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From bedside to bytes: the digital transformation of the healthcare workforce
1Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
Abstract:
Digital transformation is reshaping healthcare work, whereas research on workforce implications remains fragmented across disciplines. Effects like burnout, resistance, and workflow disruption are often framed as implementation failures rather than systematic outcomes of how work is reorganized. This Mini Review advances a four-dimensional analytical lens distinguishing work execution (task distribution, sequencing, temporal organization), work experience (autonomy, cognitive load, dignity), work governance (standardization, monitoring, accountability), and work learning and adaptation (workarounds, skill development, technology reshaping). The framework specifies information-mediated work, including documenting, coding, classifying, and verifying data, as the coupling mechanism binding these dimensions. This coupling is constitutive, in that documentation defines legitimate work;, transductive, in that changes spread across dimensions; and asymmetric, in that non-datafied work becomes invisible. Four characteristic paradoxes emerge: efficiency-intensification (execution-experience), empowerment-surveillance (experience-governance), innovation-compliance (learning-governance), and adaptation-deviation (learning-execution). These are structural features rather than design flaws, since informational practices that generate benefits in one dimension produce costs in another. Digital transformation also redistributes burdens unequally, concentrating execution demands, surveillance intensity, and learning constraints among lower-status workers. The framework reframes persistent tensions as predictable outcomes of dimensional misalignment rather than individual or technological shortcomings, and offers a diagnostic orientation for research and practice. Sustainable transformation depends on managing cross-dimensional trade-offs rather than eliminating them, with deliberate attention to whether digital systems support dignified, expert work.
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