Digital Work : Coping with Contradictions in Changing Healthcare

Abstract: Digital work is bringing significant change to all professions, as established work settings are replaced by remote work and digital teamwork and collaboration. Contradictions arise when work is no longer bounded in time or space and personal and professional life merge. This raises several issues. The issues include control of time, professional boundaries, and privacy and security. Healthcare is one area where digital technology is a growing influence on professional work, roles, and relationships. The medical profession demands constant learning as it undergoes accelerating advancements in both medicine and technology. This has the effect of a change in patient-physician relationships as patients access medical information on public sites and interact with providers outside the clinical setting.The research documents the effects of professional use of multiple technologies to interact, share knowledge, and coordinate. The research problem therefore addresses the blending of personal and professional technology use in healthcare specifically and the public sector in general, focusing on the impact of digitally engaged patients on practice.The aim of the thesis is to explore dimensions of digital work that arise from the use of digital technologies in daily work and learning, with a focus on the professional role of physicians.It poses the following research questions: RQ1) What opportunities and challenges do physicians experience from using digital technologies for work and learning and how do they view their role and expertise in relation to informed and digitally engaged patients? And RQ2) What does the analysis reveal about thecharacteristics of digital work, and its implications for professionalism? The topic covers dynamics between information, technology, and people, in the context of work and learning in healthcare. Therefore, the perspectives guiding the research lie at the intersection of multiple disciplines, like Information Systems, workplace learning and health informatics. The thesis adopts a sociotechnical approach wherein the concept of information system is understood broadly to comprise information content, social context, and specific technologies. For the analysis of the research data, it combines workplace learning theories with concepts from the information infrastructure, and infrastructuring literature to identify and analyze characteristics and contradictions of digital work. The thesis comprises five peer-reviewed research papers. The data comes from 15 semi-structured interviews, three focus groups and a survey of 148 Swedish resident physicians. The project is informed by an engaged research approach, including observations from longitudinal collaborative research, and development projects that involved physicians and other public sector professionals. By exploring and describing physicians’ interactions with multiple digital technologies as part of everyday work, the thesis responds to calls for research to capture the sociotechnical dimensions and effects of digital technologies on work beyond traditional standalone systems. It addresses a real-world problem that public sector healthcare faces, by providing contextual details and insights into how digital health technology and public information intervene in the patient-physician relationship. The findings suggest that digital work can be understood as a process of coping with contradictions, where physicians reconfigure professionalism through ongoing efforts to embrace the new forms of work without sacrificing core values. The thesis concludes with guidelines to address the transformation of professional roles and responsibilities, the new qualities and competencies required for digital work, and the need for interdisciplinary research and consideration of diverse perspectives for an appropriate design of sociotechnical medical systems.