Abstract
This paper attempts to show how healthcare professionals navigate in relation to Automatic Speech Recognition (ASR) by examining workarounds. The use of ASR in entering information into electronic health records (EHRs) is an important topic to study as hospitals increasingly adapt to the technology. This paper is based on ethnographic multi-sited fieldwork. It gathers information about the use of ASR in workflows, its limitations, how physicians perceive it, and what workarounds they employ when it does not work as expected. The study analyses a Danish hospital that underwent an ASR implementation almost two decades ago, yet they still experience frequent system modifications. Once the physicians experience these changes, they promptly criticize the technology for failing to live up to proclaimed expectations. The paper demonstrates how a simplistic understanding and a following of a predetermined plan of complex technology, such as ASR, contributes to workflow-related challenges and workarounds. As a result, the research proclaims a concern towards information recording, saving, and retrieval related to differences in how information is entered into an EHR by using ASR. Further, studies of workarounds proclaim these to be a way for physicians to achieve the desired goal of patient safety, where this study finds some workarounds as contradictory actions based on revolt practices towards managerial decisions.
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References
Møller, J.E., Vosegaard, H.: Experiences with electronic health records. IT Prof. 10(2), 19–23 (2008)
Derman, Y.D., Arenovich, T., Strauss, J.: Speech recognition software and electronic psychiatric progress notes: physicians’ ratings and preferences. BMC Med. Inform. Decis. Mak. 10(1), 1–7 (2010)
Halbesleben, J.R., Wakefield, D.S., Wakefield, B.J.: Work-arounds in health care settings: literature review and research agenda. Health Care Manage. Rev. 33(1), 2–12 (2008)
Kobayashi, M., Fussell, S.R., Xiao, Y., Seagull, F.J.: Work coordination, workflow, and workarounds in a medical context. In: CHI 2005 Extended Abstracts on Human Factors in Computing Systems, pp. 1561–1564 (2005)
Hodgson, T., Magrabi, F., Coiera, E.: Efficiency and safety of speech recognition for documentation in the electronic health record. J. Am. Med. Inform. Assoc. 24(6), 1127–1133 (2017)
Tucker, A.L., Edmondson, A.C.: Managing routine exceptions: a model of nurse problem solving behavior. In: Advances in Health Care Management. Emerald Group Publishing Limited (2002)
Pasquale, F.: New Laws of Robotics: Defending Human Expertise in the Age of AI. Belknap Press, Cambridge (2020)
Burke, A.: Occluded algorithms. Big Data Soc. 6(2), 2053951719858743 (2019)
Thomas, S.L., Nafus, D., Sherman, J.: Algorithms as fetish: faith and possibility in algorithmic work. Big Data Soc. 5(1), 2053951717751552 (2018)
Dourish, P.: Algorithms and their others: algorithmic culture in context. Big Data Soc. 3(2), 2053951716665128 (2016)
Seaver, N.: Algorithms as culture: some tactics for the ethnography of algorithmic systems. Big Data Soc. 4(2), 2053951717738104 (2017)
Alapetite, A., Andersen, H.B., Hertzum, M.: Acceptance of speech recognition by physicians: a survey of expectations, experiences, and social influence. Int. J. Hum. Comput. Stud. 67(1), 36–49 (2009)
White, K.S.: Speech recognition implementation in radiology. Pediatr. Radiol. 35(9), 841–846 (2005)
Hayt, D.B., Alexander, S.: The pros and cons of implementing PACS and speech recognition systems. J. Digit. Imaging 14(3), 149–157 (2001)
Alapetite, A.: Impact of noise and other factors on speech recognition in anaesthesia. Int. J. Med. Inform. 77(1), 68–77 (2008)
Ramaswamy, M.R., Chaljub, G., Esch, O., Fanning, D.D., VanSonnenberg, E.: Continuous speech recognition in MR imaging reporting: advantages, disadvantages, and impact. Am. J. Roentgenol. 174(3), 617–622 (2000)
Kirkedal, A.S.: Danish Stød and Automatic Speech Recognition. Ph.D. dissertation, Copenhagen Business School, Frederiksberg (2016)
Lai, J., Karat, C., Yankelovich, N.: Conversational speech interfaces and technologies. In: The Human-Computer Interaction Handbook. CRC Press, Boca Raton, pp. 407–418 (2007)
Debnath, S., Roy, P.: Study of speech enabled healthcare technology. Int. J. Med. Eng. Inform. 11(1), 71–85 (2019)
Dupret, K.: Working around technologies—invisible professionalism? N. Technol. Work Employ. 32(2), 174–187 (2017)
Debono, D.S., et al.: Nurses’ workarounds in acute healthcare settings: a scoping review. BMC Health Serv. Res. 13(1), 175 (2013)
Dupret, K., Friborg, B.: Workarounds in the danish health sector–from tacit to explicit innovation. Nordic Journal of Working Life Studies, vol. 8 (2018)
Koppel, R., Wetterneck, T., Telles, J.L., Karsh, B.T.: Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety. J. Am. Med. Inform. Assoc. 15(4), 408–423 (2008)
Ash, J.S., Berg, M., Coiera, E.: Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J. Am. Med. Inform. Assoc. 11(2), 104–112 (2004)
Blijleven, V., Koelemeijer, K., Wetzels, M., Jaspers, M.: Workarounds emerging from electronic health record system usage: consequences for patient safety, effectiveness of care, and efficiency of care. JMIR Hum. Factors 4(4), (2017)
Nicolini, D.: Practice Theory, Work, And Organization: An Introduction. OUP Oxford, Oxford (2012)
Gherardi, S., Nicolini, D.: The organizational learning of safety in communities of practice. J. Manag. Inq. 9(1), 7–18 (2000)
Knorr-Cetina, K., Savigny, E., Schatzki, T.R. (eds) The Practice Turn in Contemporary Theory. Routledge, Milton Park (2001)
Nicolini, D.: Zooming in and out: studying practices by switching theoretical lenses and trailing connections. Organ. Stud. 30(12), 1391–1418 (2009)
Schatzki, T.: The Site of the Social: A Philosophical Exploration of the Constitution of Social Life and Change. University Park, PA, Pennsylvania State University Press, Pennsylvania (2002)
Kjeldsen, L., Ingemann, J.H., Rasmussen, S., Nørup, I.: Kvalitative Undersøgelser i Praksis: Viden om Mennesker og Samfund. Samfundslitteratur, Frederiksberg (2018)
Halkier, B.: Fokusgrupper (3. udg. ed.). Samfundslitteratur, Frederiksberg (2016)
Fabian, J.: On recognizing things. the “ethnic artefact” and the “ethnographic object”. L’Homme. Rev. Fr. D’Anthropol. 170, 47–60 (2004)
McDonald, S.: Studying actions in context: a qualitative shadowing method for organizational research. Qual. Res. 5(4), 455–473 (2005)
Beerepoot, I., Van De Weerd, I.: Prevent, redesign, adopt or ignore: Improving healthcare using knowledge of workarounds (2018)
de Vargas Pinto, A., Maçada, A.C.G., Mallmann, G.L.: Workaround behaviour in information systems research. Revista de Gestão (2018)
Latour, B.: Opening pandoras black box. Technol. Organ. Innov. Theor. Concepts Paradigms 2, 679 (2000)
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Vase, S. (2021). How Workarounds Occur in Relation to Automatic Speech Recognition at Danish Hospitals. In: Kurosu, M. (eds) Human-Computer Interaction. Design and User Experience Case Studies. HCII 2021. Lecture Notes in Computer Science(), vol 12764. Springer, Cham. https://doi.org/10.1007/978-3-030-78468-3_31
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