an end product to invoice. Over the years, the DTC-system has received a lot of critique. Therefore, in 2012 an improved program has been introduced, referred to as ‘DTC on its way to transparency’ (DOT). This qualitative research examines how the DOT-system in hospitals performs as an actor-network. It does so by incorporating an actor-network approach, which allows to provide insight in how human actors and objects of technology may combine to provide networks within organizations. The results show that because the DOT-system is able to establish itself as an obligatory passing point medical professionals have to pass, medical professionals have to interact with the system in order to achieve a long-term interest. The system establishes a frame which determines the identity and room of maneuver for medical professionals. It affects them as they cannot escape from the frame without forsaking their long-term interest for the Hospital and the exercise of their profession. Their common goal with the DOT-system on the long-term and the people who speak for it create a strong connection with the medical professionals and this makes them keep connecting with the system. Practically, this means that a back-log in registration is done at another moment, whether this is during a break, in the evening at home, or even during weekends.
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Faculteit der Managementwetenschappen