Abstract
This paper attempts to provide a relational understanding of the generative power of information technologies: an understanding that sees information technologies as embedded in workpractices. This theoretical undertaking, inspired by actor-network theory and work within CSCW, has a practical and political aim. The problems it discusses are directly relevant for the aims and hopes of CSCW: the design of systems that fit workpractices better than traditionally designed systems, and that enhance worker's competencies and responsibilities. The paper depicts information technologies as reading and writing artifacts. Taking parts of the medical record as an example, the paper argues that those tools -- in relation with the reading and writing activities of nurses, doctors, laboratory systems -- can be seen to perform two roles in work practices. They accumulate inscriptions and coordinate activities of other entities in the work practice, and in that way afford the handling of more complex worktasks. This focus on the generative power of these artifacts leads to a reconsideration of the notions of ‘supporting’ work and ‘transparent’ technologies, and to a series of specific entry-points for a politics of IT.
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References
Agre, Philip E (1994): Surveillance and Capture: Two Models of Privacy. The Information Society, vol. 10, pp. 101-127.
Anonymous (1963): Electronic Data Processing Apparatus. Journal of the American Medical Association, vol. 186, pp. 146-147.
Berg, Marc (1996): Practices of Reading and Writing. The Constitutive Role of the Patient Record in Medical Work. Sociology of Health and Illness, vol. 18, pp. 499-524.
Berg, Marc (1997a): Of Forms, Containers and the Electronic Medical Record: Some Tools for a Sociology of the Formal. Science, Technology and Human Values, vol. 22,no. 4, pp. 403-433.
Berg, Marc (1997b): Rationalizing Medical Work. Decision Support Techniques and Medical Practices. Cambridge: MIT Press.
Berg, Marc (1998): The Politics of Technology: On Bringing Social Theory in Technological Design. Science, Technology and Human Values, vol. 23,no. 3, pp. 456-490.
Berg, Marc and Geoffrey Bowker (1997): The Multiple Bodies of the Medical Record: Towards a Sociology of an Artefact. The Sociological Quarterly, vol. 38,no. 3, pp. 511-535.
Berg, Marc and Els Goorman (1999): The Contextual Nature of Medical Information. International Journal of Medical Informatics, in press.
Bowers, John (1992): The Politics of Formalism. In M. Lea (ed.): Contexts of Computer Mediated Communication. Hassocks: Harvester.
Bowker, G. (1995) Lest We Remember: Organizational Memory and the Production of Knowledge. Unpublished manuscript.
Bowker, Geoffrey C., Susan Leigh Star, William Turner and Les Gasser (eds.) (1997): Social Science, Technical Systems, and Cooperative Work: Beyond the Great Divide. Mahwah, NJ: Lawrence Erlbaum.
Button, Graham and Richard Harper (1996): The Relevance of ‘Work-Practice’ for Design. Computer Supported Cooperative Work, vol. 4, pp. 263-280.
Button, Graham and R.H.R. Harper (1993): Taking the Organisation into Accounts. In Graham Button (ed.): Technology in Working Order. Studies of Work, Interaction, and Technology. London: Routledge.
Callon, Michel (1987): Society in the Making: The Study of Technology as a Tool for Sociological Analysis. In Wiebe E. Bijker, Thomas P. Hughes and Trevor Pinch (eds.): The Social Construction of Technological Systems. Cambridge: MIT Press.
Callon, Michel and John Law (1995): Agency and the Hybrid Collectif. South Atlantic Quarterly, vol. 94,no. 2, pp. 481-507.
Collins, Harry M. (1990): Artificial experts. Social Knowledge and Intelligent Machines. Cambridge: MIT Press.
Dick, Richard S and Elaine B Steen (eds.) (1991): The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, D.C.: National Academy Press.
Dodier, Nicolas (1995): Les hommes et les machines. Paris: Métailié.
Edwards, P.N. (1996): The Closed World. Computers and the Politics of Discourse in Cold War America. Cambridge: MIT Press.
Galegher, Jolene and Robert E Kraut (1990): Technology for Intellectual Teamwork: Perspectives on Research and Design. In J. Galegher, R.E. Kraut and C. Egido (eds.): Intellectual Teamwork. Social and Intellectual Foundations of Cooperative Work. Hillsdale, NJ: Lawrence Erlbaum Associates.
Gasser, Les (1986): The Integration of Computing and Routine Work. ACM Transactions on Office Information Systems, vol. 4,no. 3, pp. 205-225.
