Lecture on Digitalization and our Work Environment


System development work is difficult, and many IT systems do not work satisfactorily despite intensive technology development. My research is about improving the situation and understanding what the problems are. I am working on developing improved working methods in the organizations and projects that develop and introduce IT. The focus here is user-centered methods, gender, sociotechnical perspective and agile development. I have also researched the skills that the people in the projects need to master to be able to work with the development of complex systems that support people in a good way.

If you are curious about my research – listen to the 12 min long lecture in Swedish


On Digitalisation and Fragmentation of Time

Diane Golay and Åsa Cajander did a presentation on Fragmentation of Time and Digitalisation for the Uppsala University Academic Senate this fall. This blog post captures some of what we said in the presentation.  Enjoy!

Digitalisation of work sometimes has the unintended side effect that it fragments our time. Fragmentation commonly refers to the separation of activities into many discrete pieces. It is usually calculated based on two different aspects: the length of continuous work episodes, and the number of interruptions. In those terms, fragmented work is characterized  by short work tasks and frequent interruptions, as opposed to a work rhythm made of few but long work episodes with no or few interruptions.

Several studies have pointed to the increasing fragmentation of our work.  For instance, a 2009 study found that people switched tasks about every 12 minutes. Two years later, another study found that a modern worker’s day comprised an average of 88 work episodes, most of which (90%) lasted for 10 minutes or less. The found average duration for those work episodes was of just under three minutes.

Work fragmentation is related to a perceived increase in work pace and work intensity. It is also detrimental to the actual work taking place. The causes of fragmentation can be both external, such as a phone call or a computer that stops working, or internal, i.e. self-initiated, such as looking up an information on the web while working on a report.

External interruptions have a particularly negative effect on work. A context switch requires cognitive overhead, and context- switching is related to time costs. Concrete negative consequences of external interruptions include errors, stress, work delay, difficulty resuming the interrupted task, and increased user frustration. Interruptions are however not always negative: inquiries, breaks, and adjustments can facilitate the primary task by providing valuable information or creating an environment that encourages increased productivity. Context plays a significant role in determining whether interruptions are considered to be beneficial or detrimental. In general, interruptions that occur outside of one’s current working sphere context are disruptive as they lead one to (sometimes radically) shift their thinking. In contrast, interruptions that concern one’s current working sphere are considered helpful.

However, it should be noted that fragmentation is also a natural part of our work. Work tasks are to a small or high degree woven together and fragmented in complex patterns. Workers seldom work with one task at the time. Interruptions are a to some extent also a natural part of our work. Breaks are for example crucial for collaboration and learning.

So we should not aim for a fully continuous workflow, but might want to try and reduce external and internal interruptions that are not related to the task(s) at hand. Finding an amount of fragmentation that works for us will enable us to boost our work performance, reduce our cognitive workload, and simply make us feel better at and about our work.


[1] Jin, J., & Dabbish, L. A. (2009). Self-interruption on the computer. Proceedings of the 27th International Conference on Human Factors in Computing Systems – CHI 09, 1799. https://doi.org/10.1145/1518701.1518979

[2] Wajcman, J., & Rose, E. (2011). Constant connectivity: Rethinking interruptions at work. Organization Studies, 32(7), 941–961. https://doi.org/10.1177/0170840611410829

Dr Grünloh did an Excellent Job Defending her PhD

We all knew that Christiane Grünloh of our team knows how to do great and important research. But we were still amazed by her skills at the defense! Also, the atmosphere was really super nice and the defense was really a discussion among true professionals more than a questioning. The opponent David Hendry did such an excellent job and was really well prepared. If you weren’t there you missed something special!

Minna Salminen Karlsson from the HTO team, who is indeed very experienced, said:

“This was one of the best PhD defences that I’ve been to!”

The title of the PhD thesis is “Harmful or Empowering? Stakeholders’ Expectations and Experiences of Patient Accessible Electronic Health Records”. The research deals with the national eHealth service in Sweden that gives people access to their electronic health records.

