Socio-technical Framework Research Articles

Flipping healthcare by including the patient perspective in integrated care pathway design: A scoping review

BackgroundDespite the recognized benefits of integrating patient perspectives into healthcare design and clinical decision support, theoretical approaches and standardized methods are lacking. Various strategies, such as developing pathways, have evolved to address these challenges. Previous research emphasized the need for a framework for care pathways that includes theoretical principles, extensive user involvement, and data from electronic health records to bridge the gap between different fields and disciplines. Standardizing the representation of the patient perspective could facilitate its sharing across healthcare organizations and domains and its integration into journal systems, shifting the balance of power from the provider to the patient. ObjectivesThis study aims to 1) Identify research approaches taken to develop patient-centred, integrated, care pathways supported by electronic health records 2) Propose a socio-technical framework for designing patient-centred care pathways across multiple healthcare levels that integrates the voice of the patient with the knowledge of the care provider and technological perspectives. MethodsThis study conducted a scoping review following the Joanna Briggs Institute guidelines and PRISMA-ScR protocol. The databases PubMed, Scopus, Web of Science, ProQuest, IEEE, and Google Scholar were searched using a key term search strategy including variations of patient-centred, integrated care, pathway, framework and model to identify relevant studies. Eligible articles included peer-reviewed literature documenting methodologies for mapping patient-centred, integrated care pathways in healthcare service design. ResultsThis review summarizes the application of care pathway modelling practices across various areas of healthcare innovation. The search resulted in 410 studies, with 16 articles included after the full review and grey literature search. ConclusionsOur research illustrated incorporating patient perspectives into modelling care pathways and healthcare service design. Regardless of the medical domain, our methodology proposes an approach for modelling patient-centred, integrated care pathways across the care continuum, including using electronic health records to support the pathways.

The Influence of Blockchain Technology on the Use of Electronic Drug Prescription Based on Cultural Safety Sociotechnical Framework

The Influence of Blockchain Technology on the Use of Electronic Drug Prescription Based on Cultural Safety Sociotechnical Framework

Sociotechnical Cross-Country Analysis of Contextual Factors That Impact Patients' Access to Electronic Health Records in 4 European Countries: Framework Evaluation Study.

The NORDeHEALTH project studies patient-accessible electronic health records (PAEHRs) in Estonia, Finland, Norway, and Sweden. Such country comparisons require an analysis of the sociotechnical context of these services. Although sociotechnical analyses of PAEHR services have been carried out in the past, a framework specifically tailored to in-depth cross-country analysis has not been developed. This study aims to develop and evaluate a method for a sociotechnical analysis of PAEHRs that advances a framework for sociotechnical analysis of eHealth solutions first presented by Sittig and Singh. This first article in a series presents the development of the method and a cross-country comparison of the contextual factors that enable PAEHR access and use. The dimensions of the framework for sociotechnical analysis were thoroughly discussed and extended in a series of workshops with international stakeholders, all being eHealth researchers focusing on PAEHRs. All countries were represented in the working group to make sure that important national perspectives were covered. A spreadsheet with relevant questions related to the studied services and the various dimensions of the sociotechnical framework was constructed and distributed to the 4 participating countries, and the project participants researched various national sources to provide the relevant data for the comparisons in the 10 sociotechnical dimensions. In total, 3 dimensions were added to the methodology of Sittig and Singh to separate clinical content from features and functions of PAEHRs and demonstrate basic characteristics of the different countries regarding national and regional steering of health care and information and communications technology developments. The final framework contained the following dimensions: metadata; hardware and software computing infrastructure; features and functions; clinical content shared with patients; human-computer interface; people; workflow and communication; the health care organization's internal policies, procedures, and culture; national rules, regulations, and incentives; system measurement and monitoring; and health care system context. The dimensions added during the study mostly concerned background information needed for cross-country comparisons in particular. Several similarities were identified among the compared countries, especially regarding hardware and software computing infrastructure. All countries had, for example, one national access point, and patients are provided a PAEHR automatically. Most of the differences could be identified in the health care system context dimension. One important difference concerned the governing of information and communications technology development, where different levels (state, region, and municipality) were responsible in different countries. This is the first large-scale international sociotechnical analysis of services for patients to access their electronic health records; this study compared services in Estonia, Finland, Norway, and Sweden. A methodology for such an analysis was developed and is presented to enable comparison studies in other national contexts to enable future implementations and evaluations of PAEHRs.

