Re-Infrastructuring for eHealth: Dealing with Turns in Infrastructure Development

Abstract

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 how actors worked to re-infrastructure through adapting primary care information systems, information flows and representations of patient data. Our findings show how the work of reinfrastructuring revolves around addressing two key design concerns: a) bringing novelty without being trapped in the existing arrangements or harming what is in place, b) bringing changes that are within a specific direction although they happen through distributed decision taking.

An Afterword to ‘Infrastructuring and Collaborative Design’

“…The articles that build on empirical work, employ a variety of research methodological approaches, ranging from no research method described but a case study used to illustrate the chosen conceptual framing and argument (Bødker et al 2017) to detailing multi-method approaches (Mikaelsen et al 2018;Menéndez-Blanco et al 2017;Crabu and Magaudda 2018;Ulriksen et al 2017;Grisot and Vassilakopoulou 2017;Young and Lutters 2017;Lindley et al 2017). In addition to ethnographic (Ulriksen et al 2017;Parmiggiani 2017;Kow and Lustig 2018), qualitative multimethod (Crabu and Magaudda 2018), and qualitative interpretive approaches (Grisot and Vassilakopoulou 2017;Mikaelsen et al 2018), the assortment includes approaches with different degrees of researcher engagement with the design projects studied (Bødker et al 2017;Lindley et al 2017;Young and Lutters 2017;Marttila and Botero 2017).…”

“…In addition to ethnographic (Ulriksen et al 2017;Parmiggiani 2017;Kow and Lustig 2018), qualitative multimethod (Crabu and Magaudda 2018), and qualitative interpretive approaches (Grisot and Vassilakopoulou 2017;Mikaelsen et al 2018), the assortment includes approaches with different degrees of researcher engagement with the design projects studied (Bødker et al 2017;Lindley et al 2017;Young and Lutters 2017;Marttila and Botero 2017). Furthermore, one study reports of integrating an ethnographic approach with involvement in design during the project (Young and Lutters 2017).…”

“…The twelve articles published in this special issue, while all viewing their material through the lens of infrastructuring and collaborative design, have covered a range of substantive fields/domains, including information infrastructure development for healthcare and welfare (Grisot and Vassilakopoulou 2017;Ulriksen et al 2017;Mikaelsen et al 2018), infrastructuring for cultural commons in digital cultural heritage (Marttila and Botero 2017), formation of 'publics' around the theme of dyslexia (Menéndez-Blanco et al 2017), voting technology deployment in digital civics (Lindley et al 2017), infrastructure development for a new cross-disciplinary synthetic science field of Land System Science (Young and Lutters 2017), infrastructuring in an oil company (Parmiggiani 2017); infrastructuring in education (Bødker et al 2017), grassroots infrastructure development for wireless community network (Crabu and Magaudda 2018), and infrastructuring an open source digital currency and payment platform, Bitcoin (Kow and Lustig 2018), and last, in a somewhat different vein, discussing how to study information infrastructure as an empirical real-world phenomenon of infrastructuring (Karasti and Blomberg 2018). …”

“…Several of the articles based on ethnographic and qualitative approaches rely on a widely-trusted set of empirical methods, typically consisting of participant observation, interviewing and document analysis (Crabu and Magaudda 2018;Grisot and Vassilakopoulou 2017), with some study specific added extras, such as Young and Lutters conducting a community survey (2017), Ulriksen et al collecting system logs (2017), and Mikaelsen et al making field trips to health and welfare centers where the same system they studied had been implemented and visiting residential homes (2018). These additions suggest some adaptation to the empirical setting of investigation in negotiation with the authors' research interests.…”

Between Personal and Common: the Design of Hybrid Information Spaces

“…For this research program, we examine how Bthings change over timeB (Pettigrew 1997) by employing multiple methods of data collection, including observations, interviews and document analysis (Benbasat et al 1987). The empirical material yielded for this research has been analyzed previously to investigate the work of infrastructuring and the influence of established logics on infrastructure transformation (Grisot and Vassilakopoulou 2015;Grisot and Vassilakopoulou 2017;Vassilakopoulou et al 2017). For this prior analysis, we conceptualized the new patient-oriented solutions as extensions of the overall Norwegian healthcare information infrastructure and explored the challenges of developing new technological capabilities not as standalone objects, but as elements in wider infrastructures.…”