Robots Conquering the Homeland of the Vikings: Making Sense of Robot Vacuum Cleaning in Danish Public Eldercare
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Robots Conquering the Homeland of the Vikings:
Making Sense of Robot Vacuum Cleaning in Danish
Public Eldercare
Jeppe Agger Nielsen, Kim Normann Andersen & Anne Sigh
Department of Political Science, Aalborg University, Denmark
[agger, kandersen]@dps.aau.dk
Presented at the Annual European Group of Public Administration (EGPA) Conference (PSG I: E-
Government (ICT in PA), Edinburgh (Scotland, UK), 11-13 September 2013
Abstract
The movement of robots from the production line to the service sector provides a protein
solution to innovate and transform public service delivery. However, although robots
increasingly are adopted in public service delivery (e.g., in healthcare and eldercare) as an
alternative to traditional labor intensive services, little is known about their impact on
organizations work processes, and how key stakeholders react toward robots. On this backdrop,
this single case study investigates implementation and use of robot vacuum cleaners in Danish
eldercare at the local government level. Using an extended version of the technological frame
concept, this paper illustrates how technologist, managers, frontline staff and clients have
different perceptions towards robot vacuum cleaning. The technologist and managers praise the
new innovation for facilitating savings on the current accounts. By contrast, the frontline staff
and clients find that robots do not sufficiently clean the floors. With the domestication of the
robots, this paper argues that public administration literature needs to rethink whether this is only
jet another generation of technologies or something radically new is surfacing to energize
changes in public service delivery.
11. Introduction
June 8, 793 the Viking attack on Lindisfarne on the East coast of England marked the beginning
of the 200 year long Viking age and generating images of strong and often brutal humans from
the North. In 2013, the eldercare in the homeland for the Vikings is being conquered by robot
vacuum cleaners. A massive armada of robots is being rolled out in the Danish public eldercare
to take over manual work in the labor-intensive eldercare sector.
Similar to the legends of the Vikings, the roll out of robots is a viewed by a mixture of
admiration and fear. At the political scene top ministers have praised robots as a future-oriented
way to effective transform public service delivery and support the available resources with
intelligent technology solutions (Morgenavisen Jyllandsposten 2013). In sharp contrast, the use
of robots has been severely criticized by the powerful Danish Association of the Elderly fearing
that robots undermines personalized services and being a masked privatization of welfare
services (DaneAge 2012). Despite being controversial, Danish municipalities have increasingly
adopted robot vacuum cleaners for fully or partially replacement of manual cleaning. A recent
report demonstrates that 66% of the 98 municipalities in 2013 have decided to adopt robot
vacuum cleaners in eldercare. Moreover, 23% of the municipalities considered to adopt them
(KL 2013). More broadly, advances in robot technology have ushered in areas in which robots
appears to offer an alternative to traditional labor for providing routinized task and services in
public sector health and eldercare (Mutlu & Forlizzi 2008; Broadbent et al. 2010; Liebert 2011).
Although robots increasingly are adopted in public service delivery such as healthcare and
eldercare, little is known about the interplay with physical work processes, and how key
stakeholders react toward robots. There is a major gap in public administration literature to
explore the entry of robots in the public sector. Thus, our research on robot vacuum cleaning is
aiming to bring the organizational and public administration literature in use on what we view as
a growing field of technology use in the public sector.
While many associate robot vacuum cleaners as not being part of information and
communication technologies (ICTs), we argue that the convergence of the media and
technological tools makes it highly relevant to consider robots to be part of ICT and use the
theoretical and case study lessons from the public administration related work on ICT to help
2understand and possible guide the adoption of robots. For example, the recent robot vacuum
cleaning models from Samsung offers TCIP communication for programming start and stop as
well as other functionalities such as video communication. Online monitoring of not only the
vacuum cleaning but also communication with the elderly is potential to exploit. Therefore the
technical development is an issue of convergence where the monitoring of the vacuum cleaning
will be done from remote distance and the role of government operated eldercare may shift from
a labor intensive service to a robot management service.
The idea that robot technology can make planned changes is manifested in the Scandinavian
countries national strategies for eldercare, but may be at odds when implemented in local
government organizations facing a variety of stakeholders with different, multiple and often
ambiguous objectives. Given the track record of planned technology development and
implementation, researchers should modify such uniformed and optimistic view (King and
Kraemer 2012; Baptista, Newell and Currie 2010; Fountain 2001). In this line of thinking we
draw from the work of Orlikowski and colleagues (Orlikowski and Gash 1994; Orlokowski
2000) to investigate action and reaction towards robots. We rely on a single case study (Yin
2009) from Danish local government (municipality) funded eldercare that deployed robot
vacuum cleaners in eldercare. Billund Municipality (i.e. the specific case setting for this paper)
has introduced robot vacuum cleaners as a regular substitute for manual vacuum cleaners in
eldercare, with almost 400 robots into use.