You can read more about the PhD thesis in Christiane’s blog found here

Winding Road to Become Professor of Human Computer Interaction

Next week it is time to celebrate that I have become a new professor of Human Computer Interaction. Up until a couple of years ago I would never had thought that this would happen. The typical professor in my world is odd or excentric, very smart and a man. Well, perhaps I am a bit excentric? Hmm. Especially when it comes to sleeping I do follow a slightly different orbit from the rest of society. I am indeed a proper party pooper and fall asleep early in the evenings  :-o. Also my winding background is not very traditional for professors. There was a recent paper about my background in ACM Crossroads found here for those who are curious. But I do not see myself as very smart at all, and I think I am quite an average person generally. Moreover, I am very happy about being a woman.

How did I then end up being a professor of Human Computer Interaction? Well, I think that my best abilities as a researcher is curiosity and being brave. Also I think that Human Computer Interaction is an area that fits well with my interests as it is transdisciplinary. In short: I can fit the areas that I am interested in well into the subject of Human Computer Interaction even though they transcend education, enterprise usability, eHealth, gender and wellbeing. There was a text about my research on the university’s web page found here. Finally, I am convinced that I would not have come this far without the fabulous people I work with both in the HTO group, the UpCERg group and internationally. In a good collaboration everyone is a winner and research becomes so much more fun. A good example of this is that my colleagues Mats Daniels and Arnold Pears are also inaugurated as full professors at the same ceremony as I am, and also the important research that my colleagues and I do.

The inauguration of full professors is a public ceremony with newly appointed professors and this year it takes place on the 16th of November at 15.00. The ceremony has its roots in the medieval times and has been held every year since 1625. Perhaps I’ll see you there?





Closed Loop Medication

My name is Iosif Kakalelis and I’m towards the end of my master studies in computer science at Uppsala University. I have finished my four-year bachelor in my hometown Thessaloniki in Greece, where I studied Applied informatics at the University of Macedonia, a business school. My degree combines IT with business, marketing and economics. Here in Sweden, it is more flexible in terms of forming study plans. During my first year l, I experimented with different courses but in the end I realized that I was still more interested at working in real-life projects dealing with  needs of society. Hence, I chose to do my master-thesis at Uppsala University Hospital.

Nowadays, technology has been embraced by society in almost every applicable field. Healthcare is no exception. New, innovative technologies are gradually being introduced in different health facilities around the globe in order to make healthcare more effective, less costly and better monitored.

Uppsala University Hospital intends to introduce Closed Loop Medication [1] to its whole workflow. Pre-studies have already been carried out and certain funds are available for this ambitious project. This suggested solution concerns almost everyone involved in healthcare. Most often the end-users are nurses, who first check and then administer the prescribed medicine to patients. Other examples of people affected by this change are doctors who prescribe, pharmacists who control and verify the correct medicine doses but may also include storekeepers who inspect the availability of medical supplies. 

 The selected medication is prescribed on an unverified prescription order that is then transcribed. Transcribing includes performing multiple crosschecks of the prescription order to real-time patient information, healthcare industry practices, and medication information to generate a verified prescription order. After transcribing, the appropriate dispensing method is determined for the prescription order and dispensed. The dispensed medication is administered after confirmation by the administering clinician of the right patient, right medication, right dosage, right route, and right time. The whole process of medication use described above is monitored continuously in real-time. The monitored information is communicated to the prescribing, transcribing, dispensing and administering parts of the system. [1]

In other words, automation is part of the entire process, starting from the doctors who are prescribing medicine, pharmacists checking and verifying the prescribed medicine, nurses receiving medicine from vending machines and finally the patient being given prescribed meditation in a customized package for him. The reason for automating the process is ultimately to achieve improvement in the accuracy and speed of the medicine distribution chain. Although the hospital today is considered technologically advanced, they are currently using different software, which was developed and often owned by third parties, for each part of the chain. Furthermore, for some specific tasks there is not even an available software solution. The drawback of this approach is that, often, there is limited to no communication and connection between the different software.

