“We need to digitise carefully”
What is the best way to introduce digital technology in society and in our lives? According to Åsa Cajander, we need to devote more time and money in the development and introduction phases of digitising so that it doesn’t lead to new problems. “I want to make sure that the work people do continues to be good for them even when it is digitised, and I want to lend a hand with methods to ensure that this occurs.”
Computerised information systems, web and app-based e-services, teaching through digital learning management systems – information technology’s influence on our lives is only increasing. New electronic tools promise to simplify our lives. But how well do these aspirations correlate with the results? Researcher Åsa Cajander is studying how the digitising of various social functions affect work and the individual.
“Today we are creating digital gaps in society and in people who are burned out. Digitalisation follows the same curve as the burnout curve. It’s certainly not the only reason we burn out, but it’s one of them.”
The underlying factors might seem boundless, as numerous and complex as the individual users. But Åsa Cajander maintains that the architects of IT systems still need to become better at taking into account the interaction between technology and society at large.
“As matters now stand, those working in IT projects think that issues involving the working environment, gender and culture are so incredibly jumbled that it’s not possible to even begin addressing these issues. But we cannot think that way. We cannot ignore the problems just because they are complicated. We still have to work to achieve digital systems that work better for us than those we now have.”
As a researcher in human-computer interaction, Åsa Cajander employs what is known as action research. This research is based on project collaboration with different social groups to help make improvements and participate in a transformation process. The focus is on interviews and surveys of participants as well as meetings and workshops.
“My research team and I then often write articles together with those who are in the project. So it’s not like being a fly on the wall as many researchers are.”
One of the largest projects in which Åsa Cajander has been involved was when Region Uppsala 2011 introduced electronic medical journals for patients. She was the research leader of studies with patients and health care staff before and after the controversial introduction.
“The health care staff felt that the change came very much from the top. Many of them still find it very hard to understand what is positive about having online journals. They think it creates anxiety among the patients and takes time away from staff when patients ask questions about what they read in their journals,” says Cajander.
On the other hand, 97 per cent of all patients think it’s obvious that they should be able to have access to their journal online.
“We have a problem with continuity of care. At least now, patients can now log on and follow their care, see where the referrals are, when the next visit is and compare test results.”
The challenges include whether e-journals should be made available in languages other than Swedish. Difficult words and technical terms should have links to reference works. In addition, doctors rarely bring up the possibility for patients to read their journals online and thus prepare for the visit. This is something that would give patients a better understanding of their illness and greater motivation to follow the doctor’s recommendations, Cajander maintains.
As a researcher, she can make recommendations but rarely influences decision makers directly – though it has happened.
“In the e-journal project there was discussion of whether there should be a two-week waiting period before the patient could log on to the journal to see test results and read what the doctor has written. In that case my research team conducted an interview study with 30 patients, in which we asked how they wanted the system to work. And they did not want to have a two-week waiting period! The study contributed to the decision not to adopt the proposal. Of course, there was resistance from the doctors, but they had no choice as it became a political decision.”
At the same time, she points out that it is necessary to create good conditions for health care administrative work and the working environment. Ill health among doctors is increasing, and the number of nurses is decreasing, while the ageing population needs care during a longer and longer span of life.
“It doesn’t add up. And the biggest problem is not money but the nursing staff, and how many nurses there are. We need to strive to see that they are happy in their profession and remain on the job. Therefore, we also need to digitise with care.”
“To a great extent, it’s really about change management and communications. Communication is fundamental, of course. Without it, everything is flawed.”
Her research team consists of 12 individuals from a variety of different fields – one doctoral student is an ethnographer, another is a computer scientist in human-computer interaction, a third came from the civil engineering programme in technology and society systems. The senior researchers in the group have backgrounds in gender studies, business administration and computer science. With a head of research who has specialised in working environment issues, it is no wonder that the interdisciplinary collaboration works well.