By using the concept of technological frames, we explore how critical stakeholders in eldercare
make sense of robot vacuum cleaners as they were applied in day-to-day practices. Following
Orlikowski and Gash (1994) we assume a close relationship between attitudes and actual
behavior; thus if robots are to become successful technologies it requires support from the actors
involved. We also argue that factoring in a client perspective is an adequate extension of the
original framework (Orlikowski and Gash 1994). Shifting the focus towards robot technology
that has a direct impact on the service to the citizen, it seems appropriate to include the clients’
interpretations to more fully understand the advantages and challenges of using robots. This lead
us to pose the following two interrelated research questions:
3 How do technologist, managers, frontline staff, and recipients of public eldercare make
sense of robots?
What are advantages and challenges from the use of robots from different set of actors?
Next, we outline our theoretical framework. We then present the research design and method,
followed by an analysis of the implementation and use of robot technology in Danish eldercare.
In conclusion we outline practical and theoretical implications as well as limitations of our study
and recommendations for further research.
2. Theoretical lens guiding the our case study
In our research unfolded in this paper we are triggered by a theoretical interest and examination
of how the actors, as they interact with a technology in the implementation and ongoing
practices, make sense of the technology (Weick 1995). Similar approaches have previously been
used with success to address the complexities involved in public sector ICT implementation
(e.g., Fountain 2001; Bekkers and Homburg 2005; Grunden 2009). More specifically we are
investigating how underlying assumptions, expectations, and knowledge that people have about
new technology (i.e. technological frames) are crucial to understanding technological use and
change in organizations as they critically influence the way people act around technology (Pinch
and Bijker 1984; Orlikowski & Gash 1994). As suggested by Siino & Hinds (2005) we expect,
robot vacuum cleaning - a fairly unfamiliar technology – to occasion sense making when
introduced into eldercare work environment.
Orlikowski and Gash (1994) divides technological frames into three main categories: Nature of
Technology which refers to how actors perceive technology, including its suitability and
function. Technology Strategy captures desired impact supporting organizational goals. The third
category is Technology in Use which includes the actors understanding of how technology is
used and will be important in daily routines. In sum, the three categories: “reflect what the
technology is (nature of technology), why it was introduced (technology strategy), and how it is
used to create various changes in work (technology in use)” (Orlikowski and Gash 1994, p. 184)
and help to determine different actor’s perceptions of technology. The categories overlap in
practice, but may prove useful as an analytical lens to assess similarities and differences in
actors' understandings of technology. Moreover, technological frames are flexible in nature, as
4different groups perception of a given artifact may change the over time (Orlikowski and Gash
1994; Orlikowski 2000).
Orlikowski and Gash (1994) identify three vital groups in technology implementation:
technologist, managers and users. Technologist key interest captures a technical understanding of
technology, where technology is seen as a tool to be designed and perform a given task.
Managers key interest refers to strategic understanding of technology where expectations
typically associated with the new technology will change the workflow, thus providing a
financial return or improve services. User interest refers more to an instrumental understanding
of technology with the expectation that the use of technology provides an immediate return in the
form of revised and easier workflow.
In a situation of shared frames there is an agreement on how to use technology: “Congruence in
technological frames would imply, for example, similar expectations around the role of
technology in business processes, the nature of technological use, or the type and frequency of
support and maintenance” (Orlikowski & Gash 1994, p. 180). In a conflict situation, however,
there are significant differences in expectations, assumptions or knowledge about technology,
which may have fatal consequences for implementation. Moreover,”… frames can create
”psychic prisons” that inhibit learning because people cannot look at old problems in a new
light and attack old challenges with different and more powerful tools – they cannot reframe”
(Orlikowski and Gash 1994, p. 177).
Although Orlikowski and Gash’s (1994) framework may prove useful in understanding modern
age technology (such as robot innovation in the public sector), we propose an extension to the
original model. Shifting the focus towards healthcare innovation, and in particular robot
technology that have a direct impact on the service to the citizen, it seems suitable to include the
clients’ interpretations of how technology is expected to improve service delivery. The inclusion
of this dimension enables the analysis to complement the intra-organizational aspects with
client’s interpretations of robot vacuum cleaners, as an essential element in the identification of
opportunities and pitfalls of using robots.
More recently Orlikowski (2000) has focused more intensively on actors situated use of
technologies by proposing a practice-oriented understanding of the interaction between actors,
5technologies, and social action. In this view different social group’s interaction with a
technology is seen as recursive; users do shape the technology, while structure in turn shapes
their use. Accordingly, the social construction of technology does not end once designed and
developed, but rather continue during its use (Orlikowski 2000; Leonardi and Barley 2010).
Moreover, technology implementation is far from always a straight forward process; sometimes
progress happens through coincidences. “When users choose to use a technology, they are also
choosing how to interact with that technology. Thus they may, deliberately or inadvertently, use
it in ways not anticipated by the developers” (Orlikowski 2000, p. 408).
Adding the client dimension to the theoretical lenses, we offer a potential contribution to the vast
amount of studies that have adopted the Orlikowsky and Gash framework. Although the human-
computer interaction studies have addressed the end users, it took close to two decades to include
the citizen or client perspective in the institutional theoretical lenses. Also, we emphasize
ongoing usage of technology by drawing on the ideas of situated use of technology.
