Troubling Care – A critical look at the systemic shift toward healthcare digitization

Format: Papers, RSD10, Topic: Health & Well-being, Topic: Sociotechnical Systems

Shivani Prakash, Felicia Nilsson and Josina Vink

The Oslo School of Architecture and Design

Amid recognition that care is contentious and highly political, conscientious design in healthcare systems cannot simply work blindly toward what is thought to be ‘good care’. Systemic design must grapple with the inherent conflicting values in care. This paper works to ‘unsettle’ care by exploring the tensions amid the evolving landscape of the Norwegian healthcare system. We attempt to embody Haraway’s idea of “staying with the trouble” in a design process positioned within a systemic transition toward digitization in healthcare. Drawing on 14 months of fieldwork, we explore the contradictions and plurality of lived experiences in this context through textual and visual collages that intentionally juxtapose divergent values of care. This paper exposes an entanglement of troubles which include: knowing by measuring/experiencing through sensing; the situated view/the isolated view of the patient; and helping the dependent/coaching the independent. This research highlights that one important way of caring in systemic design might be to hold on to the troubles in the thick present, rather than reconciling or re-framing to solve emerging either/or tensions.
Keywords: Care; Trouble; Tensions; Digitization; Healthcare

Citation Data

Author(s): Shivani Prakash, Felicia Nilsson and Josina Vink
Title: Troubling Care – A critical look at the systemic shift toward healthcare digitization
Published in: Proceedings of Relating Systems Thinking and Design
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Symposium Dates:
First published: 3 September 2021
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Proceedings of Relating Systems Thinking and Design (ISSN 2371-8404) are published annually by the Systemic Design Association, a non-profit scholarly association leading the research and practice of design for complex systems: 3803 Tønsberg, Norway (922 275 696).


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