Even worse, there is not efficient communication and real time information between the different departments of the same hospital, because, as mentioned above, different databases and software are used, sometimes even for the same functions. Therefore, it is not uncommon for nurses, for example, to manually search for the available medicine on shelves, or doctors to call other departments to ask if a specific medicine is available there. All those factors contribute to making the whole procedure more time consuming and lead to harsher working conditions for employees and generally lead to the diminishment of productivity. Clearly, there is a need for the right medication, in the right place, at the right time, with the least possible effort and risk. Effectiveness could be achieved with closed loop medication through a centralized, interconnected, and interoperable information system which embraces all the functionalities of the current solutions. This system should be closely aligned with the current routines and working habits of the staff. The fact that the end-users are usually nurses or doctors, whose time is always prioritized toward patients, should spend the minimum possible time learning and using a software for their daily tasks.

Implementing a closed-loop system, is a broad and ambitious vision that people at the hospital shares, which involves many different specialists and knowledge from different fields including logistics. The area of my study is going to be the pharmaceutical verification step in close-looped-medication. Here in Sweden, doctors prescribe medicine to patients, but before the latter receive them, the prescription has to be verified and approved by pharmacists for safety reasons. After a meeting I had at the hospital with Dr Anders Westermark and some other medical personnel, I was told that currently there is no software responsible for implementing and monitoring that process. However closed loop medication necessitates a verification solution to be implemented. Thus, this is the part I want to get involved with and below my plan is described.

First, I plan to understand, analyze the workflow of this step from the perspective of all professions involved (i.e. doctors, pharmaceutical employees). A verification system should check if prescribed medicines uphold some predefined standards and/or whether they take into account each patient’s special needs or peculiarities. In case discrepancies are found, relevant warning indicators and messages should be triggered.

Second, I will try proposing solution ideas about this verification system answering questions about how it will look like, and how that would effectively fit inside the workflow, based on feedback I will receive from all the involved actors. This thesis motivates me to study papers regarding eHealth and automation in order to discover how knowledge of the others could give nice ideas for my project.  Since the topics is about improving healthcare, potentially I could also make a small literature research about AI and automation in health. The optimal solution would include a verification system that self learns and improves.

 It is also important to study the outcome this automation will have to the people. Role of technology is to serve people’s needs and not vice-versa. They should have control and opinion in the whole process and not kept outside the loop, like simple spectators. Therefore, it is my plans to study about potential problems that automation could bring. My final suggestions should take into consideration people’s considerations and concerns.




Henderson, D., Richard, L., Marklewicz, E., Tobin,C. (2003). CLOSED LOOP MEDICATION AND METHOD.



Kick-off for a series of posts on teaching and learning

In addition to the research that we do, many of the members of HTO are involved in lots of teaching activities at the department of IT in Uppsala. Some of the courses we teach are in the area of health care, and here we have a very good collaboration with Region Uppsala. The setup of this collaboration is to aim for a win-win between students learning and the Region’s goals and visions. We have collaborated with the Region since around 2004, and it has resulted in many new learning opportunities as well as input to innovations in health care both for the Region and for the nation.

We also work with innovation and development of learning opportunities in our teaching. Åsa Cajander is a member of the Uppsala Computing Education Research Group, and this community gives lots of input and ideas for improvements of courses.

This semester we collaborate with Region Uppsala through our course on Medical Informatics and the course IT in Society. We also collaborate through joint master theses on topics of interest to the Region. We have asked a couple of our current students to write blog posts about their experiences during their thesis work, and this fall the HTO blog will contain a series of blog posts on teaching and learning activities related to the HTO group.

Visiting period at the HTO May – June 2018 – Shweta Premanandan

I had the opportunity to visit Uppsala University again during May-June 2018. And this time I was welcomed by the warm Swedish summer! I was at the HTO group to work with my co-supervisor Dr. Åsa Cajander on my PhD work. My earlier visit in November 2017 to the group was very successful during which I collected survey and interview data from the Swedish context. My research is to understand the role of culture in the acceptance and use of e-government systems. And hence, data from two contexts is really important for the quality of my work.

