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Paper short abstract

AI and other digital technologies have entered the healthcare field as a promise of efficiency. This study examines the gap between that narrative and its lived reality: the glitches, repairs, and improvisations through which healthcare workers keep the script intact (or not).

Paper long abstract

Digital technologies are increasingly introduced in the healthcare field through promissory discourses that present efficiency as an unambiguous good. However, efficiency is not just a technical outcome: it is a narrative that needs to be continuously maintained and defended. This study examines the gap between efficiency as it is sold and efficiency as it is lived: the frictions, glitches, and improvisations that characterise its implementation in everyday (health)care settings, and the labour both workers and institutions invest in trying to uphold this narrative.

Building on scholarship on sphere transgressions (Sharon, 2021; Sharon & Gellert, 2024; Walzer, 1983) and historical analyses of efficiency and automation (Alexander, 2008, 2009), this research argues that corporate-driven efficiency enters healthcare not as a stable value, but as a script that is constantly under negotiation. When digital systems produce unexpected outputs, break down, or fail to fit their own aims, workers are left to absorb that gap: repairing, reframing, and improvising in ways that sustain the appearance of smooth, efficient operations. These everyday practices of maintenance are not incidental to the implementation of digital technologies, but a constitutive part of it.

Engaging with empirical cases from the literature on digitally supported homecare, medical chatbots, and digital mental health technologies, this study aims at showing how efficiency-as-narrative and efficiency-as-practice diverge, and how that divergence is managed. This research investigates how a value originating in industrial and market spheres crosses into healthcare, reshaping what counts as legitimate care practice, while bypassing the critical assessment that sphere transgressions demand.