The medical profession is highly specialized, demanding continuous learning, while also undergoing rapid development in the rise of data-driven healthcare. Based on clinical scenarios, this study explores how resident physicians view their roles and practices in relation to informed patients and patient-centric digital technologies. The paper illustrates how the new role of patients alters physicians’ work and use of data to learn and update their professional practice. It suggests new possibilities for developing collegial competence and using patient experiences more systematically. Drawing on the notion of flipped healthcare, we argue that there is a need for new professional competencies in everyday data work, along with a change in attitudes, newly defined roles, and better ways to identify and develop reliable online sources. Finally, the role of patients, not only as consumers but also producers of healthcare, is a rather formidable and complex cultural change to be addressed. © The Author(s) 2019.

INTRODUCTION: The emerging context of online platforms and digitally engaged patients demands new competencies of health care professionals. Although information and communication technologies (ICTs) can strengthen continuous professional development (CPD) and learning at work, more research is needed on ICT for experiential and collegial learning.

METHODS: The study builds on prior qualitative research to identify issues and comprises a quantitative assessment of ICT usage for learning in health care. A survey was administered to Swedish physicians participating in a CPD program as part of specialist medical training. Conclusions focused specifically on learning dimensions are drawn from correlation analyses complemented with multiple regression.

RESULTS: The findings show that physicians' actual use of ICT is related to perceived performance, social influence, and organizational context. Social norm was the most important variable for measured general usage, whereas performance expectancy (perceived usefulness of ICT) was important for ICT usage for learning. The degree of individual digitalization affects performance and, in turn, actual use.

DISCUSSION: The study highlights the need to incorporate ICT effectively into CPD and clinical work. Besides formal training and support for specific systems, there is a need to understand the usefulness of digitalization integrated into practice. Moving beyond instrumentalist views of technology, the model in this study includes contextualized dimensions of ICT and learning in health care. Findings confirm that medical communities are influencers of use, which suggests that an emphasis on collegial expectations for digital collaboration will enhance practitioner adaptation.

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.

Information Systems (IS) research and practice face ever more complex challenges as Information Technology (IT) for work expands beyond organizations and merges into everyday life. The COVID-19 pandemic of 2020 has amplified the need to understand digital work and its implications for professionalism. This study addresses that gap in the literature. The focus is on blended IT, referring to the fact that professionals today use personal and organizational IT interchangeably for work, while they also face a new situation of increased citizen involvement in their institutions through IT. This paper draws from three empirical public sector cases with the aim to contribute a deeper understanding of what digital work entails and how public sector professionalism is reconfigured by blended IT.

The research question is: how is public sector professionalism reconfigured in digital work? Our findings illustrate this reconfiguration in three main ways: a) the personal and professional uses of IT merge,influencing professional autonomy; b) the incursion of patient and citizen IT into the scope of work challenges established views on knowledge and expertise; and c) altogether, balancing the streams of blended IT impinges on the core value of the common good that is characteristic of public sector professionalism. These three processes of reconfiguration outline professionalism in digital work.