Disentangling the socio-technical impacts of digitalization: What changes for shop-floor decision-makers?

With the diffusion of Industry 4.0 technologies, firms can decentralize operational decisions, fostering a data-driven Digital Transformation (DT) across all organizational levels. Digitalized shopfloors can leverage an unprecedented availability of data for better and faster decision-making, resulting in enhanced operational performance. However, limited research has investigated the organizational and individual implications for those who run the manufacturing lines: production managers, supervisors, team leaders, and workers. By adopting a socio-technical framework, this study aims to disentangle the effects that digitalization has on shopfloors’ organizational structures, decision-making processes, and individual competencies, as well as the interdependencies among them. An exploratory approach was adopted, based on an empirical cross-country study involving 34 semi-structured interviews conducted in the Italian and Spanish automotive sectors. Analyzed through the lenses of information-processing, knowledge-based, and dynamic capability theories, our findings reveal through five propositions how digitalization induces a “polarization” of operational decision-making: shopfloors are run by knowledgeable data-empowered production managers and autonomous information-processing team leaders on the front line, with a reduced importance of supervisors. Upskilling needs appear for team leaders but not production workers, whose involvement, however, emerges as a key factor for a successful digitalization and overall performance in initial DT stages. This study contributes to literature on digitalization by exposing managerial tensions and dynamic capabilities, along with a deeper understanding of the micro-foundations of DT in terms of implications for shop-floor decision-makers. Managerial implications are directed at creating awareness about the centrality of production team leaders, and future research avenues are proposed.

Streamlining operations management by classifying methods and concepts of Lean and Ergonomics within a sociotechnical framework

Companies have implemented Lean to increase efficiency and competitiveness. However, the importance of Ergonomics is often neglected, resulting in ergonomic problems and lower profitability and acceptance of Lean. This study presents a comprehensive approach to Operations and Production Management (OPM) considering sociotechnical synergies. For Lean and Ergonomics, literature-based main methodologies and categories are defined. These main methodologies/categories are used as search-term combinations in a further literature search. This literature is divided into “Production worker” (PW), “Physical environment” (PE), “Industry 4.0 technology” (i4.0), “Company culture” (CC), and “Manufacturing methods” (MM) based on a metric, the sociotechnical system (STS) concept. This makes it possible to determine the percentage of participation in Lean and Ergonomics articles by STS category. The main differences can be seen in PE (Lean: 10%; Ergonomics: 24%) and i4.0 (Lean: 29%; Ergonomics: 15%). However, for PW (Lean: 18%; Ergonomics: 21%), CC (Lean: 19%; Ergonomics: 20%), and MM (Lean: 26%; Ergonomics: 20%), there are similarities between Lean and Ergonomics. The OPM user should manage the PW, CC, and MM factors equally with Lean and Ergonomics, as the objective is the same. For PW, CC, and MM measures, a professional separation into Lean/OPM and Ergonomics/Occupational Medicine does not make sense. Concerning i4.0, there is a danger that the human factor in (especially innovation-oriented) OPM will be unjustly neglected and that too much emphasis will be placed on supposedly human-free technology.

Laying the ground for future cross-organizational process mining research and application: a literature review

