Les défis que soulève l’informatisation de la pratique médicale sur le plan de l'innovation technologique
Bibliographic record
Abstract
Résumé : Dans cet article, nous explorons les multiples défis soulevés par l’informatisation du travail médical à partir de la problématique de la mise en place du virage ambulatoire dans le secteur de la santé. Nous montrons que le processus d’innovation technologique au sein des organisations de soins repose trop souvent sur une logique technico-économique, sous-estimant le rôle du professionnel de la santé en tant que porteur de pratiques. Nous mettons l’accent sur l’idée, forte, qu’il y a nécessité pour ces organisations de repenser le processus d’innovation technologique en intégrant une logique médico-intégrative fondée sur un modèle organisationnel de collaboration entre des sujets aux domaines d’expertise complémentaires (professionnels de la santé, gestionnaires, administrateurs, promoteurs de nouvelles technologies, ingénieurs et informaticiens, etc.), c’est-à-dire un modèle qui permet d’aller à la rencontre de « l’usager réel » et qui ne se limite pas à penser un « usager modèle ». D’où le modèle intégratif sur lequel nous insistons, qui repose à la fois sur le rôle central des professionnels de la santé dans le processus d’innovation technologique comme experts de leur quotidienneté et sur la prise en compte des enjeux technologiques et économiques auxquels sont confrontées les organisations de soins. Finalement, nous posons la nécessité de repenser la communication dans les organisations de soins. Abstract: In this article, based on the problem of the shift to outpatient care in the healthcare sector, we explore the multiple challenges raised by the computerization of medical work. We show how the process of technological innovation within health organizations too often rests on a technical-economic logic, thereby underestimating the role of health practitioners as the ones who communicate practices. We focus on the idea that it is necessary for these organizations to rethink the process of technological innovation by integrating a medical-integrative logic based on an organization model of collaboration between subjects from different areas of expertise (health professionals, managers, administrators, promoters of new technologies, engineers and computer experts, etc.), that is to say, a model that reaches out to the “real user” and that is not limited to picturing a “model user”. This is why we insist on an integrative model, which is based on health professionals as experts of their daily work, playing a central role in the process of technological innovation as well as on the consideration of the technological and economic processes that health organizations are confronted with. Ultimately, we propose that it is necessary to rethink communication between health care organizations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.046 | 0.079 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.005 | 0.030 |
| Scholarly communication | 0.031 | 0.021 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.010 | 0.008 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".