3. Design and Method
The research context of our case study is public sector provided eldercare in Denmark. The
Danish Social Services Act obligate municipalities to facilitate the help and support that older
people need (Ministry of Social Welfare 2010). Within the legislative umbrella, two forms of
eldercare exist: (1) institutional care in residential homes owned and operated by the
municipalities, and (2) home care in the form of practical (e.g., cleaning) as well as personal
(e.g., bathing) services delivered in the private homes of older citizens (Jensen and Lolle 2013).
Home care is also predominately provided by municipality employed staff although recipients of
home care services can choose private companies for both the practical and personal care and
then have the costs reimbursed by government. Internationally, Denmark is considered as a
frontrunner in the area of public financed eldercare with extensive offers for the elderly and with
a high amount spent per capita on resources (Doyle and Timonen 2007). More than 100,000
people are employed in the sector.
Danish eldercare has since the mid-1990s increasingly used information and communication
technology (Nielsen et al. forthcoming), and more recently robots are becoming increasingly
integrated into day-to-day work (KL 2013). Although there have been some experiments with
6robot vacuum cleaning in other Danish municipalities, Billund is representing the best case
(Flyvbjerg 2006). Billund has since 2011 systematically used robot vacuum cleaners to substitute
man power, and represents the first large-scale robot innovation project in Danish eldercare. In
addition, Billund is considered a “model municipality" for robot implementation in eldercare in
Denmark (Morgenavisen Jyllandsposten 2012). Billund, in which LEGO is located, has a
population of 26.367 citizens (pr. 1.1.13) and is a mid-size Danish municipality covering an area
of 541 square kilometers. In 2013, 219 clients lived in Billund Municipality residential homes,
and 583 clients received home care services.
In order to gain insight into the actors interpretation of robot innovation, semi-structured
interviews have been conducted in 2012 and 2013 with technologist, managers, frontline staff
and clients in Billund Municipality as summarized in Table 1. Interviews were subsequently
transcribed in full length to facilitate analysis.
Table 1. Categories of people interviewed
Categories of people Position Date
Managers Manager of social service May 2012
Manager of eldercare April 2012, 2013
Manager at the operational level May 2012
Technologist IT manager May 2012
Frontline staff Care workers (3 + 4) April 2012, 2013
Clients Citizens receiving services in residential May 2012
homes (3). Client receiving home care
services (3). The interviewed clients are
between 70 and 80 year old.
7The interviews were supplemented by a number of documents, e.g., project descriptions and
minutes from meetings (Billund Municipality, n.d), to gain further insight into the
implementation process. Finally, we used observation technique as we followed care workers "at
work" with robots to better understand situated use of robots. These fly-on-the-wall observations
took place during two mornings (May 2012) in two residential homes. These observations were
documented using field notes. Overall, field observations supplement the interviews enlightening
how robot vacuums are used in practice, thereby challenge or reinforce findings from the
interviews.
To make sense of these data from different social group we first read through the collected data
material (i.e. transcribed interviews, documents and field notes) to get an overview of the entire
material (Miles and Huberman 1994). Next, our data analysis was more directly linked to our
research question and theoretical framework. Accordingly, especially Orlikowski and Gash’s
(1994) technology frame concept inspired our structuration of data, focusing on robot innovation
strategies, implementation and use. Finally, we asked mangers in Billund Municipality to
comment our findings to ensure that we had accurately captured what they said. This process
resulted in useful feedback and in particular a number of factual issues were corrected.
Analysis
Inspired by the work done by Orlikowski and colleagues (1994) our analysis focuses on how
different actors make sense of the new robot technology and how they interact with the robot
vacuum cleaners. In the following sections, we will develop our analysis in three main parts
(strategy, implementation and use) inspired by the key elements in Orlikowski’s terminology.
The analysis includes four social groups: technologists, managers, front-line staff and clients.
Background
The formal decision to acquire robot vacuum cleaners in Billund Municipality was taken in
2010. The adoption was accompanied by an objective to have clients themselves to pay for robot
vacuum cleaner. This idea proved controversial (DaneAge 2012), but in August 2011, the
National Social Board gave green light for Billund Municipality to claim that the robot vacuum
cleaners can be regarded as ordinary consumer goods, and thus created the basis for a
8reassessment of individual visitations for practical care (i.e. cleaning) (Andersen 2012). New
standards for cleaning prescribed that “The municipal standards for vacuuming imply that
vacuuming is done by robots” (Billund Municipality, n.d).
The municipality has managed to save 150,000 euros in the municipal operating budget by
reducing the allocated time for home care cleaning visits by 12 minutes (20 %). As part of this
strategy home care clients were told to either buy their own robot, switch to a private provider
(which uses manual vacuum cleaners) or use the municipality's own robots once every three
weeks (Billund Municipality, project description). As shown in Table 2, the majority (65 %) of
clients have chosen to invest in a robot themselves. Interestingly, very few (1 %) have chosen to
make use of the municipality’s robots. However, 165 (28 %) clients prefer a private provider
who does not use robots. In the wake of the introduction of robots, more than 70 clients shifted
immediately from municipal service to a private provider to avoid using robots. If using a private
provider, a user fee of 7 euros must be paid for each vacuuming. Billund Municipality has
purchased 12 robots (IRobot) for cleaning in residential homes.
