Design Interventions as Multiple Becomings of Healthcare

Research on design of IT traditionally treats the production of scholarly knowledge and the design of new systems as related, but separate processes. We propose the fruitfulness of practicing a closer relation informed by interventionist design research (appreciating a problem through attempts at solving it) and actor network theory (reality is enacted and constructed through our engagement). Through three concrete design interventions with cardiatric healthcare, we illustrate how diverse agendas of sociological inquiry and practical design considerations are intertwined and come to enact healthcare in specific ways. We suggest this as a strategy of multiple becomings, wherein assemblages of patients, health professionals, diseases, information technology, prototypes, and design researchers together perform shifts between promoting new practical design solutions and raising novel questions on the socio-material complexities of healthcare. INTRODUCTION When the cardiologist-patient consultation was coming to an end, the design researcher intervenes to propose a new design-research concept in myRecord – a webbased prototype of a patient-centric health record. Design researcher: “There is one more thing. We‟ve created what we call „assignments‟, which are a little experimental, but in your discussion with Karl [heart patient] you indirectly ask him to do some tasks – that he must keep an eye on this and that – so, what should he write down [in myRecord]?” Cardiologist: “Oh – Yes, okay [...] Karl, we've talked about that you need to find out how your breath is. This means that you every day have to go out on the street and walk until you need a break. Then it‟ll say [in myRecord]; Monday 50 m., Tuesday 50 m., Wednesday 45 m., Thursday 70 m. – anything [...]” Karl strives to follow the cardiologist’s suggestions and almost daily for three weeks he records his weight and blood pressure in myRecord (picture 3). However, as the logbook in myRecord reveals, he is too weak to measure his walking distance. As we elaborate further in the case of ‘Patient Homework’, this snippet is meant to illustrate how design interventions enable us to enact entanglements of sociologically-inspired inquiries in healthcare practice and explicit and change-driven promotion of new design-research solutions for improved healthcare. Through design interventions new relations are performed in assemblages of healthcare professionals, diseases, information technology, prototypes, design researchers, and theoretical conceptualizations and themes from IT research in healthcare. We suggest that conventional approaches to knowledge production within the primary fields that do IT (design) research in healthcare, such as Computer-Supported Work (CSCW), Information Systems (IS), and Participatory Design (PD) can be fruitfully complemented by more interventionist approaches as practiced within contemporary design research (Medical Informatics is focused on evaluation of IT and less on the design process, thus not included in this positioning). By three cases of design interventions we engage multiple interests within interventional assemblages and show how new relations are performed between concrete DESIGN INTERVENTIONS AS MULTIPLE BECOMINGS OF HEALTHCARE