MULTIPLE LOGICS AT WORK IN INFORMATION INFRASTRUCTURE IN USE: A CASE STUDY ON HEART TRANSPLANTATION

This paper investigates the information practices of different professionals in a distributed and interdisciplinary work process. Specifically, it looks at how a collection of information artefacts, both electronic and paper based, is used in the process. To conceptualize heterogeneous and collective artefacts in use, this paper draws on the literature on information infrastructures and on recent development in Actor-Network Theory. The empirical material presented comes from an interpretive case study on the heart transplant process in a large hospital in Norway. The paper discusses how the information infrastructure in use in this process works coherently according to multiple logics of information use. The findings are related to the nature of technology as complex object in use and their relevance is discussed in relation to change processes in hospitals

How the \u27New\u27 Makes Use of the \u27Old\u27: Understanding Reconfigurations of Information Systems and Organizations in the Norwegian Health Sector

This paper presents initial findings from ongoing research on how novel ICTs can make use of established sociotechnical arrangements in a productive way. Empirically it is based on three case studies on the design, development and use of web-based information systems that support patients’ interaction with healthcare providers. The cases under study are intriguing as they provide empirical evidence of the role that novel technologies (within the Web 2.0 genre) can have for accelerating a healthcare shift towards “patient centeredness” and patients’ active involvement in care (co-production of services). Our aim is to reach an improved understanding of reconfiguration dynamics paying attention to associations and interactions between the “old” and the “new”

HOW LIGHTWEIGHT TECHNOLOGIES SUPPORT DIGITAL INNOVATION IN THE CONTEXT OF PATIENT-CENTERED CARE

A central challenge for healthcare is technology innovation. The literature has reported on the many challenges to IT innovation efforts in hospitals and in digital health services in general. Recently, the increased use of mobile apps, personal devices, web interfaces – so-called lightweight technology – has introduced a novel innovation logic where recombinability seems to emerge as a core capability to enable innovation. However, we still know little about how recombinability supports digital innovation in healthcare. Specifically, we explore the recombinability of lightweight technologies in the context of digital innovation for patient- centeredness. Our research builds on a comparative analysis of two case studies in Scandinavia. The two cases show that recombinability is crucial to enable flexible personalization. We discuss different strategies of recombinability to enable digital innovation for patient-centered health practice

Data Infrastructures in the Public Sector: A Critical Research Agenda Rooted in Scandinavian IS Research

Extant Information Systems research emphasizes the strategic benefits of digitalization and value co-creation for business. Less is known, however, about the dynamics of how value is co-created in the digitalization of the public sector, where data infrastructures are increasingly adopted. We identify three core empirical challenges for value co-creation in the public sphere, corresponding to the following conceptual tenets: participation in infrastructuring processes, data curation, and data protection. We propose to draw on the Participatory Design tradition that permeates the Information Systems field in Scandinavia to critically harness the political meaning of value co-creation. Drawing on a two-year project on the design of data infrastructures in three areas of the public domain (environmental monitoring, healthcare, and smart cities), we contribute to Information Systems by proposing a research agenda consisting of three future directions for critical studies of value co-creation in data infrastructures in the public sector

INFRASTRUCTURES FOR PATIENT-CENTEREDNESS: CONNECTING NOVEL AND EXISTING COMPONENTS TO SERVE STRATEGIC AGENDAS FOR CHANGE

Web-based access to health services, health information and personal health records are increasingly offered to patients for enabling a new, more active patient role. However, incorporating such solutions into national health infrastructures poses challenges. In an information infrastructure perspective, the design of such technologies requires two main intertwined activities: designing ˜the new´ and dealing with ˜the old´ (i.e. the already established infrastructural arrangement). In this paper, we study such activities through the concept of institutional work to investigate how actors go about creating, maintaining and disrupting what was established in provider-centric healthcare. This is investigated in the context of an ongoing national initiative to design and develop a web-based, platform that will support shifting healthcare towards patient-centeredness. Analysing actors´ efforts for patient authentication , availability and comprehensiveness , we identify the pivotal role of activities that are about rearranging seemingly separate technological and institutional components

