Why it is hard to support group work in distributed healthcare organizations: empirical knowledge of the social-technical gap.

We used a participatory design process to understand and to support the group work of cancer clinical trial protocol design within a distributed organization, the Southwest Oncology Group (SWOG). We also designed a collaborative writing system to facilitate its protocol reviewing and revising processes over the Internet. After a series of iterative prototyping and formative evaluations over the past two years, we identified a social-technical gap in our group work support research at SWOG. This gap consists of technical challenges, expanding user needs, conflicting user needs from different roles, insufficient incentive for using groupware technology by certain members, subtle organizational nuances, and the changing organizational structure. This paper describes our longitudinal evaluations results and elaborates on the social-technical gap. We think this gap may generalize to other healthcare group work settings.