Purpose Process mining (PM) has emerged as a leading technology for gaining data-based insights into organizations’ business processes. As processes increasingly cross-organizational boundaries, firms need to conduct PM jointly with multiple organizations to optimize their operations. However, current knowledge on cross-organizational process mining (coPM) is widely dispersed. Therefore, we synthesize current knowledge on coPM, identify challenges and enablers of coPM, and build a socio-technical framework and agenda for future research.Design/methodology/approach We conducted a literature review of 66 articles and summarized the findings according to the framework for Information Technology (IT)-enabled inter-organizational coordination (IOC) and the refined PM framework. The former states that within inter-organizational relationships, uncertainty sources determine information processing needs and coordination mechanisms determine information processing capabilities, while the fit between needs and capabilities determines the relationships’ performance. The latter distinguishes three categories of PM activities: cartography, auditing and navigation.Findings Past literature focused on coPM techniques, for example, algorithms for ensuring privacy and PM for cartography. Future research should focus on socio-technical aspects and follow four steps: First, determine uncertainty sources within coPM. Second, design, develop and evaluate coordination mechanisms. Third, investigate how the mechanisms assist with handling uncertainty. Fourth, analyze the impact on coPM performance. In addition, we present 18 challenges (e.g. integrating distributed data) and 9 enablers (e.g. aligning different strategies) for coPM application.Originality/valueThis is the first article to systematically investigate the status quo of coPM research and lay out a socio-technical research agenda building upon the well-established framework for IT-enabled IOC.

Through the lens: A qualitative exploration of nurses' experiences of smart glasses in urgent care.

To investigate the real-world experiences of nurses' using smart glasses to triage patients in an urgent care centre. A parallel convergent mixed-method design. We collected data through twelve in-depth interviews with nurses using the device and a survey. Recruitment continued until no new themes emerged. We coded the data using a deductive-thematic approach. Qualitative and survey data were coded and then mapped to the most dominant dimension of the sociotechnical framework. Both the qualitative and quantitative findings were triangulated within each dimension of the framework to gain a comprehensive understanding of user experiences. Overall, nurses were satisfied with using smart glasses in urgent care and would recommend them to others. Nurses rated the device highly on ease of use, facilitation of training and development, nursing empowerment and communication. Qualitatively, nurses generally felt the device improved workflows and saved staff time. Conversely, technological challenges limited its use, and users questioned its sustainability if inadequate staffing could not be resolved. Smart glasses enhanced urgent care practices by improving workflows, fostering staff communication, and empowering healthcare professionals, notably providing development opportunities for nurses. While smart glasses offered transformative benefits in the urgent care setting, challenges, including technological constraints and insufficient organisational support, were barriers to sustained integration. These real-world insights encompass both the benefits and challenges of smart glass utilisation in the context of urgent care. The findings will help inform greater workflow optimisation and future technological developments. Moreover, by sharing these experiences, other healthcare institutions looking to implement smart glass technology can learn from the successes and barriers encountered, facilitating smoother adoption, and maximising the potential benefits for patient care. COREQ checklist (consolidated criteria for reporting qualitative research). No patient or public contribution.

Towards Secure and Transparent Elections: A Review of Electronic Voting Integrated with Blockchain Technology

Abstract: This paper provides an in-depth examination of the integration of blockchain technology with electronic voting (evoting) systems, aimed at ensuring the security and transparency of electoral processes. While prior research predominantly focused on the technical aspects of e-voting, recent efforts have acknowledged the intricate socio-technical dynamics at play. Drawing on conceptualizations and principles that view e-voting as complex socio-technical frameworks, this paper explores avenues for enhancing accessibility, efficiency, and integrity. Blockchain technology emerges as a transformative solution, offering cryptographic assurances to address vulnerabilities like data manipulation and centralization. Through blockchain integration, e-voting systems can uphold crucial principles such as verifiability, anonymity, fairness, and transparency, thus fostering trust in electoral procedures. The proposed systems leverage cryptographic techniques and smart contracts to protect voter anonymity, ensure data integrity, and enable end-to-end verification. Furthermore, the paper advocates for decentralized architectures to mitigate risks associated with centralized databases. By emphasizing the pivotal role of blockchain technology, this paper contributes to the advancement of e-voting systems towards secure and transparent elections.

PETRAS: a socio-technical framework for Internet of Things research and development

This paper presents a case application of a socio-technical framework for Internet of Things (IoT) research and development in the United Kingdom. Applying a socio-technical system approach to IoT, this paper seeks to provide a clear understanding of the interplay between technical and non-technical aspects of IoT research and development. It describes the socio-technical requirements for IoT design and development and provides the current snapshot of research in the United Kingdom to meet these requirements. Finally, the paper provides useful information on how to conceptualize IoT research within human-centered contexts and a useful guide for centre design and evaluation to those developing new research centres or seeking to reinvigorate existing ones.

