Using the concept of hubots to understand the work entailed in using digital technologies in healthcare
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 21 August 2017
Abstract
Purpose
The purpose of this paper is to explore the human work entailed in the deployment of digital health care technology. It draws on imagined configurations of computers and machines in fiction and social science to think about the relationship between technology and people, and why this makes implementation of digital technology so difficult. The term hubots is employed as a metaphorical device to examine how machines and humans come together to do the work of healthcare.
Design/methodology/approach
This paper uses the fictional depiction of hubots to reconceptualise the deployment of a particular technology – a computer decision support system (CDSS) used in emergency and urgent care services. Data from two ethnographic studies are reanalysed to explore the deployment of digital technologies in health services. These studies used comparative mixed-methods case study approaches to examine the use of the CDSS in eight different English NHS settings. The data include approximately 900 hours of observation, with 64 semi-structured interviews, 47 focus groups, and surveys of some 700 staff in call centres and urgent care centres. The paper reanalyses these data, deductively, using the metaphor of the hubot as an analytical device.
Findings
This paper focuses on the interconnected but paradoxical features of both the fictional hubots and the CDSS. Health care call handling using a CDSS has created a new occupation, and enabled the substitution of some clinical labour. However, at the same time, the introduction of the technology has created additional work. There are more tasks, both physical and emotional, and more training activity is required. Thus, the labour has been intensified.
Practical implications
This paper implies that if we want to realise the promise of digital health care technologies, we need to understand that these technologies substitute for and intensify labour.
Originality/value
This is a novel analysis using a metaphor drawn from fiction. This allows the authors to recognise the human effort required to implement digital technologies.
Keywords
Acknowledgements
This paper presents independent research commissioned by the National Institute for Health Research SDO and HS&DR programmes (SDO 08/1819/217 and SDO 10/1008/10, see www.journalslibrary.nihr.ac.uk/projects/ for further details). The views and opinions expressed here are those of the author and do not necessarily reflect those of the NIHR NHS, or the Department of Health. This paper could not have been written without the huge effort expended by the team engaged in research about the CDSS and the participants at each of the sites, and the authors thank Susan Halford, and Jane Prichard, in particular, for indulging these forays into Swedish television programmes and discussions about cyborgs and robots. The authors thank the anonymous reviewers for their very helpful feedback and timely advice on literature on metaphors, and Catherine Pope also thanks the audience at the Organisational Behaviour in Health Care Conference 2016 for their helpful comments on the earlier version of the paper presented there.
Citation
Pope, C. and Turnbull, J. (2017), "Using the concept of hubots to understand the work entailed in using digital technologies in healthcare", Journal of Health Organization and Management, Vol. 31 No. 5, pp. 556-566. https://doi.org/10.1108/JHOM-12-2016-0231
Publisher
:Emerald Publishing Limited
Copyright © 2017, Emerald Publishing Limited