{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:23:21Z","timestamp":1777929801407,"version":"3.51.4"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Research Council of Norway","doi-asserted-by":"publisher","award":["HELSEVEL 314382"],"award-info":[{"award-number":["HELSEVEL 314382"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"abstract":"<jats:p>Coordination among health professionals across levels of care is essential for safe treatment, yet fragmented digital systems complicate the obtaining and sharing of patients\u2019 medication information. This ethnographic study explores how medication information is coordinated in everyday work and how tools are involved. We observed 145 hours of work and conducted 24 interviews with physicians, pharmacists, and nurses in Norwegian primary and specialized care. Data were analyzed thematically, informed by sociocultural and boundary work perspectives. We found that coordination is continuous, situated work that can be supported, but not replaced, by digital tools. The observed health professionals engaged in both competitive and collaborative boundary work. Competitive strategies (disengagement, opposing established responsibilities, and delegating work tasks) rendered coordination of medication information \u201cdirty work.\u201d Collaborative strategies (requesting information, cleaning up, and preventing discrepancies) restored alignment and enabled the sharing of accurate information. Digital medication lists operated as boundary objects: they facilitated the sharing of patients\u2019 medication use but sometimes failed to align perspectives, contributing to fragmentation and the construction of \u201cdirty work.\u201d Conceptually, we extend boundary work understandings by documenting the defense against jurisdiction as a competitive strategy and by demonstrating how this boundary work may produce \u201cdirty work.\u201d This study thus contributes to understanding the interplay between structural fragmentation, professional practices, and digital tools in healthcare coordination. Policy and system design should recognize and support the boundary work that enables the coordination of medication information.<\/jats:p>","DOI":"10.1177\/10497323261433815","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T21:22:20Z","timestamp":1776288140000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Coordinating Medication Information Across Primary and Specialized Care: An Ethnographic Study of Health Professionals\u2019 Work and Use of Digital Tools"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5257-1211","authenticated-orcid":false,"given":"Stine Agnete","family":"Ingebrigtsen","sequence":"first","affiliation":[{"name":"University Hospital of North Norway"},{"name":"University of Troms\u00f8 \u2013 The Arctic University of Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Line Lundvoll","family":"Warth","sequence":"additional","affiliation":[{"name":"University of Troms\u00f8 \u2013 The Arctic University of Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.7208\/chicago\/9780226189666.001.0001"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/089124100129023936"},{"key":"e_1_3_6_4_1","volume-title":"The invisible work of nurses: Hospitals, organisation and healthcare","author":"Allen D.","year":"2015","unstructured":"Allen D. (2015). The invisible work of nurses: Hospitals, organisation and healthcare (1st ed.). Routledge. https:\/\/doi.org\/10.4324\/9781315857794","edition":"1"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1525\/sop.2013.56.3.327"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191028"},{"issue":"1","key":"e_1_3_6_7_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4220\/Sykepleienf.2016.56830","article-title":"Elektronisk meldingsutveksling ved utskrivning av pasienter fra sykehus til kommune [Electronic message exchange at discharge from hospital to municipal care]","volume":"11","author":"Brattheim B. J.","year":"2016","unstructured":"Brattheim B. J., Helles\u00f8 R., Melby L. (2016). Elektronisk meldingsutveksling ved utskrivning av pasienter fra sykehus til kommune [Electronic message exchange at discharge from hospital to municipal care]. Sykepleien Forskning, 11(1), 26\u201333. https:\/\/doi.org\/10.4220\/sykepleienf.2016.56830","journal-title":"Sykepleien Forskning"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/13620-004"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0730888420983396"},{"key":"e_1_3_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315609901"},{"key":"e_1_3_6_11_1","volume-title":"Research design: Qualitative, quantitative & mixed methods approaches","author":"Creswell J. W.","year":"2018","unstructured":"Creswell J. W., Creswell J. D. (2018). Research design: Qualitative, quantitative & mixed methods approaches (5th