Organisational and professional hierarchies in a data management system: public–private collaborative building of public healthcare and social services in Finland

Abstract

Nordic countries are considered international leaders in producing combinable data on their citizens' encounters with public institutions, as well as the digitalisation of public services. Publicsector professionals increasingly collaborate with private IT companies in developing data analytics products for cost saving and cost-efficiency. This article presents the results of a two-year ethnographic study of a collaboration between the Knowledge Team of a public-sector organisation and a private-sector IT company for developing and maintaining a data management system in one Finnish regional healthcare and social service organisation. The data management system is defined as a data analytics product that provides management with information about clinical and financial aspects of organisation management. We combine perspectives of science and technology studies and the sociology of professions to situate our research on the data management system as a boundary object within the broader context of professional work. Via our theoretical framework, we examine the negotiation process through which the data management system becomes a boundary object in practice. This process includes not only the accommodation of diverse epistemic cultures but also organisational and professional hierarchies that empower some experts to shape the data management system towards their visions and interests. This article applies the 'boundary object' concept to elucidate structural power differentials in public-private partnerships and multi-professional collaborations.

Emotional labour in the collaborative data practices of repurposing healthcare data and building data technologies

“…I became particularly intrigued by the performative character of these numerous moments of silence (for more, see Dupret, 2019), which appeared to be related to the power relations within the public organisation and the public–private partnership (for more, see Choroszewicz and Alastalo, 2021). The interviews with the KT members and the KT's own team meetings provided me with insights into the instances of silence in the collaborative meetings, which appeared to be linked to the following situations: (a) the KT members had no time to acquaint themselves with the issue and thus had nothing to say about it; (b) they were mostly present as listeners and were thus engaged in other work tasks during the meetings; (c) they wished to express critical comments or questions but felt pressured not to do so; (d) they were impeded by the hectic pace and technical language of technical demonstrations by the IT company experts; (e) they had no access to DMS testing; or (f) they were overwhelmed by and frustrated with the laborious collaboration with few benefits from the DMS for their everyday work.…”

“… 4. The collaborative building of the DMS, including the impact of power hierarchies on its shaping, is discussed in detail in another paper published from this study as a part of the same research project (see Choroszewicz and Alastalo, 2021). …”

(In)visible everyday work of fostering a data‐driven healthcare and social service organisation

“…While this perpetual piloting might have benefits for all collaborating parties (see, e.g. Choroszewicz & Alastalo, 2023), it also distributes accountability among private stakeholders and those engaged in short‐ and long‐term pilot projects ultimately aimed at fostering the transition to data‐driven public organisations (Kaun, 2022). This situation could benefit private IT companies that, through experimentation, gain insights into the technological needs and data of public organisations, thereby enabling them to strengthen their own position in the technology market.…”

“…Here I describe the ethnographic research practice that is specifically relevant to this article. In my two other articles, I provide additional information (for more, seeChoroszewicz, 2022;Choroszewicz & Alastalo, 2023).3 As the number of KT experts changed during the fieldwork, so too did the size and composition of the team.That said, there were around 16 experts on the team at any given time during the course of the fieldwork. Due to this small size of the KT, no meta-information is provided, and I refer to the team only as the 'knowledge production and technology expert team (KT)'.…”

“…Here I describe the ethnographic research practice that is specifically relevant to this article. In my two other articles, I provide additional information (for more, see Choroszewicz, 2022; Choroszewicz & Alastalo, 2023).…”