2026-09-21T19:23:44Z https://www.ideals.illinois.edu/oai-pmh

oai:www.ideals.illinois.edu:2142/115540 2023-07-11 col_2142_5131 col_2142_17395 com_2142_5130 com_2142_181 com_2142_8903

Lammers, John C Lammers, John C Poole, Marshall Scott Jackson, Sally A Barley, William C 2022-05 application/pdf en text Submission published under a 24 month embargo labeled 'U of I Access', the embargo will last until 2024-05-01 The student, Ann Bryan, accepted the attached license on 2022-04-13 at 08:31. The student, Ann Bryan, submitted this Dissertation for approval on 2022-04-13 at 08:41. This Dissertation was approved for publication on 2022-04-14 at 07:23. DSpace SAF Submission Ingestion Package generated from Vireo submission #17650 on 2022-11-11 at 11:56:10 The microfoundations of institutional theory and discourse of professionalism: The case of physicians, medical scribes, and electronic health records Bryan, Ann L 2022-04-14 Electronic health records physicians medical scribes institutional theory discourse of professionalism profession This dissertation draws together literature on institutional theory, practice theory, and profession to address the space between policy planning and lived experiences. Using the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and its electronic health record based Meaningful Use Incentive Program as context, two studies were conducted to explore how professionals react to and within institutional arrangements, drawing on the microfoundations of institutional theory and the discourse of professionalism. More specifically, the first study considers meeting transcripts of policy planning and identifies oppositional forces within the discourse of professionalism that became embedded within electronic health records, which healthcare professionals were mandated to use. As a result of these embedded tensions I argue that physicians had opportunity to create their own discourse of professionalism that pushed back against policy intentions through the addition of medical scribes, which was the focus of the second study. Combined, these studies demonstrate the importance of profession in advancing our understanding of materiality and power within institutional scholarship, and in particular working to connect macro perspectives such as policy planning and micro perspectives such as day-to-day work routines. Thesis eng https://hdl.handle.net/2142/115540 Copyright 2022 Ann Bryan Ph.D. Dissertation Communication University of Illinois at Urbana-Champaign Communication