ed.). Sage.","edition":"5"},{"key":"e_1_3_6_12_1","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI230936"},{"key":"e_1_3_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/01708406221074146"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1108\/JOE-06-2023-0032"},{"key":"e_1_3_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijmr.12330"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/135050840072008"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/2095325"},{"key":"e_1_3_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098619858049"},{"issue":"31","key":"e_1_3_6_19_1","first-page":"63","article-title":"Entusiastisk etablering og kontinuerlig vedlikehold: Samhandling p\u00e5 tvers av grenser innenfor helsetjenesten [Enthusiastic establishment and continuous maintenance: Coordination across boundaries in within health care services]","volume":"17","author":"H\u00e5land E.","year":"2015","unstructured":"H\u00e5land E., Osmundsen T. (2015). Entusiastisk etablering og kontinuerlig vedlikehold: Samhandling p\u00e5 tvers av grenser innenfor helsetjenesten [Enthusiastic establishment and continuous maintenance: Coordination across boundaries in within health care services]. Nordiske Organisasjonsstudier, 17(31), 63\u201385. https:\/\/hdl.handle.net\/11250\/2473183","journal-title":"Nordiske Organisasjonsstudier"},{"key":"e_1_3_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11947-4"},{"key":"e_1_3_6_21_1","first-page":"153","volume-title":"Digitalisering i sykepleietjenesten \u2013 en arbeidshverdag i endring","author":"Helles\u00f8 R.","year":"2019","unstructured":"Helles\u00f8 R., Lyngstad M., Brattheim B. J., Melby L. (2019). Samhandling mellom sykepleiere i spesialist- og kommunehelsetjenesten f\u00f8r, under og etter samhandlingsreformen [Coordination between nurses in specialist and municipal healthcare services before, during, and after the Coordination Reform]. In Helles\u00f8 R., Olsen R. M. (Eds.), Digitalisering i sykepleietjenesten \u2013 en arbeidshverdag i endring (pp. 153\u2013176). Cappelen Damm Akademisk. https:\/\/doi.org\/10.23865\/noasp.71"},{"key":"e_1_3_6_22_1","unstructured":"Hertzum M. Ellingsen G. A. (2023). Infrastructural complexity: A mapping of medication management in Norway. In Infrahealth 2023 - Proceedings of the 9th international conference on infrastructures in healthcare 2023 Siegen Germany European Society for Socially Embedded Technologies (EUSSET). https:\/\/doi.org\/10.48340\/ihc2023_p004"},{"key":"e_1_3_6_23_1","volume-title":"Men and their work","author":"Hughes E. C.","year":"1958","unstructured":"Hughes E. C. (1958). Men and their work. Free Press."},{"key":"e_1_3_6_24_1","doi-asserted-by":"publisher","DOI":"10.7577\/pp.5928"},{"key":"e_1_3_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.02.004"},{"issue":"62382","key":"e_1_3_6_26_1","first-page":"e62382","article-title":"Inadequate medication reconciliation in hospitals","volume":"12","author":"Kleppe T.","year":"2017","unstructured":"Kleppe T., Haavik S., Kvangarsnes M., Hole T., Major A.-L. S. (2017). Inadequate medication reconciliation in hospitals. Sykepleien Forskning, 12(62382), Article e62382. https:\/\/doi.org\/10.4220\/Sykepleienf.2017.62382en","journal-title":"Sykepleien Forskning"},{"key":"e_1_3_6_27_1","doi-asserted-by":"publisher","DOI":"10.5465\/annals.2017.0089"},{"key":"e_1_3_6_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s44247-024-00108-6"},{"key":"e_1_3_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsw\/bcab209"},{"key":"e_1_3_6_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy9010046"},{"key":"e_1_3_6_31_1","doi-asserted-by":"publisher","DOI":"10.18778\/1733-8077.11.3.05"},{"key":"e_1_3_6_32_1","first-page":"243","volume-title":"Qualitative research practice: A guide for social science students and researchers","author":"Nicholls C. M.","year":"2014","unstructured":"Nicholls C. M., Mills L., Kotecha M. (2014). Observation. In Ritchie J., Lewis J., Nicholls C. M., Ormston R. (Eds.), Qualitative research practice: A guide for social science students and researchers (pp. 243\u2013267). Sage Publications."},{"key":"e_1_3_6_33_1","unstructured":"Norwegian Ministry of Health and Care Services. (2012). Forskrift om fastlegeordning i kommunene (fastlegeforskriften) [Regulation on the general practitioner scheme in the municipalities (the GP regulation)]. https:\/\/lovdata.no\/dokument\/SFO\/forskrift\/2012-08-29-842"},{"key":"e_1_3_6_34_1","unstructured":"Norwegian Ministry of Health and Care Services. (2008). Forskrift om legemiddelh\u00e5ndtering for virksomheter og helsepersonell som yter helsehjelp [Regulation on medication management for institutions and healthcare personnel providing healthcare services]. https:\/\/lovdata.no\/dokument\/SF\/forskrift\/2008-04-03-320"},{"key":"e_1_3_6_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/10497323251340934"},{"key":"e_1_3_6_36_1","volume-title":"Helsetjenesten