Time to reflect: Supporting health services over time by focusing on collaborative reflection

When health services involve long-term treatment over months or years, providers have the ability, not present in acute emergency care, to collaboratively reflect on clients' changing health data and adjust interventions. In this paper, we discuss temporality as a factor in the design of health information technology. We define a temporal spectrum ranging from time-critical services that benefit from standardization to long-term services that require more flexibility. We provide empirical evidence from fieldwork that we performed in organizations providing long-term behavioral and mental health services for children. Our fieldwork in this context complements and provides contrasts to previous CSCW studies performed in timecritical hospital settings. Current literature shows a bias toward standardized records and routines in the implementation of health information technology, a policy that may not be appropriate for long-term health services. We discuss how the design of information systems should vary based on temporal factors.