The Camera as an Actor Design-in-Use of Telemedicine Infrastructure in Surgery

Abstract

This paper describes the evolvinginterrelationship between a pre-establishedwork practice and a new technology, with anemphasis on how the technology itselfparticipates in the process and introduceschanges, while at the same time being changeditself. The case study concerns theintroduction of multimedia communicationtechnology into a surgical operating theatre.Concepts from Actor-network theory are found toprovide a useful perspective on the descriptionand analysis of the case. The technology andthe work practice are viewed as a newheterogeneous actor-network, whoseconfiguration changed continuously. Thesechanges are conceptualised as alignmentattempts where the different actants' interestsare translated and inscribed into e.g.artefacts, rules or routines. The alignment ofthis heterogeneous network was achieved througha continuous process of design, test andredesign of different configurations of people,practices and artefacts. The relevance of thefindings is discussed, related to how we maythink about design of open and generictechnologies. Viewing design as design ofconfigurations ; the creation of a well-workingmix of people, practices and artefacts, may bea helpful and relevant design metaphor.