Contested meanings of patient-centred care in Klecun (2016)

Core claim

In Klecun (2016), patient-centred care (PCC) is not treated as a single settled idea but as a contested discourse. The article argues that policy and scholarly discussions use PCC in different ways, and these differences matter because they shape what kinds of healthcare transformation are imagined and what role information technology is expected to play. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)

Why PCC is contested

The paper shows that PCC is invoked positively and often normatively, but its meaning is unstable. In some accounts, PCC emphasizes respect for patients’ experiences, values, needs, and participation in decisions. In others, it is linked to choice, access, convenience, responsiveness, and service redesign. Policy discourse can also mobilize PCC to justify wider reforms in organization, governance, and resource allocation. As a result, the same label can support quite different agendas. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)

PCC versus organization-centric care

A key contrast in the paper is between organization-centric and patient-centred healthcare. Organization-centric systems prioritize institutional routines, professional control, and administrative needs. PCC, by contrast, is presented as aspiring to organize care around the patient’s perspective. However, the paper shows that policies may claim to promote PCC while still embedding assumptions that remain organization-led, meaning the shift is more complex than a simple replacement of one model with another. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)

Relation to discourse analysis

Klecun approaches PCC through discourse analysis. This means PCC is understood not just as a care model but as a way of talking about, legitimizing, and directing change. PCC discourse interacts with other discourses identified in the paper, including IT discourse, new public management, e-government, evidence-based medicine, and health economics. Together these shape what transformation is seen as necessary, desirable, and feasible. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)

Why the contested meanings matter for IT

Because PCC is interpreted differently, the role assigned to IT also varies. If PCC means empowering patients and designing around their lived needs, IT would need to support communication, participation, and service experience in patient-relevant ways. But if PCC is interpreted mainly through managerial or policy goals such as system efficiency, provider choice, or structural reform, IT may be designed and implemented around organizational priorities instead. The article therefore links ambiguity in PCC to misalignment in health IT transformation. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)

Main takeaway

The article’s main takeaway is that PCC should not be accepted as a self-evident term. Its multiple and contested meanings shape policy visions, reform strategies, and expectations of IT. Understanding these competing meanings is necessary for evaluating whether healthcare change is genuinely patient-centred or only framed that way rhetorically. Reference: [Policy_discourses_of_IT_and_patient-centred_care](material:135)