Chiara Carboni (Erasmus School of Health Policy & Management (ESHPM) from Erasmus University Rotterdam) is a PhD candidate in the Medical Delta program: Journey from Prototype to Payment. She has explored the impact of automated healthcare technology from a sociological perspective and will defend her dissertation on November 29th this year.
What is the focus of your research, and how did you come to choose this topic?
“My research focuses on understanding the social dimensions of the digital transition in healthcare. In other words, how do healthcare professionals interact with innovative technologies like AI? How do they adapt to the changes these technologies generate, and conversely, how should the technology adapt to healthcare practices to be effectively applied?
For this research, I hung out with physicians and nurses in different settings. I physically embedded myself in hospital departments, observed local practices, and had many conversations. This ethnographic approach gave me insight into the impact of AI on healthcare practice and allowed me to explore the social and ethical questions arising from the introduction of AI in various clinical contexts.
The data I collected from these interactions were analyzed to identify patterns, trends, and new themes. The primary goal is to provide a nuanced understanding of how clinical practice is changing due to not only to AI itself, but also to expectations around it. The idea is to make these professional and organizational changes an object of shared deliberation for professionals, managers and developers. I believe that deciding which technologies should be integrated into the workflows of healthcare professionals, and how, should be an object of open conversation. I hope the empirical materials analyzed in my PhD can provide a basis for that.”
What insights have you gained from your research?
“During my research, I noticed how the tasks and workflow of healthcare professionals change not only once AI is introduced, but even before that. Managers and healthcare professionals regard AI as central to the future of healthcare. For instance, in pathology departments, AI-driven image analysis is expected to play a crucial role. But to realize that vision, organizational and professional changes are necessary. Therefore, although AI applications in everyday clinical care are still somewhat rare, departments are proactively preparing for the implementation of AI. Hospitals have invested in digital infrastructure and adjusted their diagnostic processes accordingly.
Another shift I observed is the pursuit of efficiency. Hospitals turn to AI to streamline processes and improve efficiency in clinical practice. For example, I studied a data analysis dashboard in an intensive care unit. This dashboard was designed to monitor and analyze patient stability in real time, allowing nurses to focus more on patients who require the most attention at that moment.
While such AI-driven systems can indeed enhance efficiency, there is a risk that they may undermine the authority and decision-making autonomy of healthcare professionals. Nurses may feel that their knowledge and experience are being replaced by an automated system.
Moreover, the focus on the most urgent cases could come at the expense of holistic patient care. The system creates a work environment that revolves primarily around the most critical cases. But of course, even in acute settings, care provision is much more than that. Moreover, given that burnouts are a significant issue among healthcare professionals, it is important to consider the type of work environment we are creating if healthcare professionals are constantly dealing with urgent cases.
My research aims to strike a balance between leveraging the benefits of AI integration and addressing the social and ethical implications. This way, we can mitigate potential negative consequences for healthcare professionals and patient care.”
How does interdisciplinary collaboration contribute to your research?
“With a background in medical anthropology and science and technology studies, I have been able to leverage many collaborations during my PhD. Erasmus School of Health Policy & Management, where I was based during my PhD, has a long history of working closely with healthcare professionals and policymakers.
I spent time in various hospital departments, such as pathology, intensive care, and acute psychiatry. Although I learned a lot from these experiences, it was at times challenging to have to adapt to different work cultures and communication styles.
For successful collaboration, it is important to understand each other's values and goals. Working with multiple disciplines gave me a wide range of perspectives on the use of AI.
Medical Delta played a significant role in facilitating this collaboration and formed a vibrant interdisciplinary community. It provided me with access to a diverse network of academic colleagues and healthcare professionals, offering valuable insights and fostering meaningful collaborations. The interdisciplinary nature of this community enriched my research journey, allowing me to integrate perspectives from different disciplines and contribute to empirical social science research in healthcare.”
The previous interviewee, Karin van Garden, is curious: Would you have chosen a different field of study if you could choose again?
“When I reflect on my research journey, I have learned how important it is to embrace different perspectives and engage with people in the field early on. The collaborative opportunities and enriching experiences outweigh the challenges of interdisciplinary research. My advice to future Medical Delta PhD candidates is to remain open-minded, bold, and curious. Conducting research within an interdisciplinary field requires flexibility and perseverance.
The most important thing I learned during my studies is to develop a critical mindset. It is the continuous process of learning, unlearning, and questioning that makes you a skilled researcher.
So yes, ultimately, I can say that I am satisfied with the path I have taken, and I am motivated to continue unraveling the complexities of implementing innovations in healthcare.”
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This interview is the fifteenth in a series with PhD candidates and postdoc researchers funded by Medical Delta. Chiara's research is funded by the Medical Delta program: Journey from Prototype to Payment.