Table 2. Home care clients with and without robots in Billund Municipality. 2013.
N Percent (%)
Home care clients who have invested in robot vacuum cleaning 377 65
Home care clients who use the municipality’s robot vacuum cleaning 4 1
Home care clients who are approved for manual vacuuming 37 6
Home care clients who receive home care from private providers (vacuuming 165 28
with manual vacuum cleaners)
Total recipients of home care (including cleaning) 583 100
Strategy
9Managers and technologists were enthusiastic about the use of robots as a promising way to
modernize eldercare. Top managers were confident that robots could save money and clean just
as well as manual vacuum cleaners. In addition, they considered it an important improvement for
clients to be able to vacuum as often as they like (and not only every three weeks, which they
had been approved for). Overall, top managers had a clear vision of what benefits robots could
bring to the municipality. Due to economic constraints, the municipality had to save money,
which became a key motivation for adoption:
For the municipality it is crucial to ensure effective care for clients. We have to
support the available resources with intelligent technological solutions (Billund
Municipality, project description).
In general, this optimistic view was echoed by technologists (as assumed by Orlikowski and
Gash 1994). The IT manager saw robots as an obvious means to transform the way that services
are delivered to clients. Similar, robot suppliers also praised the new technology. One of the
suppliers wrote:
A robot vacuum cleaner does exactly what it promises – it vacuums automatically
so you don’t need to. With a robot vacuum cleaner you will free up time for other
tasks. The robot does a thorough job and gets completely into the corners, which
can be seen in our robot vacuum cleaner video (www.roboteksperten.dk).
Moving down the management hierarchy, somewhat different perceptions of the motivation
behind the adoption of robot technology were evident. Managers at the operational level did not
see savings as the main objective, but emphasised an improved working environment as a key
motivation. This exemplifies how different understandings of robots may coexist within the same
social group (managers) (Orlikowski and Gash 1994).
Although there was awareness that the robots were introduced because of cost savings, the front
line staff (and to some extent clients) regarded improvement of the working environment as a
key motivation. One of the care workers expressed this objective by stating that the reason for
implementing robot vacuum cleaners was:
… to support the staff and avoid work-related injuries, no doubt.
Implementation
Moving forward from the strategic motives to the implementation process, top managers
considered the implementation a success in which front line staff were deeply involved. The
10managers emphasized how the demand for robot usage originated within the front line staff
themselves. Said the manager of eldercare:
It was a committee of managers and employees in eldercare which in 2010
prepared a proposal for savings to the politicians. One of the suggestions implied
that robots could ensure savings of about 150,000 euros each year. So it was
actually front line staff representatives who helped explain why robots are a good
idea.
She further argued that resistance and scepticism about robots have been limited. In her view
both the municipality in general and the front line staff in particular were ready for change.
Additionally, because the idea of using robot vacuum cleaners originated "from below":
We are privileged to have employees who are ready for this. But I also think that
it is because it actually comes from their needs. We do not say you have to do this
or that. Of course we soften them a little; it's obvious. But we have framed it in
such a way that it is about their ideas and needs. They have a lot to say.
A noticeable initiative in the involvement of front line staff during implementation has been
education from so-called welfare technology ambassadors. According to the top managers these
ambassadors played a crucial role in reducing resistance towards change – “they have been able
to sell the idea of robot innovation to their colleagues” as expressed by a manager.
The manager at the operational level who was interviewed was somewhat less enthusiastic
regarding the implementation process. She confirmed that it has at times been difficult to
convince staff that the use of robot vacuum cleaners is a good idea; she recognized that it is not
possible to get all employees to use the robot vacuum cleaners. She remarked:
It's always like that with major changes. You always have employees that are
lagging a half year or even a year afterwards. This happens every time, and I do
not think that I can change it.
While the top managers considered the implementation process a success in which employees
were deeply involved throughout, the front line staff had another interpretation of what happened
in the early phase. In fact, the interviewed frontline staff agreed that the decision about
introducing robot vacuum cleaners came as a surprise. They were especially frustrated by lack of
information. A care worker said:
Well, we got a bit of a shock with the robot vacuum cleaner.... In fact, everyone
else knew about it before we knew about it.
11And another continued:
... the municipality had given the announcements on robot innovation to the
newspapers... so some information had not reached us before there was a general
announcement. I felt we should have been informed much earlier, giving us some
time to get to know them [the robot vacuum cleaners] so that when clients had
questions, we could have had a chance to answer them – because there were some
big questions: Will it get into the corners? Can it get around the furniture? We
could not answer these questions.