User Participation in Infrastructuring: Exploring the Space for Action

This paper addresses the concept of participation in the context of design and transformation of a health information infrastructure. Recent work on transformation of health information infrastructures shows that bottom-up user-driven processes are preferred, however, the role of the user in infrastructuring remains under-researched. We investigate user representatives\u27 space for participation in design of an infrastructure, based on the Scandinavian tradition of Participatory Design. We take a user perspective to infrastructuring, investigating the work of user representatives (health workers) who engage in technology design, requiring engagement with local practices in shaping data practices. We have conducted a longitudinal case study on the design and development of a data platform for patient handover in a large Norwegian municipality. We contribute with an understanding of participation in the transformation of infrastructures as user representatives engage local organizations as both facilitators for their own design process, i.e. designers preparing and transforming their local services, as well as participants into design of the infrastructure, i.e. designers shaping technology. We contribute to literature on infrastructuring by showing how user representatives explore possbilities for action, shaping the infrastructuring process

TECHNOLOGY INNOVATION IN THE FACE OF UNCERTAINTY: THE CASE OF \u27MY HEALTH RECORD\u27

In this paper we address the challenges faced when new e-health components are introduced within an existing infrastructural arrangement by focusing on the delicate balance between immediate usefulness and forward-looking preparedness. While e-health solutions are currently seen as a core element of on-going health sector reforms in most European countries, much of the challenges related to their design, development and implementation remain understudied. Based on an interpretive case study of technology innovation in the Norwegian healthcare context, we study the practices of building and putting to use a novel web-based platform for communication between users and providers of healthcare services. In particular, we analyse the conceptual design, the association with the installed base, and the relationship with users as core enacting practices of the project team members. We make use of the concepts of generativity and robustness to bring into focus and articulate possible approaches for change anticipation

Data Curation as Governance Practice

Data governance is concerned with leveraging the potential value of data in data infrastructures. In IS research, data governance has developed as a management perspective, implying a narrow view of who makes decisions about the data in infrastructures. In contrast, we propose a data governance in practice view and focus on the day-to-day decisions of users working with the data. Drawing on an interpretive case study of three data infrastructures in the Norwegian public sector, we ask: How can we characterize data governance in practice? We find that the work of data curation is a fundamental element of data governance practice. Data emerge dynamically as assets, enfolding the involved users’ interests and contexts. We contribute to the IS literature in two ways. First, we characterize three main practices of data curation: achieving data quality, filtering the relevant data, and ensuring data protection. In so doing we foreground the role of the users as contributing to shaping data infrastructures. Second, we develop an analytical framework which specifies the unfolding of user involvement in data infrastructures-in-use and conceptualizes this work as emergent. Our contributions have implications for developing training support for users as data curators, and for the ethics of data managemen

BOUNDED RECOMBINABILITY OF DIGITAL TECHNOLOGIES FOR PATIENT-CENTRED CARE

A central challenge for healthcare is technology innovation. The literature has reported on the many challenges to IT innovation efforts in hospitals and in digital health services in general. Recently, the increased use of mobile apps, personal devices, web interfaces – so-called lightweight technology – has introduced a novel innovation logic where recombinability seems to emerge as a core capability to enable innovation. However, we still know little about how recombinability supports digital innovation in healthcare. Specifically, we explore the recombinability of lightweight technologies in the con- text of digital innovation for patient-centeredness. Our research builds on a comparative analysis of two case studies in Scandinavia. The two cases show that recombinability is crucial to enable personalization and the collaborative management of illness between patient and healthcare and it entails reorganizing the healthcare practice. In addition, the findings show that the logic of recombinability was in both cases bounded by the patient and healthcare practice. We discuss bounded recombinability as a logic to maximize the value of digital innovation for a local practice

Enabling Electronic Interactions between Patients and Healthcare Providers: a service design perspective

This paper investigates the design of electronic services for patient-healthcare provider interactions. Empirically, the paper draws from two cases on electronic health appointment management within the Norwegian healthcare system. We investigated the realisation of these new electronic services through the lens of service design adopting a process approach and following their evolution over time. Our findings suggest that the design of services for patient-provider interactions requires a) reconsideration of the whole relationships going beyond the digital solution part, b) flexibility that allows user-defined tailoring of digital solutions after being introduced to use, c) support of continuity in user involvement, d) creative exploitation of the regulatory constraints