Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
Soc Sci Med. 2022 Jan;292:114572. doi: 10.1016/j.socscimed.2021.114572. Epub 2021 Nov 18.
The digitalization of healthcare work has gained center stage in academic debates spanning disciplines as diverse as medicine, sociology and STS. The different analytical interests and methodological traditions of these three strains of scholarship have, however, resulted in quite diverging approaches to this issue. Points of interest have ranged from the (disattended) promise of increased efficiency of healthcare work, to dynamics of task delegation, (re-)professionalization and (re-)distribution of invisible work, to the disruption of informal organization. Instead of studying these dynamics in practice, in this paper we foreground the potentiality for theory-making inherent in the systematic cross-contamination of different theoretical and disciplinary perspectives. We perform a Critical Interpretive Synthesis (CIS) centering the ways the digitalization of healthcare work has been investigated in recent STS, sociological and medical literature. To open up assumptions and insights intrinsic to each body of literature for scholars and practitioners in other fields, we propose here a metaphor-based variation on CIS approaches. We probe, in turn, what slime molds can teach us about STS's focus on interconnections and materiality, how we can better understand sociological analyses of invisible work exploring them through theatrical performances, and which lessons river engineering offers concerning medical scholarship's discussion of efficiency and proper healthcare work. Thinking through these metaphors, we conceptualize the digitalization of healthcare work as a phenomenon spanning, at once, the directionality of technological innovation trajectories and the open-endedness of situated changes in work practices. Based on our analysis, we propose focusing on technological scripts, and various forms of invisible work and informal organization as entry points into the study of the tension between directionality and open-endedness in the context of the digitalization of healthcare work.
医疗工作的数字化已经成为医学、社会学和 STS 等多个学科学术辩论的焦点。然而，这三个学术流派的不同分析兴趣和方法传统导致了对此问题的截然不同的方法。关注点范围从（被忽视的）提高医疗工作效率的承诺，到任务委托、（再）专业化和（再）分配无形工作，以及非正式组织的破坏。本文不是在实践中研究这些动态，而是强调从不同理论和学科视角的系统交叉污染中产生理论构建的潜力。我们对最近的 STS、社会学和医学文献中对医疗工作数字化的研究进行了批判解释性综合（CIS）。为了向其他领域的学者和从业者开放每个文献主体固有的假设和见解，我们在这里提出了基于隐喻的 CIS 方法的变体。我们依次探讨了黏菌可以教给我们什么关于 STS 关注的相互联系和物质性的知识，我们如何通过戏剧表演更好地理解社会学对无形工作的分析，以及河流工程学为医学学术讨论效率和适当医疗工作提供了哪些教训。通过这些隐喻思考，我们将医疗工作的数字化概念化为一个现象，同时跨越了技术创新轨迹的方向性和工作实践中无定形变化的开放性。基于我们的分析，我们提出关注技术脚本以及各种形式的无形工作和非正式组织，作为研究医疗工作数字化背景下方向性和开放性之间紧张关系的切入点。