The frontline staff were apparently not well-informed that they should use the robot vacuum
cleaners in their daily work routine. At the later stages of the implementation process, the front
line staff felt more involved and better informed. The welfare technology ambassadors were
designated immediately after the introduction of robot vacuum cleaners, which may be seen as a
wise move by management as the frustrations over lack of involvement and information that had
arisen from the clumsy start were improved with this initiative.
The clients who were interviewed represent somewhat mixed views regarding information about
the introduction of robot vacuum cleaners. A client said:
There's nothing to complain about.
Another client was more sceptical:
We were only told that we should have robots, and that they [the municipal staff]
should not vacuum for us anymore. And it's actually the only thing we were told.
The municipality, however, conducted several information sessions early in the process for
clients and relatives to answer urgent questions and raise emerging concerns about the use of
robot vacuum cleaners. Besides serving the obvious informative purpose, the information
sessions also enabled the municipality to identify possible criticisms from clients.
Turning to the technologist perspective it is noteworthy that the IT department was not involved
in the implementation of the robot vacuum cleaners. The IT department felt that it was
unnecessary for them to get involved, and the managers in eldercare also found it unnecessary to
involve the IT department. Any questions of a technical nature were directed towards suppliers
of robots.
Use
12The third element in our analysis is the use of the robot vacuum cleaners. A crucial aspect of
using technology is having sufficient knowledge to effectively operate the device. Such
knowledge is typically acquired through training and education (Orlikowski and Gash 1994). Yet
in the Municipality of Billund, managers decided to reduce the amount of formal education and
training they provided to front line staff. At least three reasons appear to account for this. First,
robots were seen as a simple technology that could be learned and used by front line staff (and
clients) with relative ease. Second, the municipality assumed that traditional training programs
were unnecessary as it was clients themselves who purchased the robots. Third, the managers of
eldercare emphasized that it is through use and experimentation, rather than formal education,
that people learn to operate the robots appropriately and see increased benefits of usage. A
manager noted:
It was most beneficial when the staff were allowed to take the robots to their own
home and try the robots themselves. In fact, they became super salesmen towards
citizens. It was the right strategy…. And then we have welfare technology
ambassadors in our organization who are enthusiastically helping to get new
technology – not just robots – implemented in the best possible way in eldercare.
A care worker agreed:
The opportunity to try out robots in our own homes has certainly resulted in a
more positive view towards robots.
These quotations illustrate how front line staff’s perceptions of robot technology in use changes
as they interact with it (Pinch and Bijker 1987; Orlikowski and Gash 1994). In fact, testing the
robots ensured a more positive approach towards the new innovation. Yet, front line staff still
had a divided rather than uniform view of the limited amount of training received. A care worker
from a residential home explains:
… the training has been insufficient. It would have been useful to have the robot
vacuum cleaner demonstrated: how to carry it, and how to empty and maintain it.
Evidence from our case site illustrates that robots were in daily use. However, robot vacuum
cleaners did not always completely replace the manual vacuum cleaner. Instead, front line staff
sometimes continued to use the manual vacuum cleaner. A manager at the operational level
remarked:
Many of the staff have accepted the robots. But there are also some who are still
using the manual vacuum cleaner.... I have employees who refuse to use robots.
13This sentiment was echoed by the front line staff. A care worker employed in a
residential home noted:
We use robots, but we also still use the manual vacuum cleaner just as we did
earlier. We use robots in the dining room, but not in the corridors because we
constantly have clients walking around.
And another care worker continued:
We probably lacked leadership. They haven’t been as persistent as they could
have been. Otherwise we would have used it more.
By contrast to the managers’ and technologists’ optimistic perspectives, the front line staff had
different perceptions of robots. In particular, resistance was evident early on. Said a care worker:
In the beginning there was no one who cared about this new odd thing. The staff
would rather vacuum the old way so that we get into the corners!
Consistent with these views our observations in residential homes illustrated some of the
problems of using robots. For instance, the basic task of emptying the robot appeared to be a
cumbersome activity. The staff also explained that clients in residential homes would never start
the robots themselves. In addition, the use of robots required more planning and preparation than
anticipated. For instance, furniture needs to be removed from the floor before robots can be used
effectively. A care worker observed how the use of robots also needs to be tailored to other
services:
When we turn on the robot we have to be completely finished with the morning
care because we cannot have the robot going while we have to run back and forth
to provide care. It requires more planning than we expected.
Whereas robots in residential homes function as a supplement to manual vacuum cleaners, they
are more readily seen as a replacement in home care (at least seen from a front line staff
perspective). The interviewed care workers agreed that robots are systematically used in home
care services. They also highlighted several benefits of using robots, although they reported
feeling pressed for time as their client visits were reduced by 12 minutes. Said a care worker:
We use robots. It is efficient for us to be able to start the robot and do other things
at the same time. It may well happen that the robot does not pick up all the dirt in
the corners, but it picks up most of the dirt. The municipality has decided that we
should have robots – it's the quality of cleaning we offer our clients.
14The staff also mentioned that robots are more allergy friendly than manual vacuum cleaners, and
that the physical work environment is improved by the use of robots. As expressed by a care
worker:
It's not as burdensome for my back. I do not get worn out when I can rely on the
robot. I think that is a good thing.
