0000000000896846
AUTHOR
Miria Grisot
Re-Infrastructuring for eHealth: Dealing with Turns in Infrastructure Development
In this paper, we examine infrastructuring in the context of developing national, public eHealth services in Norway. Specifically, we analyze the work of a project team engaged in the design and development of new web-based capabilities for communication between citizens and primary healthcare practitioners. We frame the case as a study of re-infrastructuring to signify a particular occasion of infrastructuring that entails facilitating a new logic within established social and technological networks. To make sense of the particularities of re-infrastructuring, we draw from research in infrastructure studies which considers embeddedness as a resource in infrastructure evolution. We analyze …
Introduction
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Information Infrastructures and the Challenge of the Installed Base
In this chapter we present the theoretical perspective of information infrastructures, which is used to analyze the empirical cases in the book. In this perspective, information technology is seen as intimately intertwined with organizational structures, procedures and work practices, and as an underlying, supporting and often invisible infrastructure. Information infrastructures are not only local, but shared among distributed actors which can have multiple and different needs and interests. Understanding the complexities and mechanisms involved in the evolution of information infrastructures is at the core of this perspective which challenges traditional management approaches. Instead of …
Information Infrastructures for eHealth
This chapter provides an introductory overview of healthcare information systems, followed by a more detailed discussion on two types of core components in a public eHealth infrastructure: e-prescription solutions and governmental patient-oriented platforms. E-prescription solutions support the electronic flow of information for prescribed medications between prescribers, pharmacies and insurers that handle related payments. E-prescription solutions aim for cost containment, enhancement of patient safety, control over doctors’ prescription patterns and process quality assurance. Governmental platforms for patient- or citizen-oriented eHealth services typically offer patients access to gener…
Friction forces and patient-centredness: Understanding how established logics endure during infrastructure transformation
n this article, we examine three cases of e-health solutions for patients in Norway. For the analysis of the three cases, we focused on friction forces that come into play when different established arrangements need to change to accommodate novelty. We argue that the design of new technologies was shaped by friction related to institutionalised practices, regulatory regimes and entrenched patient roles. These friction forces connect the past with the present, come into action when aiming for novelty and result to the perpetuation of constituents of the past during change processes. Specifically, the e-health solutions under study were strongly influenced by established healthcare provision…
Effectual tactics in digital intrapreneurship: A process model
Abstract Uncertainty and the pursuit of new ventures are intricately linked. Digital technologies open up new ways for uncertainty handling in the pursuit of novelty. In this paper, we develop a process model that traces the dynamics among uncertainty, digitally enabled tactics, and organizational novelty. The model points to the potential of technologies that are evocative, disposable, and responsive for venturing in complex, uncertainty-ridden contexts. Our research builds on extant conceptualizations of complexity in innovation journeys, in conjunction with perspectives on effectual entrepreneurial tactics. Empirically, we investigate uncertainty handling through a longitudinal case stud…
Strategies for Building eHealth Infrastructures
This chapter presents a cross-case analysis of the eleven empirical chapters of the book. We discuss the six e-prescription cases and the five patient-oriented eHealth cases in terms of the initiatives’ scope, starting point, and motivation, and then, we turn to observed strategies towards the installed base for the two types of infrastructures. E-prescription is relatively well-defined in terms of functionality and there are clear interdependencies with existing healthcare applications (e.g. Electronic Health Record systems and Pharmacy systems) as well as with established practices for prescribing, dispensing and reimbursement of drugs. The e-prescription cases illustrate a variety of app…
Platform-Supported Cooperative Work
Abstract. Platformization is transforming the way work is organized in a variety of businesses. The CSCW literature contains substantial amount of research on platforms, but this research to date has mainly been focusing on two-sided global platforms such as social media, on-demand labor, and crowdsourcing platforms. In many European countries, platformization of traditional organizations, both private and public, is well underway and accelerated by the pandemic. Platformization as a process can affect how we design systems –i.e. the platform itself and its peripheral applications and customizations –and how we use platforms for collaboration. Through this workshop we want to engage academi…
Dealing with Tensions in Technology Enabled Healthcare Innovation: Two Cases from the Norwegian Healthcare Sector
In Chapter 5, Grisot, Vassilakopoulou and Aanestad examine patient-focused ICT applications, which extend traditional health information infrastructures and have the potential to transform the relation between patients and doctors, allowing for a more active patient role. However, new design challenges emerge because it is unclear how existing infrastructures can accommodate novel usage areas, and how they should be modified or even substituted. In this chapter, the authors’ research aim is to examine such challenges, framed as ‘design tensions’ in the context of ICT-enabled innovation processes in healthcare. Building on Information Infrastructure theory, the authors examine how such desig…
The Norwegian eHealth Platform: Development Through Cultivation Strategies and Incremental Changes
This chapter describes the conceptualization process, early stage development, and incremental changes in the creation of the Norwegian eHealth platform for patient-oriented services. The platform was launched in 2011 as an information-oriented portal and gradually developed into a complex platform enabling several eHealth services. Some of these services required the linking and reuse of existing components and resources, while other required the creation of novel parts. Overall the process has been driven by strong political will and visions towards making health services more accessible to informed patients. In this chapter we examine this effort as a process of cultivation of the instal…