4.2 Article

The historiography of a profession: The societal and political drivers of the health information management profession in Australia

Journal

HEALTH INFORMATION MANAGEMENT JOURNAL
Volume 52, Issue 2, Pages 64-71

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/18333583211070336

Keywords

health information manager; electronic medical records; health professions; scientific medicine; standardisation; health information; medical records; health ICT

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This article identifies and contextualizes the societal and political drivers that have shaped contemporary Australian health information management and HIMs' scientific work. It discusses eight critical, socio-political drivers including scientific medicine, standardization, non-medical healthcare managers, bureaucratisation in healthcare, technologisation, the fast-paced risk society, the health consumer movement, and the commodification of health information. These forces continue to shape the profession and will impact its direction.
Health information permeates healthcare delivery from point-of-care, across the continuum of care and throughout the healthcare system's policy, population health, research, planning and funding arenas. Health information managers (HIMs) expertly manage that information. This commentary theorises the health information management profession for the first time. Its purpose is to identify and contextualise, via a historiographical account, the societal and political drivers that have shaped contemporary Australian health information management and HIMs' scientific work. It seeks to build our knowledge of the socio-political influences on the profession's emergence and development, and the projected drivers of its future. Eight critical, socio-political drivers were identified and are addressed in temporaneous order. Scientific medicine has reflected the influences on medicine in the past century and a half of the medical record and other technologies, laboratory-based sciences, evidence-based medicine and evidence-based health. Standardisation has underpinned and guided the profession's practice. The hegemony of non-medical healthcare managers and resource- and performance-related accountabilities emerged in the 1960s, as did the efficiencies of bureaucratisation in healthcare and post-bureaucratic shifts to textualisation and technogovernance. Technologisation has driven constant change in health information management, as have the forces of the fast-paced risk society. Since the 1980s, the health consumer movement has propelled regulatory mechanisms that accord patients' access rights to their medical records and mandate information privacy protections. Finally, a nascent commodification of health information has emerged. These forces exert ongoing impacts on the profession. They will, we conclude, singularly and collectively continue to shape its discourses and direction.

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