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

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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 re-infrastructuring 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.

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Acknowledgments

We acknowledge the support of the Responsive Architectures for Innovation in Collaborative Healthcare Services (REACH) project, funded by Norwegian Research Council, VERDIKT program (project nr. 213143), and of the C3 Center for Research-based Innovation funded by the Norwegian Research Council (project nr. 237766). We are grateful to the members of the team working on eDialogue who participated in the study, and to the anonymous reviewers for helping us improve the paper.

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  1. Department of Informatics, University of Oslo, Gaustadalléen 23 B, N-0373, Oslo, Norway

    Miria Grisot

  2. Department of Information Systems, University of Agder, Gimlemoen 25, 4630, Kristiansand S, Norway

    Polyxeni Vassilakopoulou

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  1. Miria Grisot
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Correspondence to Miria Grisot.

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Grisot, M., Vassilakopoulou, P. Re-Infrastructuring for eHealth: Dealing with Turns in Infrastructure Development. Comput Supported Coop Work 26, 7–31 (2017). https://doi.org/10.1007/s10606-017-9264-2

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