Browsing by Author "Bossen, Claus"
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- Journal ArticleA Worker-Driven Common Information Space: Interventions into a Digital Future(Computer Supported Cooperative Work (CSCW): Vol. 29, No. 5, 2020) Møller, Naja Holten; Eriksen, Maren Gausdal; Bossen, ClausThis paper empirically investigates a Common Information Space (CIS) established by medical secretaries so they could support each other during their workplace’s transition to a new comprehensive electronic health record, called the Healthcare Platform (HP). With the new system, the secretaries were expected to become partially obsolete, as doctors were to take on a significant load of the clerical work, such as documenting and coding. To handle their changing work situation, the medical secretaries set up an online support group in parallel to, but independent from, the official implementation support organization. The paper’s contribution is a characterization of the support group as a common information space (CIS), and analysis of the specific qualities of a worker-driven CIS as a forum for 1) articulation work required for re-grounding changing tasks and responsibilities, 2) archiving discussions (posts) and guidelines to further their collective interpretation, and 3) creating a space independent of management for employees to work out their new role in an organization in a situation of transition and change.
- Journal ArticleAccounting and Co-Constructing: The Development of a Standard for Electronic Health Records(Computer Supported Cooperative Work (CSCW): Vol. 20, No. 6, 40746) Bossen, ClausPatient records are central, constitutive parts of health care and hospitals. Currently, substantial sums are being invested in making patient records electronic, in order to take advantage of IT’s ability to quickly accumulate, compute, and propagate data to multiple sites, to enhance coordination of health care services and cooperation among staff, and make patient records immediately accessible to distributed actors. Investors also aim to increase health care services’ accountability and integration, and improve quality and efficiency. This paper analyses a Danish national standard for electronic health records, on the basis of an application prototype test designed to that standard. The analysis shows that, inscribed in the standard is an ambition to increase the accountability of staff and health care services at the cost of increased work, loss of overview, and fragmentation of patient cases. Significantly, despite the standard having been conceived and developed in a process of co-construction involving clinicians, clinicians did not find it adequate for their work. This analysis argues this was the result of the model of work embedded in the standard coming from a stance external to practice. Subsequently, a flip-over effect occurred, in which the model of work became a model for work. Hence, this paper argues that co-construction processes should not only include users as representatives of a profession, but strive to produce experiences and knowledge intrinsic to practice.
- Journal ArticleBetween a rock and a hard place: Negotiating Dependencies and Precarity in the On-Demand Economy(Computer Supported Cooperative Work, Vol. 31, 2022) Muralidhar, Srihari Hulikal; Bossen, Claus; O'Neill, JackiThere is growing evidence of ride-hailing platforms’ adverse impact on drivers. Nonetheless, hundreds of thousands of drivers continue to work on these platforms. Why? The key contribution of this paper is to show that workers in technology-mediated labour markets come to be increasingly dependent on the technology-provider in order to connect with the customers. As more and more customers choose to get various tasks done via intermediary platforms, for workers who perform such tasks for a living, this translates into growing dependencies on these infrastructuralized platforms for their livelihoods and thus increased vulnerabilities to the impact of platform design and policies. These ‘new dependencies’, therefore, make it critical for us not to conflate workers’ continued use of platforms with their experiencing benefits. By drawing upon a qualitative study with auto-rickshaw drivers using Ola, a ride-hailing platform similar to Uber in India, the paper shows that a consequence of ‘new dependencies’ for drivers is that they are stuck ‘between a rock and a hard place’ whereby: a) on the one hand, the platform design heightens their precarity, provides them with little benefit, and often leads to tensions with customers, b) on the other, a shift of more and more customers from street-hailing to app-based hailing over time exacerbates dependencies for drivers on these very platforms, leaving them with little choice but to continue to use them for work.
