Architectural Constraints on the Bootstrapping of a Personal Health Record

During the last decade we have seen a proliferation of electronic personal health record systems (PHRs) aiming to change the way people manage and receive healthcare. However, many of these initiatives have failed to take-off. We inquire into such unsatisfactory outcomes by drawing upon the perspective proposed in the information infrastructure (II) literature. This literature views the value of PHRs as dependent on the number of actors using them. This poses a challenge for designers (referred to as ‘bootstrapping’): how to persuade users to adopt a PHR when the user base is still small. To address the bootstrap- ping challenge, II literature suggests starting with a simple solution that creates immediate user value and enables users to enroll gradually. This paper seeks to explore how PHR architecture can hinder PHR bootstrapping through a longitudinal case study on the implementation of an integrated PHR. Our case analysis identifies four architectural constraints: poor data quality; coordination across heterogeneity; privacy and control; and re-configurability. This paper concludes by discussing the implications of the findings for the literature on personal and electronic health records and on the design of information infrastructures

Digital infrastructure evolution as generative entrenchment: The formation of a core–periphery structure

This article empirically investigates the process by which a digital infrastructure evolved and took the architectural form of a digital platform as a core–periphery structure over a 20-year period. Our study pays special attention to the developmental dependencies of the components of the infrastructure’s installed base and how the interdependencies between the platform core and periphery evolve over time. We use the notion of ‘generative entrenchment’ to provide an account of the formation and unfolding of a core–periphery structure from an evolving digital infrastructure that highlights three aspects of the process. First, the process of architectural evolution that our study depicts comprises three phases showing a gradual reversal of the entrenchment relationship of the platform core and periphery: (1) entrenchment of the periphery, (2) mutual entrenchment of the core and periphery, and (3) entrenchment of the core. Second, we show how the generatively entrenched infrastructure’s installed base shaped the decisions and choices regarding the initial platform core. Third, we identify three architectural practices (creating redundancy in the core, augmenting the core with novelty, and reducing the heterogeneity of an entrenched peripheral component and later integrating it into the core) that weakened the entrenchment of the peripheral components, amplified the role of the core, and consolidated the core–periphery structure

Digital infrastructure evolution as generative entrenchment: The formation of a core–periphery structure

This article empirically investigates the process by which a digital infrastructure evolved and took the architectural form of a digital platform as a core–periphery structure over a 20-year period. Our study pays special attention to the developmental dependencies of the components of the infrastructure’s installed base and how the interdependencies between the platform core and periphery evolve over time. We use the notion of ‘generative entrenchment’ to provide an account of the formation and unfolding of a core–periphery structure from an evolving digital infrastructure that highlights three aspects of the process. First, the process of architectural evolution that our study depicts comprises three phases showing a gradual reversal of the entrenchment relationship of the platform core and periphery: (1) entrenchment of the periphery, (2) mutual entrenchment of the core and periphery, and (3) entrenchment of the core. Second, we show how the generatively entrenched infrastructure’s installed base shaped the decisions and choices regarding the initial platform core. Third, we identify three architectural practices (creating redundancy in the core, augmenting the core with novelty, and reducing the heterogeneity of an entrenched peripheral component and later integrating it into the core) that weakened the entrenchment of the peripheral components, amplified the role of the core, and consolidated the core–periphery structure. </jats:p

Socio-Technical Attachments and IT Change: A Case of Unsuccessful Software Replacement

The paper examines how organizations and people are attached to the existing technologies. Doing so, we propose a socio-technical attachment perspective that helps us unpack different types of attachment between organizations and technologies. Based on an exploratory case study of an unsuccessful technology replacement process, we identify nine types of socio-technical attachments between the old technology and the organization. Our analysis shows that socio-technical attachments are heterogeneous, as they are related to different social and technological aspects, they possess different dynamics, and they interact over the change process. The findings contribute to the literature on resistance and inertial by adopting a balanced socio-technical perspective and unpacking the heterogeneity and dynamic micro-mechanisms that underlie resistance and inertia