International audience

The results of CSCW studies should be more effectively incorporated into software engineering practices. This paper focuses on two concepts supporting software component choice and development in IS architecture: artifact ecologies and data work. Using a case study in telemedicine, we propose MADRAE, an extension of the UML component diagram, for modeling practice-based artifact ecologies that emphasize the necessary data work. In the hospital where we tried MADRAE, it was considered helpful by the head of the IS department to analyze existing artifact ecologies and generate design and architecture proposals.

The growing use of teleconsultation, especially since the start of the Covid-19 pandemic, changes physicians' work at the hospital. In this paper, we set out to study how physicians have integrated teleconsultation into their healthcare practices. Moreover, we are interested in how teleconsultation software contributes to developing new medical practices and how the design of teleconsultation software can better support them. Based on 16 months of fieldwork in a general hospital that offers two different teleconsultation software, we have investigated teleconsultation practices through interviews and observations involving ten physicians doing teleconsultation and a telemedicine secretary. Unlike the existing informal remote care by phone, we observe that teleconsultation supports new formal healthcare practices, particularly for patient care management and inter-organizational cooperation. While analyzing the integration of teleconsultation in physicians' practices, we highlight that both pieces of software do not support those practices on equal terms according to their design. We argue that teleconsultation software design can limit the spread of these new healthcare practices and that the artifact ecology of physicians should be considered during the design process.

Telemedicine is presented by the French government and regional authorities in France as key to guaranteeing equal access to healthcare. Research on telemedicine has highlighted how it impacts the work practices of healthcare professionals and how its adoption is challenging. In this context, we are interested in understanding how the discourses and policy on equal access to healthcare are implemented and how they impact the deployment of telemedicine solutions in practice. We are currently studying the deployment of a teleconsultation solution for nursing homes inside a group of hospitals in Northeast France. On the basis of on-site visits at four nursing homes and interviews with the different stakeholders, we analyzed the domestication of the teleconsultation solution. Our first results highlight that the defined policy is useful to support the deployment of the technology but does not appear as sufficient for its incorporation into regular work practices. Our hypothesis to understand this obstacle is that nursing homes would need to endorse a new role to engage in further incorporation and later stage of domestication, which may be prevented by their existing ecosystem.