Dilemmas of therapeutic interaction in digitally mediatized hospital work settings

In the course of the digitalization of medical work and care work in hospitals, hospital information systems (HIS) are more and more replacing paper-based clinic records and documentation. Because medical doctors are still the dominant profession in health organizations, representation of medical knowledge in clinical records is often not geared towards its use by other professional groups like occupational therapists or physiotherapists. Using a framework of professional interaction that re-interprets Parsonian pattern variables (universalism, affective neutrality, functional specificity, community, and achievement orientation) in terms of dilemmas of action in a negotiated social order, this chapter presents findings from a research project on the smart aggregation and visualization of health data (SMARAGD) to better understand how the co-operation and communication between various professional groups and hierarchy levels in hospital units is shaped by HIS. Using data from group discussions conducted in three comparable units of Austrian hospitals, we elaborate on which dilemmas of professional interaction are emphasized and which form they take. To understand the various interaction dilemmas, the state of HIS development in a hospital, the culture of decision-making, the involvement of professional groups in implementing HIS, and the composition of participants of the group discussion are relevant contexts.