Turning to the clients’ attitudes, they are not convinced that robots clean sufficiently. The overall
reaction is that robot vacuum cleaning picks up most of the dirt, but the disadvantage is that they
do not get into the corners well. In addition it is necessary to move around the furniture so the
robot can get around. Most clients interviewed have invested in a handheld vacuum cleaner for
furniture as a supplement to robot vacuum cleaning. Said a client about the mixed attitude
towards robots:
There are so many different opinions for and against robots. Many believed at the
beginning that it would replace our conventional vacuum cleaners – but that is
certainly not the case. It is only a supplement because we cannot do without the
other vacuum cleaners for furniture and other things.
Another client said:
And we even had to buy the robot ourselves.... Yes, I thought it was a change for
the worse.
The citizens who were interviewed also commented on the social dimension associated with the
robots. As mentioned, the introduction of the robots was followed by a 12-minute reduction in
client visits. Although 12 minutes may not sound like a lot, it seems to have had an impact on
some of the clients, who miss the time they used to spend with the front line staff.
In Table 2, we have summarized our analysis developed above. Rows are mapped to the phases
analysed, columns to the four sets of actors interviewed (managers, technologists, front line staff,
and clients).
Table 2. Overview of managers’, technologists’, front line staff’s and clients’ perspectives
of robot vacuum cleaners (strategy, process, use)
Managers Technologists Front line staff Clients
15Strategy Enthusiastic about the Enthusiastic about Mixed perceptions about Mixed perceptions
use of robots. Cost the use of robots. robots. Aware that robots were about robots. Some see
savings as a key Robots improve introduced because of cost it as supporting staff
motivation service delivery. savings but their main while others see it as
motivation is to improve their clear-cut savings
working conditions. manoeuvring.
Impleme Top management The IT department Different views on how Mixed perceptions on
ntation consider the was not involved in implementation has proceeded. how they were informed
implementation a the implementation Lack of information in early about the introduction of
success with limited of robots. Any phases. Welfare technology robots. Some regret that
resistance to change questions of a ambassadors seen as a useful client themselves have
and dedicated technical nature are initiative. In some units, the to buy robots.
employees. Managers directed to suppliers implementation was assisted by
at the operational level of robots. sufficient management support
more sceptical. and training, while the opposite
has been the case in other units.
Use Managers recognize See robots as a Robots are in daily use. In Clients believe that
that some of the care simple technology home care, staff perceives robot do not get into the
workers are still using that is easily robots as a replacement of corners well. Seen as a
manual vacuum integrated in daily manual cleaning. In residential supplement to manual
cleaners. working practices. homes, staff see robots as a vacuum cleaners, not a
substitute for manual cleaning. replacement. Clients
have invested in a
handheld vacuum
cleaner for furniture.
Discussion and Conclusion
In the previous section, we investigated robot vacuum cleaning in eldercare through a case study
from Billund Municipality, which was the first Danish municipality to systematically use robots
in residential homes and home care. We have investigated key stakeholders whose actions will
significantly influence the process and outcome of the adoption of robot technology. The
research included a focus on how technologists, managers, front line staff and clients made sense
of the new robot technology and how they interacted with it. In this section we will discuss four
issues that have emerged from our analysis on the promises and drawbacks of the use of robots
as they move from the production line to the health care sector: 1) variance in the interpretation
of the technology; 2) the tension between savings and cleaning outcome; 3) variance of the
perception of the implementation and practical use of robots and; 4) introduction of new
benchmarking of public services.
16One of the clearest outcomes of our analysis is the variance in interpretation of the new
technology across the various stakeholder groups based on their interactions with it. Although
these differences resulted in outcomes that deviated somewhat from those expected, it did not
derail the implementation process (at least not in home care). Interestingly, residential homes
that have larger and more standardised floor surfaces (and therefore likely to be more suitable for
robots) experienced less implementation success compared to smaller private homes.
Secondly, robot vacuum cleaners seem to deliver savings on the current expenditure account.
However, our study demonstrates differing interpretations of robots; managers and technologists
praised the new innovation while care workers and clients had more varied attitudes towards
robots. Clients found that the robot does not clean sufficiently and some shifted from municipal
service to a private provider to avoid using robots (Table 2). Some care workers persist in
manual vacuuming. Resistance to change is common during technology implementation (Markus
1983) and assisted living technologies especially (such as robots) may be a sore point for front
line staff, since this type of technology can replace this group’s work. This may help in
explaining care workers’ diverse attitudes towards robots. Moreover, the robot vacuum cleaner is
a relatively mature technology, but interviews with both staff and clients show that despite this
maturity some technical problems still appeared.