“I work a lot on trying to create good conditions for collaboration, and we have, if I do say so myself, a great working environment. We really get along well together. We have different opinions, but we also have great respect for each other’s expertise,” Cajander says.
She has a background as language teacher in French and English. In her work at Fryshuset youth centre in Stockholm, she met many young people with psychosocial problems. “There was a lot of psychology, behavioural science and conflict management.” But then she became interested in mathematics and computer science – subjects she had studied in connection with her education as a language teacher at Uppsala University.
“So in 2000, I switched to being an IT consultant at a large international IT company. I worked with programming in Java in industry and conducted courses. Although simultaneously I was attending evening courses at the University because it was such fun!”
There were courses in programming, systems development methodologies and also in teaching and learning before she finally took the plunge to become a doctoral student in human-computer interaction. The winding road to higher technological studies is an experience she shares with many women, says Cajander.
“We’ve seen that when women have wound up in technical professions, this convoluted, strange background is rather common. As a result, we have to support and find means by which students can switch to technical subjects as they move along in their study career. Today there are not enough of these bridges across degree programmes.”
Åsa Cajander currently is serving a three-year term as equal opportunities officer in the IT Department. In addition she is conducting research on e-health and digitising in the Nordwit Centre of Excellence, which is run by the Centre for Gender Research. In addition to a handful of other research projects, she teaches 30 per cent of her time in the courses Medical Informatics, IT in Society and Complex IT Systems in Large Organisations. And blogs. And tweets.
How do you find the time, and above all the energy, for everything?
“I think it’s because I’m researching and lecturing a lot about the balance between working life and leisure time and the stress symptoms that exist. I know what I’m able to do and have the tools to slow down early enough when it becomes too much. And I’m good at sleeping, ha ha. I sleep a lot – nine hours a night.”
FACTS ÅSA CAJANDER
Title: Associate professor (awaiting word on a full professorship) in computer science with specialisation in human-computer interaction at the Department of Information Technology. In addition, “Excellent Teacher” at the Faculty of Science and Technology.
Education: Publicly defended her doctoral thesis on human-computer interaction in 2010 at Uppsala University
Place of residence: In Morgongåva outside Uppsala
Family: Husband; four boys, ages 6, 10, 14 and 16
Leisure time activities: Go to football and floorball games, run 4–5 km a couple times a week
Largest research achievements: In part, the DOME Consortium I built up in 2012 around the Vinnova-funded research project involving medical records online. The consortium currently consists of the universities in Karlstad and Örebro, the University of Skövde, Royal Institute of Technology and Karolinska Institutet and Uppsala University. It works very well, and we continue to meet regularly. The second major success is that I developed a didactic concept for learning environments – Open-Ended Group Projects, or OEGP. There students can develop the competencies needed to work on digitising from a holistic perspective.
Currently: Involved with the workshop Using data for better cancer treatments on 15 June at the Uppsala Health Summit.
Listens to: I listen to a lot of podcasts and audio books. A favourite among podcasts is Kommpis. Another is Changing Academic Life, which deals with stress and the working environment in academia. Also the Vårdmakt podcast. And one called You’re not so smart – great fun!
Hidden talent: Good at sewing clothes
Weakness: Lots of them! I can get tired of details, am instead very keen on overall lines of reasoning and ideas, can get facts wrong – it’s like I don’t really remember such stuff. That’s not my strong suit.
Dream project: Sometimes I imagine dropping out of this business of working as a researcher and becoming an IT strategist at a county council so that I can really contribute to change. Obtain a position for myself where I can have a bigger impact. But maybe I can also do that as a researcher.
Journaltjänst på nätet fick tummen upp (Online journal service got thumbs up)
IT-landskap ritas om vid Sveriges universitet (IT landscape is redrawn at Swedish university)
Svårt att koppla av från nya it-system (Difficult to disconnect from new IT systems)
Datorsystemen motsvarar sällan användarnas behov (Computer systems rarely correspond to users’ needs)
More about Åsa Cajander and her research team Health, Technology & Organisation at Uppsala University