Throughout the Global North, policymakers invest in large-scale integration of health-data infrastructures to facilitate the reuse of clinical data for administration, research, and innovation. Debates about the ethical implications of data repurposing have focused extensively on issues of patient autonomy and privacy. We suggest that it is time to scrutinize also how the everyday work of healthcare staff is affected by political ambitions of data reuse for an increasing number of purposes, and how different purposes are prioritized. Our analysis builds (...) on ethnographic studies within the Danish healthcare system, which is internationally known for its high degree of digitalization and well-connected data infrastructures. Although data repurposing ought to be relatively seamless in this context, we demonstrate how it involves costs and trade-offs for those who produce and use health data. Even when IT systems and automation strategies are introduced to enhance efficiency and reduce data work, they can end up generating new forms of data work and fragmentation of clinically relevant information. We identify five types of data work related to the production, completion, validation, sorting, and recontextualization of health data. Each of these requires medical expertise and clinical resources. We propose that the implications for these forms of data work should be considered early in the planning stages of initiatives for large-scale data sharing and reuse, such as the European Health Data Space. We believe that political awareness of clinical costs and trade-offs related to such data work can provide better and more informed decisions about data repurposing. (shrink)

In the current research landscape, there are increasing demands for research to be innovative and cutting-edge. At the same time, concerns are voiced that as a consequence of neoliberal regimes of research governance, innovative research becomes impeded. In this paper, I suggest that to gain a better understanding of these dynamics, it is indispensable to scrutinise current demands for innovativeness as a distinct way of ascribing worth to research. Drawing on interviews and focus groups produced in a close collaboration with (...) three research groups from the crop and soil sciences, I develop the notion of a project-innovation regime of valuation that can be traced in the sphere of research. In this evaluative framework, it is considered valuable to constantly re-invent oneself and take ‘first steps’ instead of ‘just’ following up on previous findings. Subsequently, I describe how these demands for innovativeness relate to and often clash with other regimes of valuation that matter for researchers’ practices. I show that valuations of innovativeness are in many ways bound to those of productivity and competitiveness, but that these two regimes are nevertheless sometimes in tension with each other, creating a complicated double bind for researchers. Moreover, I highlight that also the project-innovation regime as such is not always in line with what researchers considered as a valuable progress of knowledge, especially because it entails a de-valuation of certain kinds of long-term epistemic agendas. I show that prevailing pushes for innovativeness seem to be based on a rather short-sighted temporal imaginary of scientific progress that is hardly grounded in the complex realities of research practices, and that they can reshape epistemic practices in potentially problematic ways. (shrink)