i Norge: et overblikk [Health care services in Norway: An overview]","author":"Nylenna M.","year":"2020","unstructured":"Nylenna M. (2020). Helsetjenesten i Norge: et overblikk [Health care services in Norway: An overview] (2nd ed.). Gyldendal.","edition":"2"},{"key":"e_1_3_6_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732319839363"},{"key":"e_1_3_6_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-05517-w"},{"key":"e_1_3_6_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03200-6"},{"key":"e_1_3_6_40_1","volume-title":"Renew, strengthen, improve","author":"Report No. 23","year":"2024","unstructured":"Report No. 23 (2024\u20132025). Renew, strengthen, improve. https:\/\/www.regjeringen.no\/contentassets\/438ae59dbd794286839a92259d07b59d\/no\/pdfs\/stm202420250023000dddpdfs.pdf"},{"key":"e_1_3_6_41_1","volume-title":"National health and hospital plan 2020\u20132023","author":"Report No. 7","year":"2019","unstructured":"Report No. 7 (2019\u20132020). National health and hospital plan 2020\u20132023. https:\/\/www.regjeringen.no\/en\/dokumenter\/meld.-st.-7-20192020\/id2678667\/"},{"key":"e_1_3_6_42_1","volume-title":"One citizen, one health record","author":"Report No. 9","year":"2012","unstructured":"Report No. 9 (2012-2013). One citizen, one health record. https:\/\/www.regjeringen.no\/no\/dokumenter\/meld-st-9-20122013\/id708609\/"},{"key":"e_1_3_6_43_1","volume-title":"National health and coordination plan 2024\u20132027","author":"Report No. 9","year":"2023","unstructured":"Report No. 9 (2023-2024). National health and coordination plan 2024\u20132027. https:\/\/www.regjeringen.no\/contentassets\/4e5d9e6c63d24cd7bdab5d8c58d8adc4\/no\/pdfs\/stm202320240009000dddpdfs.pdf"},{"key":"e_1_3_6_44_1","volume-title":"Interpreting qualitative data","author":"Silverman D.","year":"2020","unstructured":"Silverman D. (2020). Interpreting qualitative data (6th ed.). Sage Publications.","edition":"6"},{"key":"e_1_3_6_45_1","doi-asserted-by":"publisher","DOI":"10.1057\/9780230393530"},{"key":"e_1_3_6_46_1","doi-asserted-by":"publisher","DOI":"10.18261\/issn.2387-5984-2021-02-02"},{"key":"e_1_3_6_47_1","doi-asserted-by":"publisher","DOI":"10.1057\/9780230393530_11"},{"issue":"1","key":"e_1_3_6_48_1","first-page":"16","article-title":"Hjemme-sykepleien i samhandling med spesialist-helsetjenesten [Home care services in coordination with specialized care]","volume":"11","author":"T\u00f8nnessen S.","year":"2016","unstructured":"T\u00f8nnessen S., Kassah B. l. l., Tingvoll W.-A. (2016). Hjemme-sykepleien i samhandling med spesialist-helsetjenesten [Home care services in coordination with specialized care]. Sykepleien Forskning, 11(1), 16\u201324. https:\/\/doi.org\/10.4220\/Sykepleienf.2016.56496","journal-title":"Sykepleien Forskning"},{"key":"e_1_3_6_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.117692"},{"key":"e_1_3_6_50_1","volume-title":"Mind in society: Development of higher psychological processes","author":"Vygotsky L. S.","year":"1978","unstructured":"Vygotsky L. S. (1978). Mind in society: Development of higher psychological processes. Harvard University Press."},{"key":"e_1_3_6_51_1","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.302"},{"key":"e_1_3_6_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10485-9"},{"key":"e_1_3_6_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/01708406221074135"},{"key":"e_1_3_6_54_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511803932"},{"key":"e_1_3_6_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/135050840072002"},{"key":"e_1_3_6_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470802127098"},{"key":"e_1_3_6_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06059-5"},{"key":"e_1_3_6_58_1","volume-title":"Medication safety in transitions of care: WHO technical report","author":"World Health Organization","year":"2019","unstructured":"World Health Organization. (2019). Medication safety in transitions of care: WHO technical report. https:\/\/www.who.int\/publications\/i\/item\/WHO-UHC-SDS-2019.9"}],"container-title":["Qualitative Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10497323261433815","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10497323261433815","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10497323261433815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:54:09Z","timestamp":1777679649000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10497323261433815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":57,"alternative-id":["10.1177\/10497323261433815"],"URL":"https:\/\/doi.org\/10.1177\/10497323261433815","relation":{},"ISSN":["1049-7323","1552-7557"],"issn-type":[{"value":"1049-7323","type":"print"},{"value":"1552-7557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"article-number":"10497323261433815"}}