This study examines how Digital Care Management Technologies (DCMTs) reshape accountability and empathic care practices in UK homecare agencies. Grounded in Agency Theory and Sociotechnical Systems Theory, the study investigates how digital infrastructures interact with relational care practices in digitally mediated homecare settings.
The study draws on semi-structured interviews with managers and owners from twelve UK homecare agencies. Data were analyzed using the Gioia methodology to develop inductively grounded theoretical insights into how digital technologies reconfigure care practices and organizational accountability.
The findings identify two interrelated sociotechnical conditions through which digitalization reshapes homecare work: first, accountability-as-legibility, whereby DCMTs render care activities visible and auditable in real time, strengthening managerial oversight and external assurance; second, information symmetry, where shared digital access reduces informational gaps and enables more transparent coordination among managers, carers, families and regulators. These conditions give rise to an accountability-empathy paradox: while digital visibility enhances coordination and service assurance, excessive monitoring and reporting demands can constrain carers' empathic engagement. The outcomes depend on capacity of empathic care, defined as organizational conditions that preserve carers' attentional and relational resources for empathic work under digital oversight.
This study integrates Sociotechnical Systems Theory and Agency Theory to explain how digital accountability infrastructures in homecare simultaneously enable coordination and assurance while risking the crowding out of relational care, introducing capacity of empathic care as an organizationally configured outcome.
