Sammendrag
The use of computerized tools in healthcare is becoming increasingly common, and may simplify several aspects of healthcare work. Even though the number of success stories of technology implementation in the health service has increased, there also are some “horror stories” of failed implementation. Why is it that several computer systems in healthcare do not succeed, in terms of not fulfilling what they promise? As member of an interdisciplinary research group (MOBEL), working with system development for hospitals, the question is of vital importance. System design literature may give us a hint: Traditional system design paid little attention to the contingent nature of health care work, when specifying the functions of systems. Today’s system design is far more sophisticated and systems may be flexible, in terms of being context sensitive, and providing information and guiding action, rather than commanding action. This of course requires detailed knowledge about the working environment. As sociologist, my task has been to provide system designers with descriptions of “real life” in the hospital. This was achieved through 4 months of participant observation in a hospital ward at St.Olav’s hospital, Trondheim, particularly following doctors through their working day. The empirical findings support the view that health care work in general, and seeking information in specific, is an extremely contingent activity. There exist an almost infinite numbers of contingencies, which may cause difficulties for systems aimed at giving decision support in the traditional sense. Hence contingencies must somehow be taken into account in system design.
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