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Assembling Agency for Viability: Videoconference in Orthopaedic Consultations

Authors:
Anne G Ekeland

Keywords: video-conference in orthopedic consultations; heterogeneous assemblages and agency; vulnerability and viability

Abstract:
An orthopaedic videoconference (VC) service between a university hospital and a district medical centre was initiated by an orthopaedic surgeon/PhD candidate, who also ran the service. Four hundred patients were included and randomized in two groups for the PhD project, where clinical quality, patient satisfaction and cost effectiveness were investigated. Five years after its initiation, the service was still running even after the data collection was completed. The professionals kept the service running while waiting for the results of the study to be published because of its advantages. However, conditions and regulations established for the PhD project left the service constantly vulnerable to being closed down at short notice. Based upon empirical observations, documents, presentations, articles and interviews, I explore how the service was maintained; that is, the mechanisms accounting for agency/action in keeping the service viable under unclear and shifting conditions. Within a socio-technical perspective I adopt the notion of ‘heterogeneous assemblages’ to analyse such mechanisms, implying that action is understood as shaped by a number of shifting, heterogeneous conditions or influences which may translate into common strategies through interaction. The paper presents and analyses the assemblages that came into play in certain phases of the service, and reflections about the future of the service. I argue that meaning, issues of improvement of tasks and augmentation of the scope of related activities were main conditions that assembled and translated into agency for stabilizing viability. Human motivation and creativity was therefore crucial for utilising the advantages of technologies and overcoming unsteady conditions. This assemblage surmounted other assemblages that accounted for vulnerability. Studying agency as dynamic assemblages and translations fuelled by motivation, along with the innovative agency portrayed, may be applicable to other VC services.

Pages: 41 to 46

Copyright: Copyright (c) IARIA, 2015

Publication date: February 22, 2015

Published in: conference

ISSN: 2308-4359

ISBN: 978-1-61208-384-1

Location: Lisbon, Portugal

Dates: from February 22, 2015 to February 27, 2015