Gomart, Emilie (1996) Surprised by Methadone. Trials and Translations of Drug Experience During Substitution Treatment. Annual Conference of the Society for the Social Studies of Science, October 9–12. Bielefeld.
Gomart, Emilie (1998) Éloge of Methadone: An Experiment on Constraint. Workshop Theorizing Bodies in Medical Practices, September 9–11. Paris.
Haraway, Donna J. (1991): Simians, Cyborgs, and Women: The Reinvention of Nature. New York: Routledge.
Harper, R.H.R. and John A. Hughes (1993): 'What a F-ing System! Send 'em All to the Same Place an then Expect Us to Stop 'em Hitting'. Making Technology Work in Air Traffic Control. In Graham Button (ed.): Technology in Working Order. Studies of Work, Interaction, and Technology. London: Routledge.
Harper, Richard H.R., K.P.A. O'Hara, A.J. Sellen and D.J.R. Duthie (1997): Toward the Paperless Hospital? British Journal of Anaesthesia, vol. 78, pp. 762-767.
Hayles, N. Katherine (1994): Boundary Disputes: Homeostasis, Reflexivity, and the Foundations of Cybernetics. Configurations, vol. 3, pp. 441-467.
Heath, Christian (1982): Preserving the Consultation: Medical Record Cards and Professional Conduct. Sociology of Health and Illness, vol. 4, pp. 56-74.
Heath, Christian and Paul Luff (1993): Disembodied Conduct. Interactional Asymmetries in Video-Medicated Communication. In Graham Button (ed.): Technology in Working Order. Studies of Work, Interaction, and Technology. London: Routledge.
Henderson, Kathryn (1998): The Role of Material Objects in the Design Process: A Comparison of Two Design Cultures and How They Contend with Automation. Science, Technology and Human Values, vol. 23, pp. 139-174.
Hughes, David (1988): When Nurse Knows Best: Some Aspects of Nurse/Doctor Interaction in a Casualty Department. Sociology of Health and Illness, vol. 10,no. 1, pp. 1-22.
Hutchins, Ed (1995): Cognition in the Wild. Cambridge: MIT Press.
Kaptelinin, Victor (1996): Computer-Mediated Activity: Functional Organs in Social and Developmental Contexts. In Bonnie Nardi (ed.): Context and Consciousness: Activity Theory and Human-Computer Interaction. Cambridge: MIT Press.
Knorr-Cetina, Karin (1996): The Care of the Self and Blind Variation: The Disunity between Two Leading Sciences. In Peter Galison and David J Stump (eds.): The Disunity of Science. Boundaries, Contexts, and Power. Stanford: Stanford University Press.
Latour, Bruno (1986): Visualisation and Cognition: Thinking with Eyes and Hands. Knowledge and Society: Studies in the Sociology of Culture Past and Present, vol. 6, pp. 1-40.
Latour, Bruno (1987): Science in Action. Cambridge: Cambridge University Press.
Latour, Bruno (1996): On Interobjectivity. Mind, Culture and Activity, vol. 3, pp. 228-245.
Latour, Bruno and Steve Woolgar (1986): Laboratory Life. The Construction of Scientific Facts (2 Edition). Princeton, NJ: Princeton University Press.
Ledley, R.S. (1965): Use of Computers in Biology and Medicine. New York: McGraw-Hill.
Lemoine, M.P., S. Debernard, I. Crevits and P. Millot (1996): Cooperation between Humans and Machines: First Results of an Experiment with a Multi-Level Cooperative Organisation in Air Traffic Control. Computer Supported Cooperative Work, vol. 5, pp. 299-321.
Luff, Paul and Christian Heath (1993): System Use and Social Organisation. Observations on Human-Computer Interaction in an Architectural Practice. In Graham Button (ed.): Technology in Working Order. Studies of Work, Interaction, and Technology. London: Routledge.
Luff, Paul, Christian Heath and David Greatbatch (1992): Tasks-in-Interaction: Paper and Screen-Based Documentation in Collaborative activity. In J. Turner and R. Kraut (eds.): Proceedings of the Conference on Computer Supported Cooperative Work. New York: ACM Press.
Lynch, Michael (1993): Scientific Practice and Ordinary Action: Ethnomethodology and Social Studies of Science. New York: Cambridge University Press.
Mambrey, Peter and Mike Robinson (1997) Understanding The Role of Documents in a Hierarchical Flow of Work. ACM Conference on Supporting Group Work (GROUP'97). Phoenix, Arizona, 16–19, November 1997.
