Imaginaries of the data-driven hospital in a time of crisis

Abstract

This article uses the concept of sociotechnical imaginaries to explore how public hospitals are being reimagined and reconfigured by promissory digital health. Drawing on interviews with 42 senior leaders and staff from a large NHS hospital organisation, the article describes the imaginary of a data-driven hospital and the tensions of its operationalisation. These relate to data quality, data curation and data access, and reflect a discord between the organisation's commitment to immediate patient care and its research aspirations. These tensions, however, serve to invigorate, rather than undermine, the sociotechnical imaginary of a data-driven hospital, as they prompt the translation of a general data-driven imaginary into specific sociotechnical arrangements. The article argues that the potency of the data-driven hospital imaginary must be understood in terms of its enchanting qualities: it has the capacity to excite hospital staff and to align distinct and potentially diverging hopes and expectations regarding the societal role of public hospitals. The article concludes by suggesting that the entrenchment of the data-driven imaginary can be partly explained by its strategic utility for severely resource-constrained healthcare organisations: it provides a means for organisations to position themselves towards a viable future in an otherwise dire health-care context.

Keywords: big data; computational medicine; eHealth; electronic health records; organisations; science and technology studies.