RESEARCHING DIGITALIZATION

Tuesday 19th May 2015, London 

10.00 – 16.30

A one day research workshop on the theme of Researching Digitalization was held at the London School of Economics.

Participants were invited to address two interconnected issues: the processes of digitalization and the doing of digitalization research.

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Programme

Here is the Programme for the day (with pdf  here):

9.45:  Coffee and Registration.
Lower lobby, New Academic Building, LSE – outside room NAB LG.09 (Alumni Theatre)

10.10 Welcome: structure and themes for the day – Tony Cornford

10.30  Session 1
Margunn Aanestad:  Connected Care; creating patient-oriented digitally supported health services [pdf of presentation slides here]
Ana Canhoto: Cutting through the digital chatter
Phil Godsiff: Digital Disruption of Financial Services  [pdf of presentation slides here]

Rapporteurs – Mary Darking and Valentina Lichtner

11.40 Coffee Break: Mapping round 1

12.00 Session 2
Valentina Lichtner: A research protocol for new medicines [pdf of presentation slides here]

12.30 Mapping round 2

12.50 Lunch

14.00 Session 3
Federico Iannacci: Tracing the evolutionary dynamics of digital artefacts from two different angles: the case of CUP [pdf of presentation slides here]
Edgar Whitley: Engagement 2.0 and the implications of digitizing the consent process in biobanking

Rapporteurs – Magda Hercheui and Will Venters

15.10 Tea

15.30 Mapping round 3 and Thematic Discussion

16.30 The End

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Mapping digitalization

The Delivering Digital Drugs project is aiming at mapping the terrain of digital drugs. The challenges of this method inspired the activity for the day. The workshop revolved around a mapping process: at the start of the day we introduced 4 themes for discussion and displayed them on an initial and very basic mind map. During the presentations sessions all were invited to mine the presentations for ideas and concepts to add to the map (or re-imagine it), using post it notes/marker pens. Here we have the final map created at the end of the day and a summary of the mapping activity.

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Themes and ideas

Digitalization as a distributed phenomenon was a theme that crossed the three morning presentations: Margunn Aanestad and her team in Norway are investigating  implementation of a range of distributed digital systems connecting hospitals with patients or with commissioners. Phil Godsiff research is on Bitcoin – a very much distributed phenomenon (like money is).  And  Ana Canoto and Jan Kietzmann research on data quality took them to study data from Twitter, a social network by definition distributed. Though the question emerged : does data (as in datasets used for research) converging the distributed nature of digitalization? e.g. into one place – the dataset?

These first three presentations also provided alternatives to the idea that research of digitalization can focus on ‘things’ and/or ‘processes’. To these two options, we can add of course ‘data‘ (as in Ana Canoto research on data quality) and ‘relationships‘ (inspired by Margunn Aanestad projects on Connected Care).  Also Phil Godsiff research on Bitcoin and the blockchain, reminded us that the distinction between a ‘thing’ and a ‘process’ is indeed often blurred: a Bitcoin is a thing that replaces physical coins (or paper money) as we know them, but as a blockchain – an address + a unique ID + a private key etc. – is a Bitcoin also a process? Definitely it looks like an assemblage!

The Bitcoin phenomenon was understood as a discontinuity and a disruption. And these are perhaps additional ways of looking at digitalization as process & changing (the latter suggests perhaps to look at continuities – as in the installed base embedded in a new infrastructure – as well as change).

These research projects also shared the challenge of producing practical outcomes – how to contribute to business, or clinical practice? This question was not discussed further but the theme was annotated on the mind map of researching digitalisation.

Margunn Aanestad and colleagues’ research on Connected Care in Norway resonated very much with research we have conducted in the UK. Their findings reminded us of our own experiences and what we observed in the field, researching the use of information systems in hospitals. Like for example the idea that replacing faxes with videoconferencing makes communication much too easy when one does not really wish to be in too close contact with commissioners; this reminded of the CPOE implementation that replaced all paper-based orders for tests, except for one, that made use of scarce resources, for this one the paper was kept, to make it ‘not too easy’ for doctors to order. Is this about practitioners setting their own boundaries to the connecting powers and speed of digital systems?

Ana Canoto and Jan Kietzmann research on data quality suggests there may be something intrinsic in data about quality, but this seems to be context dependent – for quality to be assessed, one needs to go back to the source of data, and therefore perhaps the activity?  Is the value of data also context dependent?

