This paper explores the implementation of a policy promoting new cooperative practices in the primary care sector. Through a two-year multi-sited ethnographic study of Multi-Professional Healthcare Centers (MPHCs) and their coordination mechanisms, we highlight the gaps between the coordinative protocols that prescribe how these structures operate, and the certified Health Information System (HIS) that has been defined by public authorities to support the new practices. These gaps make us say that the policy knot - that entangles policy, practice, and design - broke. To understand why, we studied the biography of the certified HIS and identified that it is based on the practice of general medicine only. Without simply concluding that public policy has failed because of the system's shortcomings, we reveal the human effort involved in compensating for the HIS's inability to support the articulation work required for multi-professional coordination. Based on this empirical contribution, we offer the policy-oriented technological frame as a concept to make sense of IT in public health, and the congruence loop as a guideline to avoid the breakage of a policy knot.

We present an ethnographic study of railway maintenance work, with a focus on digitalized maintenance records. This on-going research is taking place in a small private railway maintenance company in the south of France for two years. We describe the integration of maintenance records in a wide material environment, and the evolution from filling in these records on paper to smartphones. This research brings some nuance on the beneficial effects of the 'digital transformation' in this industry, and shows how the workers compensate for the overlook of their practices in the design of the digital records.

The consumption of digital services has increased and has negative effects on the quality of life at work and even on the health of employees. Some solutions, such as charters, have been considered to address these problems and standardize practices. However, these solutions are often rigid and not aligned with work practices. As a result, they are little or not used at all. Faced to these findings, we are interested in studying existing practices of defining digital communication conventions in an organization. This poster presents an ongoing case study within a French national public agency where most of the agents are nomadic workers. We are intended at involving these workers so that they can collectively negotiate conventions and dynamically handle these conventions to make possible an evolution of their work practices.

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.

International audience

Creating an overview of a patient’s situation is essential for medical work, particularly for care actors participating in integrated care pathways. While we notice the failure of national initiatives to create systems to support care actors’ practices, our research focuses on investigating the actual practices held by care actors to build these overviews. Our study shows that care actors document their patients’ cases and communicate about them. We, therefore, imply that systems supporting integrated care pathways should couple documents and discussions and permit their visualization according to three dimensions: the problems that occur, the source of information (the care actor), and the time.

The digital twin is a key technology of Industry 4.0. It offers a digital replica of a physical system. As part of research work with SNCF Réseau, we have sought to explore the role the digital twin can play to support coordination mechanisms. We conducted a multi- sited ethnography, which allowed us to define a technology probe to explore our research question in-situ. This exploratory work shows that the digital twin enables the rapid design of computational coordination mechanisms. Furthermore, we raise the point that a digital twin can bind descriptive information about the physical system and information used in coordination practices to move towards effortless coordination.

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.

In this paper, we compare two cases of collaboration within healthcare in two European countries, Denmark and France respectively. In each of these two cases, we conducted a design case study, and we found that collaboration is ad hoc, temporary, and shifting with regards to collaborators, aims, and processes. We argue for the relevance of knotworking and its analytic potential for investigating the kind of collaborative work we observed. We also argue that our two cases present a higher complexity level than how knotworking has previously been described in the literature. We describe complex knotworking as having three characteristics: 1) collaboration happens between a dynamic number of actors (who are usually loosely connected), 2) collaboration happens in episodes, and 3) cooperative work arrangements are constantly negotiated. Using the concept of complex knotworking for a comparative analysis of our two design solutions, we outline generic design guidelines for developing computer support to manage complex knotworking situations.

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.

Awareness of the huge amount of work faced by relatives in caring for a person suffering from a loss of autonomy has led to research focusing on ways to ease the burden on informal caregivers. Among them, services and devices aimed at providing social support and fighting the isolation that may be caused by the caregiving tasks appear important. However, little is known about the social support informal caregivers actually value and look for in practice. To fill this gap, we conducted a multi-sited study, focusing on older informal caregivers, because they are numerous and have lower experience with technology. Our study highlights that being part of a group is a key element in helping informal caregivers to feel that they are not alone, continue leisure activities, learn from others and sustain participation in organized activities. Through this understanding, we discuss design opportunities in a sociotechnical approach complementing online and offline social support.

We conducted a retrospective study on the experimental deployment of a telemedicine toolkit in ten nursing homes. The purpose of the experiment was to see whether the use of these toolkits could allow for better cooperation between nursing homes and the local emergency medical dispatch center to avoid sending costly vehicles and having elderly people unnecessarily discharged at the hospital. We investigated the domestication process of these toolkits by nurses and orderlies from the nursing homes. Our findings show different levels of domestication: for some of the nursing homes, the lack of practical relevance of the toolkit in emergencies and the difficulty to borrow artifacts from doctors prevented complete adoption. For three nursing homes, domestication occurred in an unexpected way in the sense that the objective of the domestication changed. These findings led us to provide recommendations for projects aimed at improving inter-organizational cooperation through artifacts.

HCI and CSCW researchers and practitioners are increasingly working in complex social and political contexts where their research activities involve emotional labor and where they have to confront moral and emotional dilemmas. Given the potential impact of these challenging situations on the wellbeing of researchers in the field, there is much need for a discourse on affective impact of research on the researcher. In this workshop, we invite discussion and reflection on the experiences of distress and the role of informal coping mechanisms (e.g., personal narratives) to address them. We will create a forum where researchers and practitioners can discuss and share experiences of projects in sensitive settings and work towards guidelines to inform future projects.

No abstract available.

Our research aims at informing the design of technological solutions to alleviate the stress resulting from the involvement of spouses of Alzheimer's disease patients as caregivers. For so doing, we have observed and analyzed the different offline solutions that are offered by a healthcare network in the Aube region (North-East of France). We discuss the key factors that we have identified for building an effective support network and identify five perspectives for the development of an online social support platform to lower the burden of spousal caregivers.

Increasing attention is currently paid to informal care and the physical, emotional, and psychological burden stemming from it. Research findings suggest that such a burden might be intensified when informal caregivers are at older ages. Aiming at reducing the burden associated with informal care, some research studies have focused on developing innovative technologies to support caregivers with their activities and responsibilities. These studies highlight the importance of understanding the many variables that characterise different care situations, emphasizing the relevance of user-centered and participatory design approaches. Following up the successful first edition of the CCCiC workshop held at the 2014 ACM CSCW conference in Baltimore, this workshop elaborates on the resulting roadmap for future research in the domain: concepts, methods, and technologies. This workshop seeks contributions exploring issues of collaboration and coordination for informal care addressing concepts emerging from field research, methodological challenges, work-in-progress, and the design and evaluation of technological solutions.

The aim of our ongoing research project is to design a platform for family caregivers to help them cope with the burden of daily caregiving. With a view to designing relevant information and communication services, we analyzed the social support practices observed among the members of a group of caregivers, whose spouses were suffering from Alzheimer's disease. Based on interviews and a field survey, we characterized this collective and identified the caregivers' latent and expressed needs. Our approach consists in linking these needs to naturally occurring situations in order to translate them into meaningful functionalities.