Making sense of complex electronic records: Socio-technical design in social care

Abstract

Dealing with complex electronic documentation is an integral part of much contemporary professional work. In this paper, we address the design of electronic records for social care professionals in the UK. Recent reforms in UK child welfare have followed a top-down, managerial approach emphasizing conformance to standard processes. The vicissitudes of a major national IT project, the Integrated Children's System, show the limitations of this approach, in particular the detrimental effect it has had on professional autonomy. Following in the foot-steps of Ken Eason, we argue that socio-technical design, by focussing on innovative applications of technology to support users (rather than the interests of the bureaucracy) offers a more promising alternative. A user-centred design exercise is presented to illustrate this approach in action. A novel interface was developed for handling the heterogeneous bundle of documents which make up the social care record, helping social workers make better sense of case-files. The prototype draws on the metaphor of the dining-room table as a way of overcoming the limitations of the computer display. We conclude that socio-technical thinking engenders a shift in mind-set, opening up a radically different design space compared to current design orthodoxy.