Clinical Registries as Strategic Experimenting Artifacts: The Case of ‘Top Zorg’ in the Netherlands

• In Event: E/valuative Actions: Exploring the Doings of E/valuation in Evaluative Systems 1

Abstract

Clinical registries, as data collecting and performance displaying artifacts, are part of the datafication or ‘numbering’ trend in healthcare (Essén & Sauder 2016). Through translating clinical work and health outcomes into numbers (e.g. the amount of pressure ulcers on a nursing ward), care practices are rendered commensurable and evaluable, demonstrating (lacking) performance. In this paper, we adopt an experimenting approach to datafication and examine how clinical registries produce new futures for hospital organizations. We build on a national evaluation project on clinical excellence (‘TopCare’) in the Netherlands, in which three non-university hospitals have obtained a (temporal) subsidy to (further) establish and ‘prove’ their clinical and research excellence—seeking to acquire a permanent research status and accompanied finance. Drawing on two ethnographic case studies– biobanking for rare lung diseases and the creation of a registry for specialized eye care– we illuminate how registries are employed and visualized to assure impact. We posit registries as strategic experimenting artifacts, tying into the ambitions of both clinical researchers to build international networks for scientific research and publications, and hospital’s aims to establish a high-quality reputation, as well as financial stability. Examining the ongoing practices and processes of data collection, categorization, commensuration and singularization, and visualization as mechanisms of valuation (Kornberger 2017), we uncover how hospital organizations seek to display and utilize the added value of their clinical care and research. The research adds to STS insights on quantification and (e)valuation, pointing out how datafication offers new registers for building authority, reputation and knowledge practices.

Authors

• Jeroen Postma

• Iris Wallenburg, institute for Health Policy and Management

• Roland Bal, Erasmus university rotterdam