Thirdly, we observed dissimilar views of the implementation process and striking differences in
the practical use of robots between residential homes and home care. Whereas care workers
considered the implementation of robots as a top-down process in which they had little influence
and lacked information, especially in early phases, managers regarded it as a participatory
process in which employees were engaged throughout. Yet all interviewed stakeholders praise
the introduction of welfare technology ambassadors as an appropriate way to support robot
implementation. This might help explain why managers succeeded in having care workers use
robots more or less as intended (at least in home care services). Within residential homes, the
robot vacuum cleaners only constituted a supplement to manual vacuum cleaners, while front
line staff viewed robot vacuum cleaners as a substitution technology (replacing manual vacuum
cleaning) in home care. This view was not shared by the citizens. The variance in working
17practices and opinions of robot technology is illustrative of the interpretative flexibility in
technology (Pinch and Bijker 1984; Orlikowski and Gash 1994).
Fourth, in the debate on robot vacuum cleaning, arguments that the technology should not be
compared with manual vacuum cleaning resulted in the introduction of new benchmarking of
public services. In fact, the most appropriate comparison is against no vacuum cleaning at all.
Billund Municipality argued that clients should buy robots themselves since the cost was
marginal and affordable. On the other hand, the Association of the Elderly (DaneAge 2012) - and
citizens interviewed in Billund Municipality - regretted this development, arguing that it might
undermine the universal welfare principles by depriving thousands of debilitated elderly citizens
free help and instead privatising responsibility. Clearly the case is illustrative of the introduction
of new concepts of benchmarking surfacing in the policy debate, possibly setting a new agenda
for the ongoing deployment of robots in eldercare.
The Danish case represents a large-scale modernization effort where robots have been widely
used in daily practices. Accordingly, insight on what happens when robot technology is being
applied in such an extreme setting (Pettigrew 1990), could be an indicator of similar effects that
might arise in other settings and countries. In the paper we have detailed how critical stakeholder
groups (technologist, managers, frontline staff and clients) had different perceptions towards
robot vacuum cleaning. Our results may help practitioners better understand how and why
different stakeholders are likely to use robots and with what (anticipated and unplanned)
consequences in different settings. Based on our case study we put forward three propositions
that could inspire practice but equally calls for more research on each of these three propositions:
1) managers need to be aware of the interpretive flexibility of robot innovation; 2) robot vacuum
cleaning offers new opportunities to replace labor but also new challenges for organizations that
engage these innovations; 3) although robot vacuum cleaners may appear as a simple technology
it requires management attention and leadership.
Robot technology is emerging, often controversial, increasingly affordable and takes many
different forms and functions. Giving the amount of robot technologies entering labor intensive
public services, we urge more research to be done in this area. This includes research on service
18robots (Ballegaard 2011) and robots to allow doctors to consult with patients or nurses from their
homes (Liebert 2011). Examining other kinds of robot technologies may very well offering
different properties to those of robot vacuum cleaners would generate. Also, investigating
different countries (e.g., U.S. or Asia) and institutional setting (e.g., hospitals) to those studied
here would also expand our understanding of how critical stakeholders make sense of and use
robots with particular consequences for organizations and individuals. Whereas we are confident
there will be a myriad of new research on building on top of the technology acceptance models
(Davis 1989) and human-computer interaction oriented research (e.g., Forlizzi & DiSalvo 2006;
Forlizzi, DiSalvo, and Gemperle 2004), we hope to convince organizational and public
administration oriented research to take the robots onboard. We have offered a theoretical
contribution factoring in a client perspective as an adequate extension of the original framework
by Orlikowski & Gash (1994). This is particular relevant in countries with a high reliance on
public sector organized and financed eldercare since the interplay between organizational
management and robots will be challenging not only the homes and elderly but also capacity and
policy saliency in these countries.
Robot technologies has for decades been announced as bringing about fundamental changes to
the work environment (Engelberger 2003), but a central question is whether this is only jet
another generation of technologies or whether robots are able to energize radically changes in
public service delivery? Although it may still be too early to give a definitive answer to this
question, the shift in service orientation from face-face service delivery to robots not only has
implications for frontline staff delivering services; it also raises some important issues for how
elderly clients with physical capability challenges are able to deal with this new technology and
how it influences their experiences of public service delivery.
References
Andersen, K. N. (2012). Robotter, støvsugning og ledelsesudfordringer. [Robots, Cleaning and
Leadership] Workingpaper 2012/1, Department of IT Management (ITM), Copenhagen Business
School.
19Ballegaard, S. A. (2011). Healthcare technology in the home. Of home patients, family
caregivers, and a vase of flowers. Ph.D. Dissertation. Center for STS-studies, Aarhus University,
Denmark.
Baptista, J., S. M. Newell, & W. Currie (2010). Paradoxical Effects of Institutionalisation on the
Strategic Awareness of Technology in Organisations. Journal of Strategic Information Systems,
19 (3): 171-183.
Bekkers, V., & V. Homburg (2005). The Information Ecology of E-Government revisited, in V.
Bekkers & V. Homburg (red.) The Information Ecology of e-Government. Amsterdam: IOS
Press.
Billund Municipality, Projektbeskrivelse. [Project description]. Internal document, Billund
Municipality, Denmark
Billund Municipality (n.d.) Kvalitetsstandarder, Hjemmeplejen Kvalitetsstandard III + IV.
[Quality standards, Home care III + IV]. Billund Municipality, Denmark.
