Patient Records & Patient Subjectivity Research - Two Pathways

 Patient Medical Records Research Projects Pathways

 Two Research Teams:  Health Insurance Team | Medical Research Team

Where? Domain (or Field)	Who? Subjects (Kinds of People)	When?	Which specific objects of inquiry?	How inequalities get set up.	--------->	Specific Object of Inquiry
Health Care Insurance	Patients (& their cognates)	both Early 20th (00s-30s) and Post-war (50s-70s)	Subjectivity		--------->	??Insurance Contracts & Standards + Patient Records
Hospital Research					--------->	??Research Data + Patient Records
Other possible vectors/categories listed below… (not a current research focus)
Clinic	Doctors			Doctors v Nurses		Journals & Conferences
Hospital	Nurses		Power	Gender Inequalities		Textbooks
Law	Researchers	Late 20th century		Racial Inequalites		Insurance Contracts
Econ/Mkt	Records Clerks			Class/SES Inequalities		Legal Docs
Gov’t			Knowledge
		Early Modern
		Mid 19th Century

Questions (more) about medical records coming out of Berg & Bowker

How did the medical record come to mediate its _______ ?


What domain(s) are our focus?  The clinical setting.  Hospital.  Insurance setting (health, life, malpractice?).  Research setting.  Legal setting (e.g.,, malpractice). Educational.  Governmental. Economics.  Public health.


Who is our focus?  What kinds of subjects?  Patients.  Professionals.


How do the records set up terrains of inequality?  E.g., between doctors and nurses, or between differently-gendered patients, or other differently-classed patients? access inequality. legal accountabilities.


When is our focus?  Early modern? 19th century (esp. professionalization).  Early twentieth-century?  Post-war period?  Late-20th century?


Which is our primary category of analysis (just to start)?  Power?  Knowledge?  Subjectivity?


                  Falling out of the above.... we might get our object of inquiry.


Specific objects of inquiry (what technologies/techno-practices?): early standardized medical records (when?); medical records textbooks (when were the first ones written?); insurance company reports?; legal documents (public case records)

Questions about medical records coming out of reading of Focuault

The Patient Question: [When does the subject who goes to the hospital to be cured change?  Who is going to hospitals?  When and why?  What kind of persons do we have on hospital beds?  When are they 'patients'?]

Subject of Medicine Question:  [When does the subject begin to be defined by these medical records?  When are persons, and not just patients, medicalized?  Relatedly, when do medical records become privileged?]

Medical Records Questions:  [When do medical records begin to be preserved within hospitals? Standardized to an extent so they can be distributed between different hospitals?  Summarizable so they can be extended to other domains/practices (i.e., medical records used in education, in criminal court, in insurance contracts, in epidemeology)?  These other domains/practices might be a possible entry in.]

Technical function of medical records technology:  [Who is compiling the medical records?  Nurses?  Medical secretaries?  What is their knowledge, role, and technological function?  Training manuals as a possible entry in.]

 Framing Question: What literature should our analysis be framed through?  Who is our audience?  What disciplines and/or journals do we want to speak to?


One possible hunch (but just a hunch at this point): [If the medicalization of the hospital was an effect/strategy (?) of 18^th c. disciplinary power, then the medicalization of the person-become-patient was an effect/strategy (?) of 20^th c. infopolitical documentation.]