STD Engineering (Sociotechnical Design and Engineering) in Health Care
Health care is a complex ecosystem of providers, insurers, financial teams, administration and patients. Each team uses process and technology in distinct ways, often unique to each location where care is provided. There have been many studies of health care, but to date the development of a theory of sociotechnical design and engineering in this context has not been articulated. The aim of this project is active participation in the development of theories salient for advancing health care outcomes deliberately, through the codesign of technologies and social structures.
Patients are increasingly gaining support for understanding their diseases through online health communities. The design differences that exist across these platforms is little examined, but critical for understanding the most effective sociotechnical strategies for providing support. This thread of Goggins work aims to close this gap, and presently includes work on a book, and the development of a proposal for funded research.
Health support forums studied are descriptively presented. We know they serve patient emotional and informational needs. We know that social support and a sense of community is provided by these forums. However, there are serious concerns in the health care professional community about the risk of expert knowledge from health care providers being absent from patient support forums. Whether the information on the forums is therefore sufficiently reliable as to be safe is an open question.
Similarly, electronic medical records systems have been implemented in a number of clinical settings, and they are operated by medical experts.
Few studies examine the extent to which EMR systems enable or impeded the provision of correct information for patients with outlier conditions, most effectively treated through off label use of pharmaceuticals. Health support forums often fill these gaps.
Few studies look across health support forums to understand the dynamics of the platform itself and the disease, and characterized how the community dynamics are different across platforms. Knowledge of these online health support community dynamics are needed to build a better understanding of how information and community support diffuse through different social structures.
Similarly, contrasting online health community support dynamics, and how they express specific care gaps in clinical EMR systems will begin to bridge a trust of divide between these two critical, sociotechnical design problems in health care
The present work will present in depth sociotechnical design contrasts across patient support communities and multi site implementations of electronic medical record systems. We will develop a set of sociotechnical design heuristics that explicitly address the challenges of trust from medical professionals toward patient support communities, and the challenges of effective treatment experienced by patients managed through strict, inflexible clinical EMR systems and current medical practice.