The data work of medical secretaries in Danish hospitals

The Danish Healthcare Sector is subject to a rapid and profound digitalization with an increased emphasis on healthcare becoming data-driven in order to increase quality and effectiveness. This movement is changing organisations, professions and work tasks for those involved, to meet the increasing need for data. While data work is constantly changing it remains widely undescribed. Hence, it is the dynamics of the allocation of data work between professions and the skills and knowledge required in undertaking the new tasks and roles that constitute the new data work, that is the field of this research.
Medical secretaries have been positioned at the center of data work within Danish hospitals since their appearance in the 1930s. In the 1950s, they primarily transcribed physicians’ dictations, but their work task portfolio has since expanded as demands for patient record keeping and data coding grew, and as complex patient trajectories required coordination. New technologies such as electronic health records and speech recognition have led to debates about the dying out of the profession, recently underscored by layoffs as the electronic health record (EHRs) ‘Sundhedsplatformen’ was implemented. At the same time, they have acquired new tasks and work roles such as ICT super-users, patient supervisors, data Ninjas and data controllers and coders.
Thus, the profession of medical secretaries provides an interesting opportunity for investigating how data work becomes part of and shapes a profession and its relations to other professions such as doctors, nurses and other administrative staff.
To investigate the skills and knowledge required by the medical secretaries in undertaking tasks and roles related to data work, presently and historically, I will take a qualitative, explorative approach and a starting point in humanistic and critical data studies and sociotechnical work-studies emphasizing the contextual knowledge and skills required to undertake this new data work.
The interest of this project is to understand the historical, current and potential role of medical secretaries in relation to digitalization and data work. The empirical part of the project will consist of 1) a technology historical analysis of the development of the dialectic between digitalization of the Danish health sector and changes in medical secretaries’ competences and task portfolio and 2) an ethnographic study of the current data work of medical secretaries in a hospital setting generating insights on both the work itself and how the dynamics of work allocation unfold from the perspective of medical secretaries. All findings will be validated with key field actors in order to explore the challenges and opportunities of data work for this particular profession.
This research project is a subproject of the grant Making Data Work Visible , which is funded by the Danish Council for Independent Research and comprised of three subprojects focusing on: 1) an investigation of data work in an existing profession (medical secretaries; this project), 2) an investigation of a central data work site (a Business Intelligence unit) and 3) a national overview of data work in healthcare in Denmark.