Heterogeneous networks and common needs.
A study of radiology departments in the process of constructing a computer supported common information space
In health care there is an ongoing process of structural change that put increasing demands on the organizations to find new ways for cooperative work. This means that complex and heterogeneous networks with requirements for cooperation must search for possibilities to combine differences and common needs [1][2]. This paper focuses on this condition through the study of the issues in constructing a common information space in a complex hospital environment. The main objective of this study was to investigate how heterogenous networks can combine differences and common needs? Here it is argued, that an active standardization process is a strategy for dealing with this issue.
The study was conducted in Sweden at radiology departments at Sahlgrenska University Hospital and the hospitals in Skövde, Borås and Varberg. These hospitals are parts of a hospital region in which there is an ongoing process to find new ways for computer supported cooperative work. The study was conducted from an ethnographical point of view, where the empirical data was collected via observations and semi-structured interviews with radiologists. The aim was to receive significant knowledge of present forms for cooperation and important information about ongoing change processes within the hospital region, for the development of new means for cooperative work. In addition, another purpose was to gain knowledge of the hospitals proposals for how to, technically and practically, deal with the need for technology supported cooperative work.
The results have shown that the hospitals in the study have very different technological basis e.g. in the use of RIS and PACS systems. This means difficulties in integrating the systems in a technology supported cooperative work. However, the study also makes visible other kinds of problems in constructing a technology supported cooperative work that means difficulties in bridging the heterogeneity of these hospital networks. The hospitals showed: 1) Insufficient knowledge of the purpose and objective for the cooperative work among the hospitals. This became obvious through the fact that the hospitals had quite different ideas of exactly what information should be communicated and how the access to the information should be formed. 2) Lack of information about the different roles that each hospital play and what this means in the process of developing a system for technology supported cooperative work. 3) Need for developing their knowledge about each other’s different and specific work conditions. Many of the suggestions of how to solve the problems surrounding the hospitals cooperative work was made rather from a local than a regional point of view. The hospitals seem to look more to their own organizations than to the hospital region.
In the hospital region the problems with different technology basis is a central issue in developing a system for technology supported cooperative work. However there are other factors creating severe difficulties in finding ways for this kind of cooperative work. A strategy for dealing with these problems and a way to bridge the heterogeneity in the hospital organizations is an active standardization process. This process deals not only with the technology problems but also the issues concerning establishing a regional perspective in the process of developing a technology supported cooperative work. The standardization process involve broad participation at the different hospitals in the region were the users are actively involved in creating the system for technology supported cooperative work. The purpose is to create a clear objective, increase the knowledge of the different hospital roles in the region and of each other’s specific work conditions. This standardization process will create necessary conditions for heterogeneous and complex hospital networks to combine differences and common needs.
The conclusion of the study is that the hospitals in the region, through a standardization process with a broad participation, can combine complex and varying organizations with common needs for cooperative work. Besides bridging the different technology basis this process will serve as means for creating a clear objective, increase the knowledge of the different hospital roles and of each other’s specific work conditions.
References:
1. Hanseth, O., Thoresen K., Winner, L. (1994). The Politics of Networking Technology in Health Care. Computer Supported Cooperative Work. Special Issue on Networking. Nos. 1-2 Vol.2, pp. 109-130. Kluwer Academic Publishers.
2. Star, S. L., Griesemer, J. R. (1989). Institutional ecology, ’translations’, and boundary objects: amateurs and professionals in Berkley’s Museum of Vertebrate Zoology, 1907-39. Social studies of science, 19:387-420.
Corresponding author:
Ulrika Josefsson,University of Göteborg
Department of Informatics,
Sweden
e-mail: tonyjos(at)algonet.se
Oral presentation at EuroPACS'98, Barcelona, Spain