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Three Lessons for Achieving Legitimacy in Designing Data-Driven Systems for Hospital Care: Attuning to Healthcare Workers’ Perspectives on Data Sharing

Sep 2026 · ACM Transactions on Computing for Healthcare · 0 citations · 58 references

Abstract

Legitimacy is a key concern when introducing data about work in healthcare, especially as data-driven systems move closer to real-world application and begin shaping how care work is represented, interpreted, and shared across stakeholders. This paper reports healthcare workers’ (HCWs’) perspectives on data sharing in a design project that uses workflow data to support care, including accounting for the needs of patients and caregivers. Guided by the principle of “minimum viable datafication” [62]- limiting data production and sharing to what is meaningful and contextually appropriate - we engage Dourish’s [26] notion of the “legitimacy trap,” in which participatory processes appear consultative, but ultimately reinforce designer or managerial assumptions. Aiming to pro-actively achieve legitimacy, rather than falsely assume it, we contribute three lessons for the Human-Computer Interaction (HCI) and Health community: 1) data representations should attune to workers’ lived experiences; 2) HCWs should be enabled to care both for their own data-related needs and the impact of data sharing on patients and caregivers; and 3) space should be created for contestation and negotiation, recognizing that data sharing must remain responsive to how stakeholders experience the representation of work.

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