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Unpacking the Sociotechnical Complexity of a Surgical Setting

Capturing the Context of Use to Inform Design and Evaluation

Time: Tue 2022-02-22 13.00

Location: Rum 9504, Hälsovägen 11c, Flemingsberg

Video link:

Language: English

Subject area: Technology and Health

Doctoral student: Hedvig Aminoff , Hälsoinformatik och logistik

Opponent: Professor Maaike Kleinsmann, Department of Product Innovation Management, Technical University of Delft, Delft, The Netherlands

Supervisor: Professor Sebastiaan Meijer, Hälsoinformatik och logistik

QC 2022-02-02


This thesis focuses on how the implementation context for a surgical telementoringservice can be understood as a complex, adaptive sociotechnical system.Teleguidance was a service for remote surgical consultation in Endoscopic RetrogradeCholangiopancreatography (ERCP), a highly specialized clinical procedure.The solution had been developed in a participatory design setting andhad also been successfully trialed in a pilot study. It was to be deployed atfour additional hospitals, but differences between the implementation contextswould make it challenging to understand clinical outcomes, and could also affectmatters such as adoption.This thesis includes four papers which converge on user needs and the sociotechnicalimplementation context for teleguidance. The aim was to demonstratehow a sociotechnical systems oriented approach could be used to identifyfactors that could interact with the implementation. The first paper describesan investigation of attitudes and expectations among end-users and other stakeholders.The second paper shows how modelling the sociotechnical work systemmade it possible to investigate and proactively identify issues that might influenceimplementation and adoption. The third paper explicates methodologicalaspects of modeling the domain. The fourth paper describes a study designed tocapture early reactions to working with the system. Seen together, the researchrepresents a design science approach, that proposes that the implementationcontext can be viewed as a complex, adaptive system, and provides examplesthat show how focusing on user and stakeholder needs and wider context ofuse is a viable approach for supporting the implementation and evaluation oftelemedicine systems in complex settings.