Abstract

The increased adoption of platform-based services in healthcare warrants new scrutiny of bias in patient care. Emerging data-driven electronic health records allow for future data extraction and eased access to data streams for purposes other than recording individual patient care, raising concerns about risks of bias and discrimination. This paper investigates nurses' de-biasing practices in their daily data work. Our understanding of bias applies to nurses’ relational practice and perspective on data work, wherein de-biasing entails attention to sociodemographic factors. We ask: What do nurses consider as relevant data to document as part of their work caring for patients, and how do they account for risks of bias? We investigate this question ethnographically in two Danish hospital wards, via 67 total observation hours. We find that nurses may approach de-biasing the patient record with a tactic of omitting data related to sociodemographic factors (e.g., class, education, or cultural background), which could provide advantage or disadvantage for the patient’s treatment. As EHRs are increasingly designed for cross-patient data extraction and new forms of decision support, nurses' de-biasing is important to consider in relation to the risks of discriminatory patient care.

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