TEACHING

Doing Field Research on Information Infrastructures

SWS & Credits

This course is a research seminar with excursions

Term: Summer 2026
Format: Research seminar with excursions
Instructors: Kai Reimers (reimers@wi.rwth-aachen.de), Yurou Zhang
Topic: Information Infrastructures for Enforcing Medication Policies in The Netherlands
Credits: 10
Maximum number of participants: 16
Language: English

Programs

Objectives: Students will learn how to conduct field research on the topic of large information systems (information infrastructures). In particular, they will become familiar with the concept of information infrastructures, how to operationalize it for empirical study, and how to collect data through in-depth interviews.

Contents: The so-called digital transformation of the healthcare sector is presently a top priority of many national governments as well as of commercial and professional organizations. Among the various therapies available to patients, medication therapies (therapies based on drugs) are still the most common and effective. Hence, the digitalization of processes involved in medication therapies is often a prime target for governments, health insurance organizations, and medical professionals. There are two main issues addressed by such efforts: the improvement of the safety of medication therapies and the control and possibly lowering of their costs.
Regarding the first area -- medication safety -- the risk of harmful and unintended but avoidable side effects becomes quite significant if a patient takes three or more drugs regularly. Often, the main problem for healthcare professionals is simply to know which drugs a patient takes. This problem can be addressed in various ways, including through a medication plan, a shared national patient record of medication data, and locally maintained patient records of medication data shared with others on demand. Next, healthcare professionals, in this case mostly physicians and pharmacists, need to evaluate the medication in terms of possible interactions between and duplications of the chemically and/or biologically active ingredients of the drugs. This evaluation can be supported by software but cannot be fully automated because adjustments need to be made in view of a comprehensive understanding of the patient’s situation. Most pharmacy and physician systems have already built in some basic checks for such interactions and duplications. More advanced systems can go further, for example by considering a patient’s genetic and physiological conditions.
Regarding the second area – medication costs – governments and health insurance organizations have traditionally adopted policies that, in some way or other, restrict the prescribing behavior of doctors and/or limit the reimbursement of drugs dispensed. A primary means of such efforts is the negotiation of discounted prices with pharmaceutical companies, contingent on the condition that a certain amount of drugs is purchased from these suppliers. In order to enforce such deals, pharmaceutical wholesalers and pharmacy chains need to ensure that doctors prescribe and pharmacists dispense primarily the drugs from these suppliers, unless medical or pharmaceutical conditions suggest otherwise. Again, checking for compliance with such policies can be supported by software but decisions about exceptions still need to be made based on human understanding of the patient’s situation.

In the Netherlands, a specific and interesting approach to digitally supporting these two areas has evolved which operates at the level of pharmacy groups and pharmacy chains. Pharmacy systems usually have implemented basic checks for medication safety. However, the market for pharmacy software is characterized by a large number of relatively small software firms that usually do not have the resources to implement more advanced functions. This gap has been exploited by marketing groups, usually led by drug wholesalers, and pharmacy chains who have developed so-called ‘software shells’ that sit atop the local pharmacy systems and that use advanced functions and technologies to check for medication safety and compliance with prescribing and dispensing rules. In total, there are four such groups/shells, two run by wholesalers and two run by chains.
The purpose of this seminar is to investigate these systems, how they function, how they have evolved, how they are used by pharmacies, which role(s) they play in the strategies of wholesalers and pharmacy chains, and how they structure the interaction with health insurance organizations and government policies. For this purpose, participants will study all available materials on these four systems (published articles, reports, websites etc.) and, based on the understanding acquired in this manner, i.e. on desktop research, conduct in-depth interviews with relevant actors to fill in the gaps that could not be closed through desktop research. Based on these inquiries, they will prepare a report that describes how these systems work and how they have evolved. The report should be such that it is suitable for being submitted to an academic journal.
In practical terms, the seminar will initially focus on required techniques for conducting case study research, based on Robert Yin’s textbook (Yin 2014). In parallel, participants will engage in desktop research about the four pharmacy systems/shells. This phase will be concluded with the presentation of an initial research design, including the naming of possibly relevant organizations and persons to be approached for interviews. In the next phase, students will contact these persons and conduct interviews, ideally face-to-face. Since all destinations in the Netherlands can be easily reached by public transport from Aachen, students are quite flexible in terms of arranging their interviews (travel expenses will be reimbursed by us). Subsequently, participants will work on their final report and, for this purpose, continuously discuss upcoming issues in the regular meetings. Based on a first version, students will present their findings orally and also submit their first report for review. Based on feedback by the instructors, they will prepare the final version of their report.

Regular meetings with mandatory in-person participation: Tuesday, 4:30 to 6:00 p.m. In case of unanticipated problems or illness, a maximum of three sessions can be missed.

Course Dates

Research Seminar

 

Curriculum:

April 14: Kick-off
April 21: Case Study Research, Chapters 1 & 2
April 28: Presentation of first findings of desktop research
May 5: Case Study Research, Chapters 3 & 4
May 12: Presentation of additional findings of desktop research
May 19: Case Study Research, Chapter 5; presentation of research design (first exam)
May 25 - 29: Excursion week; available for interviews and travel
June 2: Initial presentation of findings from empirical research
June 9: Open discussion, questions, problems
June 16: Open discussion, questions, problems
June 23: Presentation and handing in of first report version (exam)
June 30: Feedback on the first version of the report
July 7: Open discussion, questions, problems
July 14: Open discussion, questions, problems
July 21: Report due, to be submitted by email

References

Yin, R. K. 2014. Case Study Research: Design and Methods, Los Angeles et al.: Sage.

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