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G. Fitzpatrick:
"Designing eHealth technologies that work";
Talk: Summer school of science, Crnojezerska 20 HR-10000 Zagreb Croatia (invited); 2019-09-12.

The promises of IT for transforming healthcare have been around for decades, from single site electronic patient records in the 1970s, to recent large-scale national eHealth/electronic record initiatives. Yet despite significant investments and years of experiences, many initiatives continue to be extremely problematic and are yet to produce effective outcomes. Further, research studying health IT deployments appears in diverse disciplinary venues, making it difficult to fully account for what is going on. Human Computer Interaction (HCI)/Computer Supported Cooperative Work (CSCW) constitute one such venue. In this talk I will present a critical overview of some of the health-IT-related research, with a focus on institutional clinical settings, that has been published in HCI/CSCW over the last 25 years; this is based on a review conducted with colleague Gunnar Ellingsen. One of the unique features of this research is that it takes the broader socio-technical context of work as its unit of analysis and takes a bottom-up perspective, mostly using qualitative methods to understand the complex situated realities of putting health IT to work in everyday contexts. I will also use this HCI/CSCW lens to reflect on some national eHealth initiatives to date. Lessons learnt from both repeatedly remind us that this is not so much a technical challenge as a socio-technical challenge to understand the contingent and situated nature of clinical work ; it also makes clear that electronic records are not just information artefacts but are fundamentally entwined in doing care work in clinical settings. However, this also presents a challenge, especially for how to translate these findings for national-scale initiatives. If we are to have future health IT systems that really work, we need more engagement at the intersections of disciplines and between bottom up and top down perspectives.