During the duration on my visit, I worked on analysing my interview data. I discussed my work with Dr. Marta Larusdottir and Dr. Minna Karlsson, apart from discussions with my supervisor. These meetings opened me to a wide variety of ideas to work on with my interview data and they look promising. I also took a training session at the University Library on the use of Nvivo 12 for analysing interviews and organizing my literature review section. I also presented my analysis work in the Vi2 research seminar. We had some interesting discussions and I received good feedback. I am now in the process of writing chapters of my thesis. Discussions with other group members and my office-mates also were extremely helpful in this regard. The most helpful aspect of being at Uppsala university is to be able to meet so many PhD students at the department (or at the local watering hole) who may not be from my area and who are doing some really amazing work and be able to discuss research.

Uppsala never ceases to amaze me! I got a good cultural experience when I got to be a part of the staff Midsummer party. The music and the dancing was just amazing. Interacting with a multi-cultural community also helped my research work immensely. I hope to share my research work through this blog site soon!

Organization, Artifacts and Practices, 8th workshop in Amsterdam

Organizations, Artifacts and Practices (OAP) yearly workshops remind of the fact that work in organizations happens in certain physical spaces, need certain time and is performed with the help of artifacts – even in the digital age. The theme for this year’s conference was ”Rematerializing organizations in the digital age” An overarching theme in the sessions I attended was places where we work – working from home or working in open space offices, especially hot-desking, i.e. not having a designated desk.

Timon Beyes’s opening keynote on ”The work of disconnection” discussed the increasing trend of learning to disconnect from the digital world – for example digital detoxes. His descriptions of how digital media has invaded our ways of thinking even when we try to disconnect was quite thought-provoking. The occasional giggle in the audience indicated that we to a certain extent recognised ourselves in the descriptions.

In the final panel the three days’ presentations on locations and open office spaces were summed up, and, generally, open offices were criticised on basis of many surveys and interview studies, some of them done in universities. The lack of privacy was acutely felt. In the overall effort of creating open offices, even people with functions the really demand private spaces (counselling, for example) found it difficult to assert their needs, as in Bernadette Nooij’s study. Identity crises – “who am I without my books”, as a university staff asked. And, actually, some people felt more lonely, when chatting at the door of a colleague was no longer possible. As Marie Hasbi has found out, there can be gender issues – not only had female workers problems in finding a space for their handbags (the lockers relatively far away, and nowhere to lock away the handbag when moving from the desk), the acts to re-territorialise desks could have gender aspects, as well as being exposed to all colleagues all the time. And the negatives seemed to persist.

Increased working from home often goes hand-in hand with hot-desking (so the number of desks can be kept lower than the number of employees). Melanie Goisauf had studied a well functioning public bureaucracy, where working from home was introduced and found out that control of the employees by the managers increased when the team control, built on common ethos and responsibility and supported by daily interaction diminished. Instead of “us” having responsibility towards the public, single employees shifted their responsibility towards the management, and the team spirit deteriorated as competition regarding individual performance increased. As managerial control based on performance measures increased, tacit knowledge disappeared from managers’ view.

Joshua Firth’s study from New Zealand at an ICT development company, developing tools for healthcare goes in line with the HTO results: Practitioners/healthcare workers find it difficult to really get a voice in development processes, even if they would be formally enlisted, and this trend seems to get stronger the longer the process goes on. Firth talked of building in neotaylorism in the healthcare software, and just like Taylorism in its time, it profoundly changes work practices, disempowers the (healthcare) workers and centralises managerial power.

Also Joao Cunha’s study on how people enlist other people’s help when they have to use online communication is interesting in healthcare, where more and more communication is supposed to use electronic forms instead of personal interaction. Cunha found that when people just have to send a message to a great unknown, and, thus positional power or personal relationships cannot ensure that their request will be heard, they invent different strategies in trying to ensure that the request is dealt with swiftly.

