In a new preprint published ahead of a forthcoming special issue on “Information Systems and Data Work in Healthcare,” Claus Bossen and Naja Holten Møller explore how medical secretaries at a Danish hospital turned adversity into agency following the implementation of a new Electronic Health Record (EHR) system.

The study details how the introduction of the “Healthcare Platform” (HP) initially threatened to deskill medical secretaries by automating or eliminating parts of their work. However, rather than accepting marginalization, these professionals reasserted their value through strategic and collaborative socio-technical repair.

Key findings include:

1. Reclaiming expertise: Medical secretaries pushed back against deskilling and repositioned themselves as skilled data workers vital to digital healthcare operations.
2. Leadership matters: Proactive management played a crucial role by appointing technical experts and supporting local system adaptations.
3. Socio-technical repair: Modifications to templates, documentation standards, and collaboration routines helped restore and improve workflows.
4. A new professional narrative: The reframing of secretaries as core contributors to patient care enhanced recognition and morale.
5. Repair as empowerment: The case illustrates that repair can be more than technical—it can restore professional agency and foster sustainable change.

The authors argue that repair is inherently transformative, offering a means to rebuild not only broken systems but also social and professional structures. The study highlights that data work—often invisible and undervalued—is essential to the everyday functioning of digital healthcare.

This case from Denmark offers important lessons for healthcare organizations worldwide facing the complex realities of digital transformation.

You can find the preprint here.