“Most patients think I can see everything, when I open their chart.” – striving for “overview” in cross-sectoral chronic disease management

Abstract textChronic-care-management rely on the availability of clinical data on a patient’s current health status,data about treatment activities taking place in other sectors and at other point in the patient’s trajectory.In the Danish data intensive health system, such data are in principle already available cross-sectoralthrough a common national digital infrastructure. Nevertheless, the collective opinion amongstakeholders is that ‘overview’ of the patient’s case is lacking. In this paper, we explore the striving for‘overview’ among clinicians in cross-sectoral management of type 2 diabetes the digital data retrievalsystem called SAMBLIK (“togetherview”) is introduced. SAMBLIK echoes a well-known story of effortlessdata flow, hoping to enable a digital integration through technological innovation. Following empiricalthreads of ongoing ethnographical fieldwork and drawing on different strands of STS and feministscholarship, we outline a diverse set of ‘uses’ of SAMBLIK that enact different ‘overviews’, supportingbut also deviating from initial idea of use. We preliminary delineate four enactments of overview: 1)realistic overview (e.g., what data is actual available). 2) a total access overview (e.g., ideas of all datain viewing), 3) a visitation overview (e.g. what health services is available) and 4) a non-overview (e.g.,lingering on errors with data material qualities, unintendedly avoiding alternative uses of SAMBLIK).Outlining the fluidity of SAMBLIK and its multiple enactments of overviews is first step toward criticallyevaluating the role of technology in helping data-users deal with the paradoxes of experiencing a needfor more data along with raising amounts of data work.