The ethics and politics of design for the common good: a lesson from Alibaug

In this chapter I argue for a socio-technical approach to technology design for the common good that addresses its ethical and political aspects. The background is that the life of marginalized people in contemporary society is challenging and uncertain. The marginalized can face health and cognitive issues as well as a lack of stability in social structures such as family, work and social inclusion. In this context, certain democratic values embedded in technology design can conceal political asymmetries and fail to deliver ethical value exchange, where value extraction is not dominated by one party but equally shared across all stakeholders. I discuss two socio-technical perspectives called human work interaction design (HWID) and Technological Frames (TF) to expose and tackle the challenges of designing technology for the common good. I introduce and evaluate an ongoing case of a digital service delivered through an app to support a fishing community in Alibaug, India. The evaluation of the socio-technical infrastructure surrounding this app is done in two parts: firstly, I use HWID to highlight inwardly and outwardly socio-technical, ethical and power relations between human work and interaction design; secondly, an argument for the use of the concept of TF to understand the constructionist and semiotic power dynamics of different groups in participatory technology design is presented. It is shown how dominant groups’ frames can construct meanings of design decisions in terms of whether they are appropriate or not. The political leverage of the scripts embedded in artefacts used in the process of design is also explained from a semiotic perspective. I conclude by highlighting the value of an ethical and political socio-technical framework for technology design for the common good with people at the margins

Sense-able process innovation in digital health infrastructures

In this paper, we examine the role of IT in enabling and supporting process innovation at a general hospital in Norway. The motivation for our study is that fragmented and heterogeneous components of digital infrastructure in complex organisational settings hamper the ability to monitor and improve organisational performance through process innovation. Prior research indicates that loose couplings between traditional ‘heavyweight IT’ (resilient, secure, and stable) and ‘lightweight IT’ (consumer-oriented, context-aware and flexible) can support innovation. These principles have not been applied to process innovation. Our research question is, how can lightweight IT extend digital infrastructure to support process innovation, in hospital coordinative practices? We use the sense and respond framework from Overby et al. (2006) to analyze our case findings and derive a model for sense-able process innovation with lightweight IT. The model outlines how lightweight IT extends digital (health) infrastructure and affords an organisational ability to continuously sense and respond to the effects of process innovatio

Effects-Driven IT Improvement: Pursuing local post-implementation opportunities

Many opportunities for benefitting from information technology (IT) are not discovered until IT systems are in operational use. The realization of these benefits depends on local efforts that cannot presume top-management support but must themselves generate the innovation potential necessary to improve system use. To facilitate such local efforts, we propose effects-driven IT improvement. It consists of iteratively specifying, realizing, and evaluating the usage effects pursued with a system. We describe the effects-driven process and illustrate it with three real-world cases. On this basis, we discuss its contributions toward local benefits realization at the post-implementation stage. Our overarching contribution is to provide a means of operationalizing and packaging improvement initiatives in a manner that combines local and lightweight experimentation with the data-driven realization of meaningful effects. The three cases illustrate that the effects-driven process can reopen the window of opportunity for benefits realization, result in learning that calls for respecifying the pursued effect, and render evaluation data almost superfluous because the local actors are confident that the effect is substantial and real. In addition, local initiatives to improve system use may create the momentum, evaluation infrastructure, and benefits documentation necessary to pave the way for further improvements. However, these potentials come with challenges, which we also discus

The Tension between National and Local Concerns in Preparing for Large-Scale Generic Systems in Healthcare

Large-scale generic systems are typically adapted to local practice through configuration. This is especially important in healthcare, which involves a plurality of institutions and users. However, the decision to acquire a generic system in public healthcare is typically founded on regional and national health policy goals, which often are translated into various forms of standardization. As a result, national and regional health policy interests may stand in contrast to interests on the local level. Therefore, we analyze how national and local concerns are weighed against each other in the preparations for implementing large-scale generic systems in healthcare. We explore what role configuration plays and what the prospects are for long-term development. We contribute with insight into how the organizational consequences of generic systems are formed already in the preparation phase and point to how configuration easily results in standardization, thereby basically privileging national and regional health goals at the expense of local needs. Empirically, we focus on the preparations for implementing the Epic electronic health record in Central Norway.publishedVersio