- Journal ArticleBetween a Rock and a Hard Place: Negotiating Dependencies and Precarity in the On-Demand Economy(Computer Supported Cooperative Work (CSCW): Vol. 31, No. 3, 2022) Muralidhar, Srihari Hulikal; Bossen, Claus; O’Neill, JackiThere is growing evidence of ride-hailing platforms’ adverse impact on drivers. Nonetheless, hundreds of thousands of drivers continue to work on these platforms. Why? The key contribution of this paper is to show that workers in technology-mediated labour markets come to be increasingly dependent on the technology-provider in order to connect with the customers. As more and more customers choose to get various tasks done via intermediary platforms, for workers who perform such tasks for a living, this translates into growing dependencies on these infrastructuralized platforms for their livelihoods and thus increased vulnerabilities to the impact of platform design and policies. These ‘new dependencies’, therefore, make it critical for us not to conflate workers’ continued use of platforms with their experiencing benefits. By drawing upon a qualitative study with auto-rickshaw drivers using Ola, a ride-hailing platform similar to Uber in India, the paper shows that a consequence of ‘new dependencies’ for drivers is that they are stuck ‘between a rock and a hard place’ whereby: a) on the one hand, the platform design heightens their precarity, provides them with little benefit, and often leads to tensions with customers, b) on the other, a shift of more and more customers from street-hailing to app-based hailing over time exacerbates dependencies for drivers on these very platforms, leaving them with little choice but to continue to use them for work.
- Journal ArticleBoundary-Object Trimming: On the Invisibility of Medical Secretaries’ Care of Records in Healthcare Infrastructures(Computer Supported Cooperative Work (CSCW): Vol. 23, No. 1, 41671) Bossen, Claus; Jensen, Lotte Groth; Udsen, Flemming WittAs health care IT gradually develops from being stand-alone systems towards integrated infrastructures, the work of various groups, occupations and units is likely to become more tightly integrated and dependent upon each other. Hitherto, the focus within health care has been upon the two most prominent professions, physicians and nurses, but most likely other non-clinical occupations will become relevant for the design and implementation of health care IT. In this paper, we describe the cooperative work of medical secretaries at two hospital departments, based on a study evaluating a comprehensive electronic health record (EHR) shortly after implementation. The subset of data on medical secretaries includes observation (11 hours), interviews (three individual and one group) and survey data (31 of 250 respondents were medical secretaries). We depict medical secretaries’ core task as to take care of patient records by ensuring that information is complete, up to date, and correctly coded, while they also carry out information gatekeeping and articulation work. The importance of these tasks to the departments’ work arrangements was highlighted by the EHR implementation, which also coupled the work of medical secretaries more tightly to that of other staff, and led to task drift among professions. Medical secretaries have been relatively invisible to health informatics and CSCW, and we propose the term ‘boundary-object trimming’ to foreground and conceptualize one core characteristic of their work: maintenance and optimization of the EHR as a boundary object. Finally, we reflect upon the hitherto relative invisibility of medical secretaries which may be related to issues of gender and power.
- Conference PaperCollectively Improve the Quality of Life at Work: How and Which Data to Collect and Analyze?(Proceedings of 21st European Conference on Computer-Supported Cooperative Work, 2023) Bossen, Claus; Chassot, Christophe; Datchary, Caroline; Grosjean, Sylvie; Guha, Shion; Lewkowicz, Myriam; Medjiah, SamirThe European Union announced recently that Europe should be a global hub and leader in the development of Artifcial Intelligence (AI) that guarantees safety and fundamental rights (European Commission (2021)). In this workshop, we investigate how we can approach this challenge from the perspective of Computer-Supported Cooperative Work (CSCW). Starting with a general conceptual focus on algorithmic systems and their increasing role in society, we are particularly interested in such systems in and as organisations, and the questions that come up when investigating them as part of complex, cooperative work practices. The full-day workshop, designed for up to 20 participants, advances a CSCW-perspective on algorithmic/AI systems by bringing together researchers within (and where possible beyond) the CSCW community who study algorithmic systems, with the aim of sharing ongoing research and connecting participants with others who share their research interests.
