Bridging coordination practices and digital infrastructure in French Community Health Centers – A Renewal of Primary Care Information Systems

Abstract

This work investigates how labeled information systems support—or fail to support—coordination and documentation in French community health centers (“Centres de Santé”, CDS), where healthcare professionals are salaried rather than paid per service. These centers offer a unique configuration for studying coordination practices, as they allow staff to devote more time to these non-remunerated but essential collective tasks. Based on an ongoing ethnographic study, we report preliminary findings from interviews and observations conducted in one CDS. Our results highlight the central role of non-medical staff in managing information flows, the predominance of diverse artefacts (e.g., paper notes, verbal exchanges) to cope with the limitations of the current labelled information system in supporting actual workflows. We also explore how misalignments between software editors and organizational needs could affect care practices. These initial insights will inform the co-design of an alternative infrastructure and guide future engagement with software vendors.