Broadbent, E., I. H. Kuo, Y. I. Lee, et al. (2010). Attitudes and Reactions to a Healthcare Robot.
Telemedicine and e-Health, 16(5): 608-614.
DaneAge (2012). Robotter skal erstatte hjemmehjælpen [Robots in home care]. The Danish
Association for Elderly URL https://www.aeldresagen.dk/presse/nyheder/Sider/robotter-skal-
erstatte-hjemmehjaelpen.aspx?emne=Teknologi+og+IT (accessed May 30, 2013)
Davis, F. D. (1989). Perceived Usefulness, Perceived Ease of Use, and User Acceptance of
Information Technology, MIS Quarterly, 13(3): 319–340.
Doyle, M., & V. Timonen (2007). Home Care for Ageing Populations: A Comparative Analysis
of Domiciliary Care in Denmark, the United States and Germany, Northampton, MA: Edward
Elgar Publishing.
Engelberger, J. (2003). How Robots Lost Their Way. Businessweek, November 30, 2003
Flyvbjerg, B. (2006). Five Misunderstandings About Case-Study Research. Qualitative Inquiry
12 (2): 219-245.
Forlizzi, J., C. DiSalvo, & F. Gemperle (2004). Assistive Robots and an Ecology of Elders
Living Independently in Their Homes. Human Computer Interaction, 19 (1/2), 25-59.
Forlizzi, J., & C. DiSalvo (2006). Service Robots in the Domestic Environment: A Study of the
Roomba Vacuum in the Home. Proceedings of HRI06. New York, NY: ACM Press, 258-265.
Fountain, J. E. (2001). Building the virtual state: Information technology and institutional
change. Washington, DC: Brookings Institution.
20Grundén, K. (2009). A Social Perspective on Implementation of e-Government - a Longitudinal
Study at the County Administration of Sweden. Electronic Journal of e-Government 7 (1): 65 –
76.
King, J. L., & K. L. Kraemer. (2012). Too early to Say. In Snellen, I., Thaens, M., & van de
Donk, W. (eds.), Public Administration in the Information Age (pp. 281-296). Amsterdam IOS
Press.
Leonardi, P. M., and S. R. Barley (2010). What´s Under Construction Here? Social Action,
Materiality, and Power in Constructivist Studies of Technology and Organizing. The Academy of
Management Annals 4(1):1-55.
Liebert, M. A. (2011). No Longer Rocket Science: Robots Have Found Their Place in
Healthcare. Telemedicine and e-Health, 17 (6):409-414.
Nielsen, J. A., L. Mathiassen, & S. Newell (forthcoming). Theorization and Translation in
Information Technology Institutionalization. Evidence from Danish Home Care. MIS Quarterly.
Preprint available: http://www.misq.org/forthcoming/
Markus, M. L. (1983). Power, Politics, and MIS Implementation. Communications of the ACM,
26(6): 430-444.
Miles, M. B., & A. M. Huberman (1994). Data management and analysis methods, in Handbook
of Qualitative Research, Denzin NK and Lincoln YS (eds.), Thousand Oaks: Sage Publications.
Ministry of Social Welfare (2010). Consolidation Act on Social Services. URL
http://english.sm.dk/ministryofsocialwelfare/legislation/social_affairs/social_service_act/Sider/St
art.aspx (Accessed May 30, 2013).
Morgenavisen Jyllands-Posten (2012) Robotstøvsugere på vej til flere kommuner, Indland,
søndag den 1. april 2012.
Morgenavisen Jyllands-Posten (2013). Robotter skal redde velfærden.
Mutlu, B., & J. Forlizzi (2008). Robots in Organizations: Workflow, Social, and Environmental
Factors in Human-Robot Interaction. Proceedings of HRI08. New York, NY: ACM Press, 239-
248
Orlikowski, W. J., & D. C. Gash (1994). Technological Frames: Making Sense of Information
Technology in Organizations. ACM Transactions on Information Systems 12(2):174-207
Orlikowski, W. J. (2000). Using Technology and Constituting Structures: A Practice Lens for
Studying Technology in Organizations. Organization Science, 11(4):404-428
Pettigrew, A. M. (1990). Longitudinal field research on change: Theory and practice,”
Organization Science 1 (3): 267–292.
21Pinch, T. J., & W. E. Bijker (1984). The social construction of facts and artefacts: Or how the
sociology of science and the sociology of technology might benefit each other. Social Studies of
Science, 14 (1): 399-441.
Segal, H. P. (2005). Technological Utopianism in American Culture: Twentieth Anniversary
Edition. Syracuse, NY: Syracuse University Press.
Siino, R. M., & P.J. Hinds (2005). Robots, Gender & Sensemaking: Sex Segregation’s Impact
On Workers Making Sense Of a Mobile Autonomous Robot. Stanford. URL
http://www.stanford.edu/~phinds/PDFs/Siino-Hinds-2005.pdf
Weick. K. E. (1995). Sensemaking in Organizations. London. Thousand Oaks, SAGA.
22You can also read