- Conference PaperData Work in Healthcare: An Ethnography of a BI Unit(Infrahealth 2021 - Proceedings of the 8th International Conference on Infrastructures in Healthcare 2019, 2021) Pedersen, Asbjørn Malte; Bossen, ClausIn this paper, we investigate a newly established Business Intelligence unit providing healthcare data and analyses for management and staff at five hospitals in the Region. Created in 2015, the Business Intelligence Unit repurposes data generated by digital healthcare systems and aims to “[...] support the Region [...] in delivering more welfare, better quality, higher impact, and greater sustainability for less money.” Within healthcare – and in other domains – there is a strong push towards becoming (more) data- driven and repurpose data to increase efficiency, quality, and cost-effectiveness. However, whereas there are numerous publications on ‘datafication’ in the abstract, there is a dearth of studies on how the data at the center of such processes is actually produced, and even fewer studies on the people and organizational units engaged in this work. Hence, we are engaged in an ethnographic study on data work at the Business Intelligence Unit in order to gain insights into the work and practices of generating healthcare data for secondary use. In this paper, we present the preliminary findings focusing on three themes: end-user engagement, creating meaningful data reports, and establishing trust. One overall contribution is that whereas Business Intelligence work does require technical competences to work with large-volume data, it also requires competences of engaging with healthcare staff and understanding their work practices.
- Text DocumentDesigning for Transformations in Collaboration: A Study of the Deployment of Homecare Technology(Proceedings of the 2005 ACM International Conference on Supporting Group Work, 2005) Bardram, Jakob E.; Bossen, Claus; Thomsen, AndersTransformations in collaborative work due to the introduction of new technology are inevitable, but are often difficult to study. In this paper, we consider the patterns of transformation that are seen in a patient-physician relationship based on the introduction of homecare monitoring equipment. We report findings from interviews and fieldwork with patients and physicians participating in a clinical experiment of homecare monitoring. By studying both the group of patients who receive homecare-based treatment and the control group we were able to identify transformations in the collaborative activity as caused by the homecare monitoring technology. We apply activity theory as a theoretical basis for this analysis. We consider the implications of these findings for the design of pervasive health monitoring technologies.
- Conference PaperInformation Infrastructures in healthcare and emergent data work occupations: The case of medical scribes and CDIS(Infrahealth 2019 - Proceedings of the 7th International Conference on Infrastructures in Healthcare 2019, 2019) Bossen, Claus; Chen, Yunan; Pine, Kathleen H.The development of information infrastructures in healthcare is often described in abstract terms as datafication, the conversion of qualitative aspects of life into quantified data, which makes the people and actual work involved invisible. To make visible the actors and the efforts implied in the term ‘datafication’, in this paper, we describe two emergent data work occupations in healthcare: Medical scribes and clinical documentation improvement specialists (CDIS). These cases provide a starting point for understanding the impacts of digitization of healthcare and the emergence of new kinds of work and new occupations that health organizations adapted to accommodate such impacts. Making data work visible is important in order for these occupations to be acknowledged. If data work remains invisible, healthcare organizations and researchers alike will have an incomplete understanding of how data is actually produced in practice, hindering the organizational design, human resources, and organizational learning that are essential for healthcare organizations to become competent producers and users of data.
- Journal ArticleInfrastructuring and Ordering Devices in Health Care: Medication Plans and Practices on a Hospital Ward(Computer Supported Cooperative Work (CSCW): Vol. 19, No. 6, 40513) Bossen, Claus; Markussen, RandiIn this paper, we analyse physicians’ and nurses’ practices of prescribing and administering medication through the use of paper-based, and digitalized medication plans. Our point of departure is an ethnographic study of the implications of upgrading an electronic medication module (EMM) that is part of an electronic health record (EHR), carried out at an endocrinology department. The upgrade led to a temporary breakdown of the EMM, and a return to paper-based medication plans. The breakdown made visible and noticeable the taken-for-granted capabilities of medication plans in their paper-based and digital versions, and the distribution of functionalities between medication plans and clinicians. We see the case as an opportunity to analyse infrastructuring in health care, the process by which medical practices and artefacts become parts of social and technological networks with longer reaches and more channels through which coordination among distributed actors is enabled and formed. In this case, infrastructuring means an extended scope and intensity of the coordinative capabilities of medication plans, and an increased vulnerability to, and dependency on events outside the immediate loci of interaction. We particularly note the capacity of the EMM to facilitate different kinds of ordering of information and practices, and propose the conceptualizing of such digitalized artefacts as ‘ordering devices’. Ordering devices order information, stipulate action, and coordinate interaction across and within social worlds, and achieve this through the flexible support of different kinds of ordering.
