How Workarounds Occur in Relation to Automatic Speech Recognition at Danish Hospitals

Abstract

AbstractThis paper attempts to show how healthcare professionals navigate in relation to Automatic Speech Recognition (ASR) by examining workarounds. The use of ASR in entering information into electronic health records (EHRs) is an important topic to study as hospitals increasingly adapt to the technology. This paper is based on ethnographic multi-sited fieldwork. It gathers information about the use of ASR in workflows, its limitations, how physicians perceive it, and what workarounds they employ when it does not work as expected. The study analyses a Danish hospital that underwent an ASR implementation almost two decades ago, yet they still experience frequent system modifications. Once the physicians experience these changes, they promptly criticize the technology for failing to live up to proclaimed expectations. The paper demonstrates how a simplistic understanding and a following of a predetermined plan of complex technology, such as ASR, contributes to workflow-related challenges and workarounds. As a result, the research proclaims a concern towards information recording, saving, and retrieval related to differences in how information is entered into an EHR by using ASR. Further, studies of workarounds proclaim these to be a way for physicians to achieve the desired goal of patient safety, where this study finds some workarounds as contradictory actions based on revolt practices towards managerial decisions.KeywordsElectronic Health RecordsAutomatic Speech RecognitionHuman-Computer InteractionWorkarounds