Chapter 9: Enacting Relational Expertise to Change Professional Routines in Technology-Mediated Service Settings

This chapter advances understanding of how professional expertise is enacted and created to accomplish routines in the context of technology-mediated work. Information and communication technologies broaden the participation of professionals with various specialist skills and expertise to accomplish work together, which is particularly salient in health care. Broadening participation, however, creates jurisdictional conflict among professionals. Thus, a key challenge of interprofessional work is the need to mutually adapt established professional routines and overcome jurisdictional conflict to perform interdependent routine tasks. The authors examine how professionals adapt established routines by analyzing the new interactions and interdependent actions required to accomplish technology-mediated geriatric consultation routines. The findings of this study show that professionals create new patterns of actions that are shaped by relational forms of professional expertise, namely selective and blending expertise. The findings and theoretical insights contribute to the literature on routine dynamics by highlighting the importance of relational expertise, and showing how it can transform and destabilize otherwise established professional routines.