Human factors and cyber-security risks on the railway – the critical role played by signalling operations

PurposeRailways are a well-known example of complex critical infrastructure, incorporating socio-technical systems with humans such as drivers, signallers, maintainers and passengers at the core. The technological evolution including interconnectedness and new ways of interaction lead to new security and safety risks that can be realised, both in terms of human error, and malicious and non-malicious behaviour. This study aims to identify the human factors (HF) and cyber-security risks relating to the role of signallers on the railways and explores strategies for the improvement of “Digital Resilience” – for the concept of a resilient railway.Design/methodology/approachOverall, 26 interviews were conducted with 21 participants from industry and academia.FindingsThe results showed that due to increased automation, both cyber-related threats and human error can impact signallers’ day-to-day operations – directly or indirectly (e.g. workload and safety-critical communications) – which could disrupt the railway services and potentially lead to safety-related catastrophic consequences. This study identifies cyber-related problems, including external threats; engineers not considering the human element in designs when specifying security controls; lack of security awareness among the rail industry; training gaps; organisational issues; and many unknown “unknowns”.Originality/valueThe authors discuss socio-technical principles through a hexagonal socio-technical framework and training needs analysis to mitigate against cyber-security issues and identify the predictive training needs of the signallers. This is supported by a systematic approach which considers both, safety and security factors, rather than waiting to learn from a cyber-attack retrospectively.

A sociotechnical framework to assess patient-facing eHealth tools: results of a modified Delphi process

Among the thousands of eHealth tools available, the vast majority do not get past pilot phases because they cannot prove value, and only a few have been systematically assessed. Although multiple eHealth assessment frameworks have been developed, these efforts face multiple challenges. This study aimed to address some of these challenges by validating and refining an initial list of 55 assessment criteria based on previous frameworks through a two-round modified Delphi process with in-between rounds of interviews. The expert panel (n = 57) included participants from 18 countries and 9 concerned parties. A consensus was reached on 46 criteria that were classified into foundational and contextual criteria. The 36 foundational criteria focus on evaluating the eHealth tool itself and were grouped into nine clusters: technical aspects, clinical utility and safety, usability and human centricity, functionality, content, data management, endorsement, maintenance, and developer. The 10 contextual criteria focus on evaluating the factors that vary depending on the context the tool is being evaluated for and were grouped into seven clusters: data-protection compliance, safety regulatory compliance, interoperability and data integration, cultural requirements, affordability, cost-benefit, and implementability. The classification of criteria into foundational and contextual helps us assess not only the quality of an isolated tool, but also its potential fit in a specific setting. Criteria subscales may be particularly relevant when determining the strengths and weaknesses of the tool being evaluated. This granularity enables different concerned parties to make informed decisions about which tools to consider according to their specific needs and priorities.

Games as Socio-Technical Systems

In the search for a comprehensive framework to structure and instrumentalize a Pedagogy of Play, the present article explores the ludic phenomena from an interdisciplinary perspective, integrating relevant knowledge from multiple sources and complementary epistemologies. As a result, a socio-technical framework of play and games is built, described and exemplified across different cases, over a continuous territory that performs in terms of multiple scales and complexities. The overall intention is not to normalize games, but to integrate more and diverse playful interactions within our everyday lives; not only within basic education but across academic and professional life: an exertion driven by a genuine search to learn from each other and supported by a versatile set of tools. By approaching games as the tangible materialization of play, therefore delegating the material embodiment of whatever comes out of our creativity, to an active learning practice inspired by our curiosity, and that of whom we collaborate with. To conclude, the article discusses and reflects upon the political and aesthetic implications of the presented framework, highlighting the importance of attitudes and narratives that complement conventional study programs by suggesting new ways to approach pre-identified, yet open spaces.

