Complexity of Care Networks
– Can a Taxonomy of Collaboration Complexity in Homecare Support Technology Adoption? There is a huge knowledge base and great research interest in the field of care and care networks. Many studies have defined the nature of care giving as cooperative work (Procter et al., 2014; Consolvo et al., 2004). There have been several workshops on CSCW conferences through the last 20 years, aiming at a universal understanding of the concept of care networks and designing useful technology for them. Despite that multitude of knowledge, the EUSSET community gave room to that topic in the December 2022 colloquium. The focus hereby was on the complexity care collaboration faces especially in homecare settings.
In homecare, networks are mostly formed by professional, semi-professional, and informal actors, who collaborate to care for people in need. Typical challenges in this context include communication breakdowns, lack of transparency in the tasks and roles of actors in the care network, scheduling and temporal alignment of activities, coordination of handoffs, balance and fairness in task management, reconciliation of caregiving with work and life, trust building, easing of tensions among caregivers and dynamic changes in usual care arrangements (Schurgin et al., 2021; Tang et al., 2018; Renyi et al., 2017; Renyi et al., 2018; Renyi et al., 2019). The work in a care network can be quite dynamic. It requires complex knotworking to reflect these dynamics (Engeström et al., 1999; Abou Amsha et al., 2021). An infrastructural lens was put on by many studies to examine collaborative care – see e.g., Bossen and Markussen (2010) and Danholt and Langstrup (2012). In summary, factors, such as the composition of a care network and the opportunities for exchange within it, determine the success of collaboration in a care network (Broese van Groenou et al., 2016).
Should we, as CSCW researchers, support the process from amblification to application?
Originally the plan was to introduce the taxonomy proposed by Renyi et al. (2022) and discuss its potential to help capture the complexities of care coordination. From then on the discussion in the colloquium should be directed towards drafting answers for questions like: Does classifying the composition of a network help reducing the complexity of the collaboration? How can this further effect the design of care collaboration technology? Should research focus on a design “one-size-fits-all solution” to support care network collaboration or individual solutions with limited functionalities?
Influenced by the first discussion round of the colloquium, led by Khuloud Abou Amsha, however, the major question of the colloquium steered into the direction of “How far can design go?”. Should we, as CSCW researchers, support the process from amblification to application?
We were unanimous in our view that this would require strong management work. Especially in the area of outpatient home care, this professional component is usually missing. This makes grasping collective needs as opposed to individual concerns all the more difficult. Furthermore if we look at home care networks, we see that here, too, there is virtually no “empty space,” but that technology has found its way into all areas of life.
Overall there was a consensus that the introduction and testing of research prototypes in that context field is difficult. Should CSCW researchers steer towards deployment at all? And if so, are new research methods needed? The discussion made clear that going beyond designing is important and that sufficient methods are known to investigate the impact and usefulness, if not labeled as CSCW, then in related research fields. Summed up, what we need for further research projects are interdisciplinary research teams and time – longer funding periods- to design, investigate and redesign for current work requirements.
References
Abou Amsha, Khuloud; Bossen, Claus; Grönvall, Erik; and Myriam Lewkowicz (2021). Computer-Supported Knotworking: Design Guidelines Based on Two Case Studies from the Healthcare Domain in Europe. Proceedings of the ACM on Human-Computer Interaction, vol. 5, no. CSCW1.
Bossen, Claus, and Randi Markussen. (2010). Infrastructuring and ordering devices in health care: Medication plans and practices on a hospital ward. Computer Supported Cooperative Work (CSCW), vol. 19 no. 6, pp. 615-637.
Broese van Groenou, Marjolein; Marianne Jacobs; Ilse Zwart-Olde; and Dorly J. H. Deeg (2016). Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands. Health and Social Care in the Community, vol. 24, no. 1, pp. 95–104. https://doi.org/10.1111/hsc.12199
Consolvo, Sunny; Peter Roessler; Brett E. Shelton; Anthony LaMarca; Bill Schilit; and Sara Bly (2004). Technology for care networks of elders. IEEE Pervasive Computing, vol. 3, no. 2, pp. 22–29. https://doi.org/10.1109/MPRV.2004.1316814
Danholt, Peter; and Henriette Langstrup (2012). Medication as Infrastructure: Decentring Self-care. Culture Unbound, vol. 4, pp. 513–532.
Engeström, Yrjö; Ritva Engeström; and Tarja Vähääho (1999). When the center does not hold: the importance of knotworking. In Chaiklin, S.; Hedegaard, M.; Jensen, U.J. (eds.): Activity theory and social practice. Aarhus: Aarhus University Press, pp. 345–374.
Procter, Rob; Greenhalgh, Trisha; Wherton, Joe; Sugarhood, Paul; Rouncefields, Mark and Hinder, Sue (2014). The day-to-day co-production of aging in place. Computer Supported Cooperative Work(CSCW), vol. 23, no. 3, pp. 245-267
Renyi, Madeleine; Christophe Kunze; Sophie Rau; Melanie Rosner; and Petra Gaugisch (2017). Digitalisierung in Hilfemix-Strukturen: IT-Systeme zur Koordination von Versorgungsnetzwerken mit professionellen und informellen Pflegenden. In Pfannstiel, Mario A.; Krammer, Sandra; and Swoboda, Walter (eds): Digitale Transformation von Dienstleistungen im Gesundheitswesen III. Wiesbaden: Springer Gabler, pp. 201-220. https://doi.org/10.1007/978-3-658-13642-0_13
Renyi, Madeleine, Frank Teuteberg; and Christophe Kunze (2018). ICT-Based Support for the Collaboration of Formal and Informal Caregivers – A User-Centered Design Study. In Abramowicz, Witold;. (eds): BIS 2018. Proceedings of the 21st International Conference on Business Information Systems, Berlin, Germany, 18-20 July 2018. Lecture Notes in Business Information Processing, Cham: Springer vol. 320, pp. 400–411. https://doi.org/10.1007/978-3-319-93931-5_29
Renyi, Madeleine; Melanie Rosner; Frank Teuteberg; and Christophe Kunze (2019). Collaboration in Mixed Homecare – A Study of Care Actors’ Acceptance towards Supportive Groupware. In Abramowicz, Witold; Corchuelo, Rafael (eds): BIS 2019. Proceedings of the 22nd International Conference on Business Information Systems. Seville, Spain 26-28 June 2019. Lecture Notes in Business Information Processing, Cham: Springer, vol. 354, pp. 269–283. https://doi.org/10.1007/978-3-030-20482-2_22
Renyi, M., Gaugisch, P., Hunck, A. et al. (2022) Uncovering the Complexity of Care Networks – Towards a Taxonomy of Collaboration Complexity in Homecare. Computer Supported Cooperative Work(CSCW), vol. 31, 517–554 (2022). https://doi.org/10.1007/s10606-022-09433-8
Schurgin, Mark W.; Schlager, Mark S.; Vardoulakis, Laura M.; Pina, Laura R.; and Laren G. Wilcox. (2021). Isolation in Coordination: Challenges of Caregivers in the USA. In: CHI’21. Proceedings of the CHI Conference on Human Factors in Computing Systems, May 8–13, 2021, Yokohama, Japan. New York, NY, USA: ACM. https://doi.org/10.1145/3411764.3445413.
Tang, Charlotte ; Chen, Yunan; Cheng, Karen; Ngo, Victor and Mattison, John E. (2018) Awareness and handoffs in home care: coordination among informal caregivers, Behaviour & Information Technology, vol. 37, no. 1, pp. 66-68.