Accumulating and Coordinating: Occasions for Information Technologies in Medical Work

Abstract

This paper attempts to provide a relational understanding of the generative power of information technologies: an understanding that sees information technologies as embedded in workpractices. This theoretical undertaking, inspired by actor-network theory and work within CSCW, has a practical and political aim. The problems it discusses are directly relevant for the aims and hopes of CSCW: the design of systems that fit workpractices better than traditionally designed systems, and that enhance worker's competencies and responsibilities. The paper depicts information technologies as reading and writing artifacts. Taking parts of the medical record as an example, the paper argues that those tools -- in relation with the reading and writing activities of nurses, doctors, laboratory systems -- can be seen to perform two roles in work practices. They accumulate inscriptions and coordinate activities of other entities in the work practice, and in that way afford the handling of more complex worktasks. This focus on the generative power of these artifacts leads to a reconsideration of the notions of ‘supporting’ work and ‘transparent’ technologies, and to a series of specific entry-points for a politics of IT.