Memory in energy transitions: individual agency through historical narratives in the energy transition to gas and electricity in the Dutch household

Authors adopting socio-technical frameworks to study energy transitions argue that individual behavioural change and the uptake of social and technological innovations on higher-level scales are both imperative for sustainability transitions to come about. However, the way individuals are embedded in the larger system has remained largely unclear. To better understand individual embedment in energy transitions, this paper enriches sustainability transition research with the insights of memory studies. During energy transitions, social actors that enact these transitions change their identity. A core premise of memory studies is that individual and collective remembering cannot do without each other in the constitution of identity. To illustrate the role of memory in energy transitions, this paper conducts a historical case study of the role of housewives in the energy transition to gas and electricity in the Dutch household. By adopting a narrative approach, the historical narratives across the Monthly Magazine of the Dutch Association for Housewives (NVvH), published between 1913 and 1942, are explored. The results show how the master narrative prescribed the guiding principles of the historical narratives that emerged in the energy discourse. However, as part of the flexible nature of memory, a varied ‘menu of stories’ came forward that enabled individuals to identify with different historical narratives, incorporating differing energy sources and drawing on the transformative nature of memory by imagining different energy futures. It is concluded that individual agency in energy transitions moves beyond choices of use and consumption. It rests in the individuals’ ability to identify with a historical narrative that adheres to the way the individual makes sense of the world.

A sociotechnical perspective for responsible AI maturity models: Findings from a mixed-method literature review

As artificial intelligence (AI) is increasingly used in various industries, it becomes crucial for organizations to enhance their capabilities and maturity in adopting AI responsibly. This paper employs a mixed-method approach that combines topic modeling with manual content analysis to provide a comprehensive review of the literature on AI maturity and readiness. The review encompasses an extensive corpus of 1451 papers, identifying the main themes and topics within this body of literature. Based on these findings, a subset of papers was selected and further analyzed to identify AI capabilities utilizing a sociotechnical lens. This further analysis led to the identification of foundational and responsible AI (RAI) capabilities. These capabilities have been integrated in a sociotechnical framework of capabilities for AI maturity models providing valuable insights for organizations and AI service providers and a basis for further research.

Patient involvement and expectations during CT scans. Tinkering to involve patients and offer care in radiographic practice

IntroductionThis study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice. MethodsA qualitative field study was conducted in two Danish hospitals to investigate patients’ expectations and experiences of care and involvement during CT examinations.Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included. ResultsPatients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told, complying with requests put to each patient.Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries. ConclusionPatient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of “tinkering” is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures. Implications for practiceIssues were identified that may help professionals to put “the patient first”, thus, improving patient centered care.

Using the sociotechnical model to conduct a focused usability assessment of a breast reconstruction decision tool

IntroductionBREASTChoice is a web-based breast reconstruction decision aid. The previous clinical trial—prior to the adaptation of this refined tool in which we explored usability—measured decision quality, quality of life, patient activation, shared decision making, and treatment choice. The current usability study was designed to elicit patients’ and clinicians’ perspectives on barriers and facilitators for implementing BREASTChoice into the clinical workflow.MethodsWe conducted qualitative interviews with patients and clinicians from two Midwestern medical specialty centers from August 2020 to April 2021. Interviews were first double coded until coders achieved a kappa > 0.8 and percent agreement > 95%, then were coded independently. We used a sociotechnical framework to evaluate BREASTChoice’s implementation and sustainability potential according to end-users, human-computer interaction, and contextual factors.ResultsTwelve clinicians and ten patients completed interviews. Using the sociotechnical framework we determined the following. People Using the Tool: Patients and clinicians agreed that BREASTChoice could help patients make more informed decisions about their reconstruction and prepare better for their first plastic surgery appointment. Workflow and Communications: They felt that BREASTChoice could improve communication and process if the patient could view the tool at home and/or in the waiting room. Clinicians suggested the information from BREASTChoice about patients’ risks and preferences be included in the patient’s chart or the clinician electronic health record (EHR) inbox for accessibility during the consultation. Human Computer Interface: Patients and clinicians stated that the tool contains helpful information, does not require much time for the patient to use, and efficiently fills gaps in knowledge. Although patients found the risk profile information helpful, they reported needing time to read and digest.ConclusionBREASTChoice was perceived as highly usable by patients and clinicians and has the potential for sustainability. Future research will implement and test the tool after integrating the stakeholder-suggested changes to its delivery process and content. It is critical to conduct usability assessments such as these prior to decision aid implementation to ensure success of the tool to improve risk communication.