The workshop made great efforts for breaking up traditional academic lecturing styles with a number of panels and question-answer sessions. In this context Vrije Universiteit Amsterdam had an artefact I haven’t encountered before: A conference microphone shaped like a soft cube (see image). Instead of people running around with microphones, the “dice” was thrown around in the lecture hall. Fun – but also demanding that the person who had something to say had a fair ball sense to be able to catch and throw precisely enough. Still another academic ability coming on?

ECSCW–the Rise of the Machines?

ECSCW 2018 took place in the beautiful French town Nancy and was hosted by Inria. As always there was a friendly atmosphere and a nice mix of presentations. I was there to present an exploratory paper by Rebecka Cowen Forssell and myself, on the Digital Work Environment. (A presentation most likely to remembered mainly for the art nouveau homage to Nancy, I’m afraid). However, there were a lot of interesting presentations, and here I will highlight just a few topics that I personally found interesting.*

The initial keynote by Antonio Casilli on the micro work behind AI was worth the trip alone. It was a great presentation on a very important topic. Indeed, this dispelling of the myth of AI was a theme that came up in a number of talks, not least in relation to the promises of automation in Industry 4.0. I also had the opportunity in one of the breaks to listen to Edgar Daylight’s historical perspective on this–AI being notoriously famous for recurring hypes.

The presentations covered a wide range of topics, from the Tatbeer ritual (Majdah Alshehri) over socio-technical heuristics (Alexander Nolte) to digital sticky notes (Sarah-Kristin Thiel) but somehow it all fitted together. I guess part of this can be explained by some of the traditions of the ECSCW community.  Here, Stuart Geiger’s presentation of documentation work was a fine example of the ever present ethnographic perspective. The humanistic values were evident in Renwen Zhang’s talk on online support groups for depression in China as well as in Isaac Holeman’s plea for Silence.

There were quite a few presentations that were more directly relevant for my own work, including Luigina Colfini on work-life balance, Nina Boulus-Rødje on supporting knowledge workers and Pernille Bjørn on variations in oncology consultations. I also found Yuri Lima’s poster on a tool for assessment of disruptive ICT in the workplace very promising. In their study on collaborative design projects in school contexts Netta Ilvari and her colleagues used service research as a theoretical lense, a theory I have been considering using myself. 

However, the conference had a special focus on computer support for qualified industrial work—Industry 4.0/the industrial internet of things—and the challenges were well summarised by Thomas Ludwig from Siegen. The Siegen crowd was as always strong in quality as well as in quantity. There is a lot of interesting research going on there that seems to touch on many of the same topics we are studying, although in an industrial setting. As proven by the panel discussion, similar studies are of course taking place in other countries as well, examples were given from Austria and France.

Speaking of Austria, ECSCW 2019 will take place in Salzburg and we got a glimpse of the venu and the playful new facilities that Verena Fuchsberger and her colleagues are enjoying.

Who knows, maybe I’ll be back…

*A formal note: I refer just to the presenter here, in most cases there were co-authors, see the Eusset proceedings for full information.

Article in Interactions Highlighing the SIGCHI/EIT Health Summer School

Last summer many from the HTO group joined the SIGCHI/EIT Health Summer School that was organised in Dublin and in Uppsala/Stockholm. The photo in the blog post is from the amazing library at Trinity Colleague.

The magazine Interactions highlighted the summer school in their latest edition.

The article highlights some of the learning experiences from organising such a summer school, such as that demand is high for such summer courses, patient participation is very valuable and that it was easy to recruit contributors to the summer school.

I know that the other organisers of the summer school thought that it was a lot of administration, but all agreed that it was also great fun!

Interactions also highlighted some of the HTO groups’ blog posts about the summer school found here:

Jonas Moll: https://molljonas.wordpress.com/2017/07/01/ehealth-summer-school-in-dublin-day-5/

Christiane Grünloh: https://www.htogroup.org/2017/07/08/behaviour-change-social-practice-theory-and-learned-helplessness/

Diane Golay: http://dianegolay.ch/2017/07/05/on-humans-computers-and-why-users-should-not-be-blamed-for-struggling-with-computerized-systems/