Skip to main content

How Workarounds Occur in Relation to Automatic Speech Recognition at Danish Hospitals

  • Conference paper
  • First Online:
Human-Computer Interaction. Design and User Experience Case Studies (HCII 2021)

Part of the book series: Lecture Notes in Computer Science ((LNISA,volume 12764))

Included in the following conference series:

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Møller, J.E., Vosegaard, H.: Experiences with electronic health records. IT Prof. 10(2), 19–23 (2008)

    Article  Google Scholar 

  2. 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)

    Article  Google Scholar 

  3. 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)

    Article  Google Scholar 

  4. 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)

    Google Scholar 

  5. 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)

    Article  Google Scholar 

  6. 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)

    Google Scholar 

  7. Pasquale, F.: New Laws of Robotics: Defending Human Expertise in the Age of AI. Belknap Press, Cambridge (2020)

    Google Scholar 

  8. Burke, A.: Occluded algorithms. Big Data Soc. 6(2), 2053951719858743 (2019)

    Article  Google Scholar 

  9. Thomas, S.L., Nafus, D., Sherman, J.: Algorithms as fetish: faith and possibility in algorithmic work. Big Data Soc. 5(1), 2053951717751552 (2018)

    Article  Google Scholar 

  10. Dourish, P.: Algorithms and their others: algorithmic culture in context. Big Data Soc. 3(2), 2053951716665128 (2016)

    Article  Google Scholar 

  11. Seaver, N.: Algorithms as culture: some tactics for the ethnography of algorithmic systems. Big Data Soc. 4(2), 2053951717738104 (2017)

    Article  Google Scholar 

  12. 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)

    Article  Google Scholar 

  13. White, K.S.: Speech recognition implementation in radiology. Pediatr. Radiol. 35(9), 841–846 (2005)

    Article  Google Scholar 

  14. Hayt, D.B., Alexander, S.: The pros and cons of implementing PACS and speech recognition systems. J. Digit. Imaging 14(3), 149–157 (2001)

    Article  Google Scholar 

  15. Alapetite, A.: Impact of noise and other factors on speech recognition in anaesthesia. Int. J. Med. Inform. 77(1), 68–77 (2008)

    Article  Google Scholar 

  16. 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)

    Article  Google Scholar 

  17. Kirkedal, A.S.: Danish Stød and Automatic Speech Recognition. Ph.D. dissertation, Copenhagen Business School, Frederiksberg (2016)

    Google Scholar 

  18. 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)

    Google Scholar 

  19. Debnath, S., Roy, P.: Study of speech enabled healthcare technology. Int. J. Med. Eng. Inform. 11(1), 71–85 (2019)

    Google Scholar 

  20. Dupret, K.: Working around technologies—invisible professionalism? N. Technol. Work Employ. 32(2), 174–187 (2017)

    Article  Google Scholar 

  21. Debono, D.S., et al.: Nurses’ workarounds in acute healthcare settings: a scoping review. BMC Health Serv. Res. 13(1), 175 (2013)

    Google Scholar 

  22. Dupret, K., Friborg, B.: Workarounds in the danish health sector–from tacit to explicit innovation. Nordic Journal of Working Life Studies, vol. 8 (2018)

    Google Scholar 

  23. 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)

    Article  Google Scholar 

  24. 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)

    Article  Google Scholar 

  25. 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)

    Article  Google Scholar 

  26. Nicolini, D.: Practice Theory, Work, And Organization: An Introduction. OUP Oxford, Oxford (2012)

    Google Scholar 

  27. Gherardi, S., Nicolini, D.: The organizational learning of safety in communities of practice. J. Manag. Inq. 9(1), 7–18 (2000)

    Article  Google Scholar 

  28. Knorr-Cetina, K., Savigny, E., Schatzki, T.R. (eds) The Practice Turn in Contemporary Theory. Routledge, Milton Park (2001)

    Google Scholar 

  29. Nicolini, D.: Zooming in and out: studying practices by switching theoretical lenses and trailing connections. Organ. Stud. 30(12), 1391–1418 (2009)

    Article  Google Scholar 

  30. 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)

    Google Scholar 

  31. Kjeldsen, L., Ingemann, J.H., Rasmussen, S., Nørup, I.: Kvalitative Undersøgelser i Praksis: Viden om Mennesker og Samfund. Samfundslitteratur, Frederiksberg (2018)

    Google Scholar 

  32. Halkier, B.: Fokusgrupper (3. udg. ed.). Samfundslitteratur, Frederiksberg (2016)

    Google Scholar 

  33. Fabian, J.: On recognizing things. the “ethnic artefact” and the “ethnographic object”. L’Homme. Rev. Fr. D’Anthropol. 170, 47–60 (2004)

    Google Scholar 

  34. McDonald, S.: Studying actions in context: a qualitative shadowing method for organizational research. Qual. Res. 5(4), 455–473 (2005)

    Article  Google Scholar 

  35. Beerepoot, I., Van De Weerd, I.: Prevent, redesign, adopt or ignore: Improving healthcare using knowledge of workarounds (2018)

    Google Scholar 

  36. de Vargas Pinto, A., Maçada, A.C.G., Mallmann, G.L.: Workaround behaviour in information systems research. Revista de Gestão (2018)

    Google Scholar 

  37. Latour, B.: Opening pandoras black box. Technol. Organ. Innov. Theor. Concepts Paradigms 2, 679 (2000)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Silja Vase .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

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

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-78468-3_31

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78467-6

  • Online ISBN: 978-3-030-78468-3

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics