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Information Integrity and Human Infrastructure in Digital Health Care
University West, School of Business, Economics and IT, Divison of Law, Economics, Statistics and Politics. (LINA)ORCID iD: 0000-0002-0493-8974
Ronin Institute, United States.
2019 (English)In: AMCIS 2019 PROCEEDINGS, Association for Information Systems, 2019, p. 1-10Conference paper, Published paper (Other academic)
Abstract [en]

Healthcare informatics is undergoing major changes due to new infrastructures like social media that allow patients to proactively bring information to the physician consultation. We use the concept of infrastructuring to describe these changes, referring to the social practice of adapting human infrastructure for specific contexts. This poses informational and social challenges to providers, as they negotiate new boundaries with patients. Information integrity is essential because of risks to both parties. Infrastructuring in this case is the maintenance of information privacy and accuracy, or information integrity. The tasks of vetting information integrity and managing patient expectations add complexity to provider work even as physicians are positive about patients taking responsibility for their own health. The paper addresses infrastructure transformations, the process of infrastructuring, and a concept of information integrity. Using qualitative data from a medical setting, the study illustrates the contradictions physicians face in accommodating social media to their practice.

Place, publisher, year, edition, pages
Association for Information Systems, 2019. p. 1-10
Keywords [en]
Collaboration, social media, information integrity, human infrastructures, infrastructuring, healthcare
National Category
Information Systems, Social aspects
Research subject
SOCIAL SCIENCE, Informatics; Work Integrated Learning
Identifiers
URN: urn:nbn:se:hv:diva-14452Scopus ID: 2-s2.0-85073502492ISBN: 978-0-9966831-8-0 (electronic)OAI: oai:DiVA.org:hv-14452DiVA, id: diva2:1355381
Conference
Twenty-fifth Americas Conference on Information Systems, Cancún, México, August 15-17, 2019
Available from: 2019-09-27 Created: 2019-09-27 Last updated: 2021-02-05Bibliographically approved
In thesis
1. Digital Work: Coping with Contradictions in Changing Healthcare
Open this publication in new window or tab >>Digital Work: Coping with Contradictions in Changing Healthcare
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Digital work is bringing significant change to all professions, as established work settings are replaced by remote work and digital teamwork and collaboration. Contradictions arise when work is no longer bounded in time or space and personal and professional life merge. This raises several issues. The issues include control of time, professional boundaries, and privacy and security. Healthcare is one area where digital technology is a growing influence on professional work, roles, and relationships. The medical profession demands constant learning as it undergoes accelerating advancements in both medicine and technology. This has the effect of a change in patient-physician relationships as patients access medical information on public sites and interact with providers outside the clinical setting.The research documents the effects of professional use of multiple technologies to interact, share knowledge, and coordinate. The research problem therefore addresses the blending of personal and professional technology use in healthcare specifically and the public sector in general, focusing on the impact of digitally engaged patients on practice.The aim of the thesis is to explore dimensions of digital work that arise from the use of digital technologies in daily work and learning, with a focus on the professional role of physicians.

It poses the following research questions: RQ1) What opportunities and challenges do physicians experience from using digital technologies for work and learning and how do they view their role and expertise in relation to informed and digitally engaged patients? And RQ2) What does the analysis reveal about thecharacteristics of digital work, and its implications for professionalism? The topic covers dynamics between information, technology, and people, in the context of work and learning in healthcare. Therefore, the perspectives guiding the research lie at the intersection of multiple disciplines, like Information Systems, workplace learning and health informatics. The thesis adopts a sociotechnical approach wherein the concept of information system is understood broadly to comprise information content, social context, and specific technologies. For the analysis of the research data, it combines workplace learning theories with concepts from the information infrastructure, and infrastructuring literature to identify and analyze characteristics and contradictions of digital work. The thesis comprises five peer-reviewed research papers. The data comes from 15 semi-structured interviews, three focus groups and a survey of 148 Swedish resident physicians. The project is informed by an engaged research approach, including observations from longitudinal collaborative research, and development projects that involved physicians and other public sector professionals. By exploring and describing physicians’ interactions with multiple digital technologies as part of everyday work, the thesis responds to calls for research to capture the sociotechnical dimensions and effects of digital technologies on work beyond traditional standalone systems. It addresses a real-world problem that public sector healthcare faces, by providing contextual details and insights into how digital health technology and public information intervene in the patient-physician relationship. The findings suggest that digital work can be understood as a process of coping with contradictions, where physicians reconfigure professionalism through ongoing efforts to embrace the new forms of work without sacrificing core values. The thesis concludes with guidelines to address the transformation of professional roles and responsibilities, the new qualities and competencies required for digital work, and the need for interdisciplinary research and consideration of diverse perspectives for an appropriate design of sociotechnical medical systems.

Place, publisher, year, edition, pages
Trollhättan: University West, 2021. p. 97
Series
PhD Thesis: University West ; 44
Keywords
Digital work, Information Systems, physicians, professionalism, workplace learning, flipped healthcare.
National Category
Information Systems, Social aspects
Research subject
Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-16273 (URN)978-91-88847-90-4 (ISBN)978-91-88847-89-8 (ISBN)
Public defence
2021-02-26, 13:00 (English)
Opponent
Supervisors
Available from: 2021-02-05 Created: 2021-02-05 Last updated: 2021-02-05Bibliographically approved

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