Nygren, E. and P. Henriksson (1992): Reading the Medical Record. I. Analysis of Physicians' Ways of Reading the Medical Record. Comput Methods Programs Biomed, vol. 39,no. 1–2, pp. 1-12.
Robinson, Mike (1991): Double-Level Languages and Co-operative Working. AI and Society, vol. 5, pp. 34-60.
Robinson, Mike (1992): Computer Supported Co-operative Work: Cases and Concepts. In Ronald M. Baecker (ed.): Readings in Groupware and Computer-Supported Cooperative Work: Assisting Human-Human Collaboration. Morgan Kaufmann.
Rogers, Yvonne (1993): Coordinating Computer-Mediated Work. Computer Supported Cooperative Work, vol. 1, pp. 295-315.
Schmidt, Kjeld and Liam Bannon (1992): Taking CSCW Seriously: Supporting Articulation Work. Computer Supported Cooperative Work, vol. 1, pp. 7-40.
Schmidt, Kjeld and Carla Simone (1996): Coordination Mechanisms: Towards a Conceptual Foundation of CSCW Systems Design. Computer Supported Cooperative Work, vol. 5, pp. 155-200.
Schneider, Karin and Ina Wagner (1993): Constructing the ‘Dossier Représentatif’: Computer-Based Information-sharing in French Hospitals. Computer Supported Cooperative Work, vol. 1, pp. 229-253.
Simone, Carla and Kjeld Schmidt (1993) Computational Mechanisms of Interaction for CSCW: ESPRIT Report, COMIC Deliverable 3.1.
Star, Susan Leigh (1989): The Structure of Ill-Structured Solutions: Boundary Objects and Heterogeneous Distributed Problem Solving. In M. Huhns and L. Gasser (eds.): Distributed Artificial Intelligence Vol. 2. London: Pitman.
Star, Susan Leigh (ed.) (1995): The Cultures of Computing. Oxford: Blackwell.
Star, Susan Leigh and Anselm Strauss (1997) Layers of Silence, Arenas of Voice: The Dialogues between Visible and Invisible Work. Unpublished manuscript.
Suchman, Lucy (1993): Technologies of Accountability. Of Lizards and Aeroplanes. In Graham Button (ed.): Technology in Working Order. Studies of Work, Interaction, and Technology. London: Routledge.
Suchman, Lucy (1994): Working Relations of Technology Production and Use. Computer Supported Cooperative Work, vol. 2, pp. 21-39.
Suchman, Lucy (1997) Human/Machine Interventions, Annual Meeting for the Social Study of Science. Tucson, Arizona.
Suchman, Lucy and Randall H. Trigg (1993): Artificial Intelligence as Craftwork. In Seth Chaiklin and Jean Lave (eds.): Understanding Practice. Perspectives on Activity and Context. Cambridge: Cambridge University Press.
Suchman, Lucy A. (1988): Representing Practice in Cognitive Science. Human Studies, vol. 11, pp. 305-325.
Symon, Gillian, Karen Long and Judi Ellis (1996): The Coordination of Work Activities: Cooperation and Conflict in a Hospital Context. Computer Supported Cooperative Work, vol. 5, pp. 1-31.
Timmermans, Stefan, Geoffrey C. Bowker and Susan Leigh Star (1998): The Architecture of Difference: Visibility, Controllability, and Comparability in Building a Nursing Intervention Classification. In Marc Berg and Annemarie Mol (eds.): Differences in Medicine. Unraveling Practices, Techniques and Bodies. Durham: Duke University Press.
Van de Donk, Wim (1997): De arena in schema. Lelystad: Koninklijke Vermande.
Wagner, Ina (1993): Women's voice. The Case of Nursing Information Systems. AI & Society, vol. 7, pp. 295-310.
Wagner, Ina (1994): Networking Actors and Organisations. Computer Supported Cooperative Work, vol. 2, pp. 5-20.
Wagner, Ina (1995): Hard Times. The Politics of Women's Work in Computerized Environments. The European Journal of Women's Studies, vol. 2, pp. 295-324.
Whalen, Jack (1995): Expert Systems versus Systems for Experts: Computer-Aided Dispatch as a Support System in Real-World Environments. In Peter J. Thomas (ed.): The Social and Interactional Dimensions of Human-Computer Interaction. Cambridge: Cambridge University Press.
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Berg, M. Accumulating and Coordinating: Occasions for Information Technologies in Medical Work. Computer Supported Cooperative Work (CSCW) 8, 373–401 (1999). https://doi.org/10.1023/A:1008757115404
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DOI: https://doi.org/10.1023/A:1008757115404