Projects

A Learning-based Approach to Digitalization of Healthcare Services

 

The aim of the project is to explore an alternative approach to developing information infrastructures, i.e. socio-technical networks of information systems that are not defined by a definite set of functions and user groups. In contrast to traditional approaches to systems development that proceed by constructing an information infrastructure based on a model of the envisioned system and subsequently implementing that system in a specific organizational context, we assume that information infrastructures evolve through incremental adjustments, repairs, workarounds, and re-appropriation of extant tools in the unbroken continuum of everyday practice. Still, we believe that such processes can be shaped and given direction, albeit not by modelling and consciously shaping use contexts but by facilitating and shaping learning processes within and between practices involved in the information infrastructure.

We therefore aim to bring together these practices in a learning environment which we call a Learning Community. Based on the outcomes of three years of workshops and interactions in such a Learning Community in the healthcare sector, we are currently developingnew ways for patients to actively participate in both their medication therapy process and the process of evolving the information infrastructure that connects patient, physician and pharmacy practices. By enabling new forms of interaction between these practices we can create learning opportunities the results of which will be fed back into the Learning Community discussions and may then become the basis for modifying existing tools or for creating entirely new ones. An important aspect of our approach is that these tools must be ‘set free’ to be able to support learning processes, i.e. the developers of these tools must refrain from shaping use contexts and forms of appropriate use. Therefore, an important part of the project is also to explore feasible ways for such ‘freeing’ of software tools which includes the adaptation of various forms of agile project management, agile software development, and open source principles.



Information Infrastructure as a Learning Process

 

Information infrastructures develop over time as a changing constellation of practices. Changes in practices, in turn, can be viewed as learning processes. Hence, information infrastructure development can be seen as a consequence of practice-level learning processes. In this project, we use this novel and interesting lens to study and actively participate in information infrastructures for medication management of elderly people, specifically those who can no longer take charge of their own affairs as a result of dementia. Our methodical approach is to investigate and enhance current medication practices concerned with the medication of elderly people with dementia. The practical objective of this project is to significantly improve the medication therapy safety of patients with dementia while ensuring their dignity and autonomy.

We believe that, in addition to physicians, pharmacists, nurses and relatives play a significant role in medication processes and, hence, that their participation is crucial for improving medication therapy safety of patients, especially for the case of people suffering from dementia.

As an initial tool for our probing into the various practices, we will experiment with a new tool, the Federal Unified Medication Plan, which, as of April 2017, must be provided by physicians to patients that regularly use three or more prescription drugs. The specifications of the medication plan also comprise a data matrix code which facilitates the flow of information between computer systems. However, for information to ‘flow’ effectively the various practices must re-align to each other in various and often incremental ways. Understanding and promoting such manifold and variegated forms of re-alignment and inter-weaving are the main objectives and contribution of our project.