- Journal ArticleIntroduction to the Special Issue on ‘Information Infrastructures in Healthcare: Governance, Quality Improvement and Service Efficiency’(Computer Supported Cooperative Work (CSCW): Vol. 29, No. 4, 2020) Bossen, Claus; Piras, Enrico Maria
- Journal ArticleMobility Work: The Spatial Dimension of Collaboration at a Hospital(Computer Supported Cooperative Work (CSCW): Vol. 14, No. 2, 38443) Bardram, Jakob E; Bossen, ClausWe posit the concept of Mobility Work to describe efforts of moving about people and things as part of accomplishing tasks. Mobility work can be seen as a spatial parallel to the concept of articulation work proposed by the sociologist Anselm Strauss. Articulation work describes efforts of coordination necessary in cooperative work, but focuses, we argue, mainly on the temporal aspects of cooperative work. As a supplement, the concept of mobility work focuses on the spatial aspects of cooperative work. Whereas actors seek to diminish the amount of articulation work needed in collaboration by constructing Standard Operation Procedures (SOPs), actors minimise mobility work by constructing Standard Operation Configurations (SOCs). We apply the concept of mobility work to the ethnography of hospital work, and argue that mobility arises because of the need to get access to people, places, knowledge and/or resources. To accomplish their work, actors have to make the right configuration of these four aspects emerge.
- Text DocumentMoving to get aHead: Local Mobility and Collaborative Work(ECSCW 2003: Proceedings of the Eighth European Conference on Computer Supported Cooperative Work, 2003) Bardram, Jakob E.; Bossen, ClausLocal mobility is a central aspect of collaborative work that is in need of close analysis. Between the face-to-face interaction of offices or control rooms and longdistance interaction facilitated through e.g. telephones, e-mail, the www or teleconferences lie a number of work-settings in which actors move about continuously in order to accomplish their work. They do so because they need to get access to knowledge, resources, persons and/or places. We analyze the integral nature of mobility to this kind of work practice from the ethnographic description of a hospital department, and the challenges that actors have to face to accomplish their work. Based on this ethnographic case, we propose a set of concepts for understanding local mobility as an intermediate field of distributed cooperation between centres of coordination and remote collaboration. Finally, we introduce the concept of ‘mobility work’ as complementary to the concept of ‘articulation work’.
- Journal ArticleRethinking Financial Inclusion: from Access to Autonomy(Computer Supported Cooperative Work - ECSCW 2019: Proceedings of the 17th European Conference on Computer Supported Cooperative Work, 2019) Muralidhar, Srihari Hulikal; Bossen, Claus; O’Neill, JackiFinancial inclusion has been defined and understood primarily in terms of access, thereby constituting ‘inclusion’/‘exclusion’ as a binary. This paper argues such a view to be myopic that risks treating financial inclusion as an end in itself, and not as means to a larger end. ‘Access’ oriented perspectives also fail to take into account considerations of structural factors like power asymmetries and pay inadequate attention to user practices. Through the case of auto-rickshaw drivers in Bangalore, India, and their use of Ola, a peer-to-peer taxi hailing service similar to Uber, we show that access is a necessary, but not sufficient condition to achieve financial inclusion in a substantive sense. By examining in detail, the financial needs and practices of rickshaw drivers, we identify the opportunities and constraints for digital technology to better support their financial practices and enhance their wellbeing. The paper proposes adding ‘autonomy’ and ‘affordances’ as two crucial factors to be included in the discourse on financial inclusion. Finally, we outline design implications for P2P technologies to contribute towards the financial inclusion of drivers.
- Journal ArticleRethinking Financial Inclusion: from Access to Autonomy(Computer Supported Cooperative Work (CSCW): Vol. 28, 43631) Muralidhar, Srihari Hulikal; Bossen, Claus; O’Neill, JackiFinancial inclusion has been defined and understood primarily in terms of access, thereby constituting ‘inclusion’/‘exclusion’ as a binary. This paper argues such a view to be myopic that risks treating financial inclusion as an end in itself, and not as means to a larger end. ‘Access’ oriented perspectives also fail to take into account considerations of structural factors like power asymmetries and pay inadequate attention to user practices. Through the case of auto-rickshaw drivers in Bangalore, India, and their use of Ola, a peer-to-peer taxi hailing service similar to Uber, we show that access is a necessary, but not sufficient condition to achieve financial inclusion in a substantive sense. By examining in detail, the financial needs and practices of rickshaw drivers, we identify the opportunities and constraints for digital technology to better support their financial practices and enhance their wellbeing. The paper proposes adding ‘autonomy’ and ‘affordances’ as two crucial factors to be included in the discourse on financial inclusion. Finally, we outline design implications for P2P technologies to contribute towards the financial inclusion of drivers.
- Text DocumentTranslating value-based healthcare into practice(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Bonde, Morten; Bossen, Claus; Danholt, PeterIn this paper, we report from an experiment into healthcare governance called ‘new governance in the patient’s perspective’ (NG) initiated by a Danish Region. The experiment was inspired by principles of value-based health care (VBHC), and initiated to transform governance from a productivity-regime, allegedly incentivizing clinical conduct in ‘perverse’ and counter-productive ways, towards a new regime focusing on value for the patient. Pursuing this ambition the Region exempted nine hospital departments from activity-based financing based on Diagnosis-Related Groups (DRG), and asked instead the departments to develop self-chosen indicators to measure and account for ‘value for the patient’. Drawing on the notion of ‘translation’ (Latour, 1987) we analyse how NG was put into practice in the departments, and how their indicators were accounted for. Relating to literature on performance indicators, our case seemingly confirms a wellestablished distinction between indicators for internal improvement vs. external accountability. However, in pointing out the dialogues facilitated by the indicators between the Region and the departments, this distinction is challenged. Our analysis provides inspiration for healthcare governance to think of indicators as means, not for purely data-driven governance, but for dialogical practices in which concerns with accountability and local quality improvement conflate.
- Conference PaperUnderstanding and Supporting Emergent and Temporary Collaboration Across and Beyond Community and Organizational Boundaries(Proceedings of the 8th International Conference on Communities and Technologies, 2017) Amsha, Khuloud Abou; Grönvall, Erik; Saad-Sulonen, Joanna; Bossen, Claus; Lewkowicz, Myriam; Rohde, Markus; Mulder, Ingrid; Schuler, DouglasThe way the Computer Supported Cooperative work (CSCW) community talks about, defines and investigates 'work' has changed since the early workplace studies. In the current literature, work has been described as being distributed, cross-organizational and multi-actor dependent, volunteer-based, fleeting, opportunistic, in-between and community-based. Collaborative work has also been examined in the formation of Publics, as Infrastructuring or as Knotworking. Work and collaborative work is indeed something that can be unforeseen by most or all of the involved actors. It can emerge and take place temporarily at the boundaries of established entities, and be independent of existing collaboration protocols. This workshop seeks to bring together researchers and practitioners who are interested in how we study and discuss very open-ended and emergent forms of collaboration, occurring in improvised, temporary communities of action, at the boundaries of established communities or organizations, to address issue that challenges current organization of work. The aim of the workshop is to open a space of reflection on relevant concepts, through the discussion of concrete examples and cases.
- Text DocumentA Web of Coordinative Artifacts: Collaborative Work at a Hospital Ward(Proceedings of the 2005 ACM International Conference on Supporting Group Work, 2005) Bardram, Jakob E.; Bossen, ClausThis paper reports from a field study of a hospital ward and discusses how people achieve coordination through the use of a wide range of interrelated non-digital artifacts, like whiteboards, work schedules, examination sheets, care records, post-it notes etc. These artifacts have multiple roles and functions which in combination facilitate location awareness, continuous coordination, cooperative planning and status overview. We described how actors achieve coordination by using different aspects of these artifacts: their material qualities, the structure they provide as templates and the signs inscribed upon them that are only meaningful to knowledgeable actors. We finally discuss the implication for the design of CSCW tools from the study.