This paper addresses the general question proposed by the call of this special issue: "What historical or contingent events and factors influence the creation of ICT standards, and in particular, their success or failure?" Based on a case study conducted over a period of three years in a Norwegian hospital on the standardization process of an electronic patient record (EPR), the paper contributes to the current discussion on the conceptualization of standard-making in the field of Information Systems. By drawing upon the concepts of logic of ordering adopted from actor-network theory and upon reflexivity and the unexpected side effects adopted from reflexive modernization, the paper makes three key contributions: (1) it demonstrates the socio-technical complexity of IS standards and standardization efforts; (2) it shows how complexity generates reflexive processes that undermine standardization aims; and (3) it suggests a theoretical interpretation of standardization complexity by using ideas from complexity theory and the theory of reflexive modernization. These research questions are addressed by offering an historical and contingent analysis of the complexity dynamics emerging from the case.

Abstract

This paper addresses the challenges that arise when knowledge production occurs in crossdisciplinary settings. To date most studies on communities of practice have focused on knowledge production within communities of practice rather than across communities of practice. We analyse the various professional groups in a medical R&D department as a constellation of distinct, but interconnected communities of practice with different epistemic cultures. The medical R&D case is particularly interesting for this purpose, because it involved creating new cross-disciplinary practices between different pre-existing and well-established communities of practice. In line with our focus on the challenges and processes involved in cross-disciplinary knowledge production, we describe negotiations and tensions during the establishment of the department, as well as in day-to-day practice. In particular, we focus on how the 'machineries of knowledge production', that is, the actual mechanisms by which knowledge is pursued, are different across the various communities of practice. These machineries belong to different epistemic cultures on a national or even international scale, and thus every community of practice is part of a complex web of people, activities and material structures extending well beyond the immediate work context. This networked character of knowing in practice explain why learning on the system level of communities of practice can be challenging. It may lead to path-dependent learning processes, and radical change can become limited if the knowledge required by new and different practices is incompatible with the existing stock of knowledge. Consequently, we suggest that the communities of practice approach could be enriched by looking at diversity and discontinuity in the epistemic cultures and networks that the different communities of practice are associated with.

No abstract

Healthcare professionals are increasingly working with data in their care delivery practices. However, there is limited understanding of how data work is enabling novel practices. This study focuses on novel nursing practices emerging in the context of remote monitoring of chronic patients. Specifically, we analyze how personalization of care is achieved in practice through data work. The study is based on a case of a pilot center in Norway where nurses provide remote care to patients by using a specialized system. We examine the practices of the nurses and how data in the form of graphs, alerts, questionnaires and messages are used to personalize care. We identify three main practices of data work for personalization: preparatory work, continuous adjustment and question fine-tuning. Finally, we discuss the pivotal role of nurses’ data work for personalized care in remote care.