Time, as a theme, connected the two presentations in the afternoon session. Federico Iannacci began tracing the evolutionary dynamics of digital artefacts, exploring in particular whether digitisation was a mechanism, tendency or process. Drawing heavily on theories of critical realism, his talk focused on the temporal unfolding transformation of digital artefacts. Digitalisation, he argued, was the outcome of a set of mechanisms which, over time, had causal power mutually impacting actors at micro and macro levels. The term “bundling” was introduced in discussing the separation and embeddedness of digitality – digitisation separates from the medium (as bits), is also embedded (in agency and impact).

The theme continued in Edgar Whitley’s presentation on “Engagement 2.0” in which a detailed case-study of the development of a biobank dynamic consent system was presented. Where the “analogue” paper-based system was rigid and fixed in time, the digital consent could be altered and shifted over time. This allowed decisions, usually made during a period of stress, to be commuted until later or altered subsequently. Participants no longer needed to be detached from the research their bio-material contributed to, so empowering them. Finally consent could form part of a conversation in which the patient gained feedback and knowledge of the value of their contribution.

Finally, digitalisation brought one of our fundamental needs as people to centre stage, the making sense of the world through stories. In commerce, in culture, in our daily lives, the story is centre-stage. With digitalisation, the stories may become more detailed, possibly more or less nuanced. As Phil Godsiff illustrated Bitcoin can indicate its provenance through its history, in much the same way as an art-historian attempting to authenticate a painting will look for evidence as to its provenance and history, mindful of inconsistencies and gaps in this history. Edgar Whitley’s dynamic consent models provide the opportunity to explore our experienced and prospective histories. However, as Ana Canoto deftly illustrated, these stories are grounded in personal and cultural histories, and our ever shifting use of written, visual and aural language.

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Parting Thoughts

We distributed cards for participants to leave feedback, comments and ideas at the end of the workshop. In particular, we invited suggestions for themes for future workshops, planned for the autumn 2015 / spring 2016. Anyone wishing to suggest themes or ideas for these workshops, please get in touch with the research team.

Thank you very much to all who left their card in the return box. Below the comments received.

(The cards did not ask for names, but some comments were signed. We omit the signatures here as we did not ask for consent to publication).

“I liked the format which facilitated discussion and the mapping exercise (which would have disciplined my imagination had I done it).
Plus interesting empirical/conceptual input.”

“As a health care professional, I was struck by the amount of theorising by academics and how this relates back to practice, particularly with relevance to patients, they are the ones that take the drugs, how much does this work include them?
Thank you for inviting me, it has given me a unique opportunity to see things from a totally different viewpoint.”

“Regarding future workshops, I’d be very interested in a session exploring ‘The Digitalisation as Datafication’ theme – i.e. the by-product of digitalisation, the data generated by digitalisation (value, ownership, etc…)”

“Mapping exercise and ‘framing’ in advance was very good. This also allowed attendees to [..] link their own items throughout the day to the reframing of digitalisation in relation to D3.
For future workshops the co-creation of the process can be extended to different stakeholders like other NEMODE projects with specific link to new business models to allow other(s) to participate in ‘problem definition’.
I hope you’ll circulate the list of ideas in your MAP after today as it will be useful as a brief report of the discussions and main research questions! Thank you for letting me attend” {signed}

“Further concerns [for future workshops?] with:
– the nature of data and context of data
– the role of institutions in the process of digitalisation -> interpretation
– the eco-system of digitalisation processes and how they work together” {signed}

“A very interesting and valuable day. I’d like to get more involved in the D3 research program.” {signed}

“Very interesting – a good range of digitalisation research activities. Not clear who is going to be informed by the studies:
– is it about the design of interventions?
– is it about business value added opportunities?
– is it about a sociological interest on transitions?
The specifics of healthcare keep coming in my mind when thinking of presentations:
– physiology vs digitalisation (bodily properties vs digitality)
– from extrapolations and prediction to particularisation and sensing (new ways of health related knowledge building)
– the role of patients – asymmetries – blackboxing)
Assemblages as institutions – what about temporality?”

 

 

Note: summary of the event by Tony Cornford, Will Venters, Valentina Lichtner and Ralph Hibberd.