A sociotechnical framework to characterize tipping points in water supply systems

Population growth and a drying climate can push urban water supply across a tipping point into a new regime of water deficits. This research develops an analytical approach to characterize tipping points in water supply systems based on a loss of ecological resilience. A comprehensive sociotechnical modeling framework is developed to apply increasing stress gradients, representing climate change and population growth scenarios, to a water supply system and generate time series of deficits, which are analyzed to characterize tipping points. An agent-based modeling framework of water use, supply, and management simulates feedbacks and adaptations between human behavior and water infrastructure systems. Projections of climate change are generated using a stochastic reconstruction framework. A change point detection algorithm is applied to detect change points, and a tipping point rule selects a tipping point from a set of change points. The sociotechnical framework is applied for a case study to demonstrate tipping point analysis. A range of stress gradients are applied for a projected period, and tipping points are characterized for climate change scenarios and management strategies. The sociotechnical framework characterizes the resilience of water supply and can be applied to simulate, predict, and avert tipping points in water supply systems.

Computational propaganda: Concepts, methods, and challenges

In this dialogue, Phillip Howard introduces “computational propaganda” as an emerging communication tool in political communication and a perspective for investigating misinformation and disinformation. By articulating the concepts, patterns, and mechanisms of computational propaganda, Howard proposes a socio-technical framework for studying computational propaganda. He calls for mixed methods to undertake computational research alongside qualitative investigation, thus addressing the computational as well as the political. Howard emphasizes the battle against algorithm bias, manipulation, and misinformation, and he advocates building an International Panel on the Information Environment (IPIE), an international scientific collaboration, to respond to the challenges. In addition, Howard offers advice on further research in computational propaganda.

A sociotechnical framework for integration of telehealth into clinical workflow

Telehealth has received attention in recent years for improving access to healthcare and for supporting integrated care for chronic diseases. Considering that telehealth integration into clinical workflow can alter healthcare providers’ practice patterns, impacting efficiency, quality of care, and patient safety, it is timely to identify and account for system-level variables and considerations to improve the efficiency of telehealth integrations in healthcare settings. Despite the growth of telehealth, and isolated efforts to identify such considerations, a comprehensive conceptual framework for telehealth clinical integration is largely absent. To address this gap, this research effort applied a mixed methods approach to develop a sociotechnical framework to serve as a roadmap for clinics, hospitals, and other healthcare settings regarding the components that must be considered when developing and implementing a telehealth system. The developed framework, System Adoption and Integration of New Telehealth Systems (SAINTS), is grounded in literature and insights from three telehealth case studies in healthcare settings, is influenced by well-grounded sociotechnical models with application in complex healthcare systems, incorporates model-based systems engineering language for the development of structural models, and has been structured considering three temporal stages: system preparation, patient enrollment, and system implementation.

Face Work: A Human-Centered Investigation into Facial Verification in Gig Work

Through intensive research on datasets, benchmarks, and models, the computer-vision community has taken great strides to identify the societal biases intrinsic to these technologies. Less is known about the last mile of the computer-vision machine-learning pipeline: on-the-ground integration into the real world. In this paper, I analyze facial verification technology (FVT) through its use as account verification in ride-hail work. Using a sociotechnical framework combined with empirical qualitative research methods, including interviews and analysis of an online community of workers, this research is a deep dive into recognition technologies at the level of local practice. Findings reveal the high-stakes articulation labor demanded of workers to be recognized by these systems, including maintaining multiple mobile devices, repeatedly uploading requisite images, spending time and resources visiting customer-service centers, and making physical changes to their bodies and environments. These strategies constitute repairs to the failures of computer vision in dynamic environments and are required to successfully engage in the sociotechnical interaction protocols demanded by FVT. Drawing on Erving Goffman's terminology around social interaction rituals, I term these cognitive and behavioral negotiations "face work." Drivers' dynamic, responsive, and ad-hoc attempts to become machine-readable have significant implications for relations between identity and power in spaces of security and work, as well as for the integration of machine-learning systems into safety-critical infrastructures. Ultimately, this research emphasizes the crucial role of end users who create and maintain the conditions required for computer vision to produce judgment.