From Timesheets to Tablets: Information Technology in Coordination of Home Health Care Services

• In Event: 2150 - Technology, Flexibility, and Work Arrangement

Abstract

Scholarship on technology and work debate how and to what extent the rise and prevalence of machines will replace human labor. This article examines the role of software-based information technology in the coordination and management of home health care services for the elderly or disabled. It draws on data from a yearlong organizational ethnography in the staffing offices of a leading home health care company in the United States, and compares managers’ use of tablet and app based electronic health records software in the coordination of professional, clinical staff to managers’ reliance on older technologies and traditional paperwork in the coordination of paraprofessional aides. Findings suggest that software technologies designed to facilitate record keeping and communication across care teams create their own inefficiencies. Users’ substantive rationality of care work conflict with the formal rationality of medical bureaucracy, which underpins the technology’s design. The software technology mediates the relationship between managers and field staff. I argue that predictions of technologies’ replacement of human workers is currently overstated in the case of care industries. Further, by comparing management of professional clinicians to paraprofessional aides, I argue that the medical de-professionalization thesis, based on changes in large-scale structures and institutions of medicine since the 1980s, also affects those workers who were never professional. In moving from informal care to formal medicine, home health aides stand to further lose local, substantive authority in the workplace.

Author

• Tina Wu, NYU Stern School of Business