How Engineers' Imaginaries of Healthcare Shape Design and User Engagement: A Case Study of a Robotics Initiative for Geriatric Healthcare AI Applications

In the development of robotics and Artificial Intelligence (AI) for healthcare, human-centered approaches seek to meet the requirements of healthcare practice and address social and ethical aspects proactively. In this work, an important but neglected aspect of human-computer interaction (HCI) is how engineers understand and envision the healthcare context. Drawing on insights from STS on engineers' imaginaries and their role in shaping research and development of new technologies, we propose engineers' imaginaries of healthcare as a point of analysis and intervention for ethical and social aspects of AI and robotics for healthcare. To illustrate the utility of this lens, we use it to on report a case study of an engineering project that develops robotic and AI applications for healthcare. We followed and sought to advance an embedded ethics and social science approach, where ethicists and social scientists accompanied this engineering project using direct interdisciplinary collaboration, observations, and in-depth qualitative interviews with the project's engineers (n = 18). We analyze how the engineers imagine healthcare as an environment for robots, healthcare workers as potential users, and healthcare practices, and how these imaginaries connect to the design narratives that guide their work. Our findings provide pertinent input for HCI, STS, and engineering ethics related to healthcare AI and robotics, as they speak to prevalent narratives of "assistance"systems, aspects of how human healthcare practices are reframed and valued in the face of new technologies, questions of division of labor between machines and healthcare practitioners, and the implications of 'acceptance' as a frame for user-centered design.