Infrastructuring and Participatory Design: Exploring Infrastructural Inversion as Analytic, Empirical and Generative

  • Jesper SimonsenEmail author
  • Helena Karasti
  • Morten Hertzum


The participatory design of CSCW systems increasingly embraces activities of reconfiguring the use of existing interconnected systems in addition to developing and implementing new. In this article, we refer to such activities of changing and improving collaboration through the means of existing information infrastructures as infrastructuring. We investigate a relational perspective on infrastructuring and provide an overview and a detailed account of a local infrastructuring process by tracing the concrete relations that emerged. The elusive quality of information infrastructures as being invisible is analyzed through the notion of infrastructural inversion. Infrastructural inversion is the gestalt switch of shifting attention from the activities invisibly supported by an infrastructure to the activities that enable the infrastructure to function and meet desired needs for collaborative support. Initially, infrastructural inversion was conceived as a conceptual-analytic notion, but recent research has also positioned it as an empirical-ethnographic and generative-designerly resource. In this study, we rely on all of these stances and contribute to the generative-designerly position. We explain the notion of infrastructural inversion and describe how it is distinct from the CSCW concept of articulation work. The context of the analysis includes a participatory design project that sought to reduce patients’ fasting time prior to surgical operations by improving the interdepartmental coordination at a hospital. The project revealed the webs of relations and interdependencies in which fasting time is inscribed at the local level as well as regionally, nationally, and beyond. We pursue the relations, trace their connectedness across multiple scopes, and show how the process alternated between empirical and analytic activities of exploring relations and design-oriented activities of reaching closure. Our analysis shows that the notion of infrastructural inversion can enrich participatory design: Infrastructural inversion embraces the exploratory activities of tracing relations, while the design agenda drove the need for reaching closure. We conclude by discussing lessons learned for infrastructuring and for participatory design that engages with infrastructuring.


Information infrastructure Infrastructuring Infrastructural relations Infrastructural inversion Conceptual-analytic, empirical-ethnographic, and generative-designerly strategies Participatory design Effects-driven participatory design Collaborative design Healthcare 



The study was part of the Clinical Communication project, a research and development collaboration between Region Zealand, Roskilde University, and University of Copenhagen, Denmark, and Imatis Inc., Norway. The study was financially supported by Region Zealand and Roskilde University. Research assistant Lene Hansen provided practical support and transcribed the selected meetings. We owe thanks to all the clinicians who took part in the activities of the fasting-time project. Special thanks are due to the three hospital representatives in the project group: Dorte S. Jensen, Helle P. Dengsøe, and Monica H. Marqvorsen.

We acknowledge the Velux Visiting Professor Program of The Villum Foundation that funded Helena Karasti’s stay at Roskilde University for a year in 2015-2016 during which the analysis reported in this article was conducted.

Declarations of interest: The authors took part in the fasting-time project and, thereby, also in the project meetings analyzed in this paper. Apart from this participation we have no conflicts of interest to declare.


  1. Aanestad, Margunn Anne Merete Driveklepp, Hilde Sørli, and Morten Hertzum (2017). Participatory continuing design: “Living with” videoconferencing in rehabilitation. In A.M. Kanstrup; A. Bygholm; P. Bertelsen; and C. Nøhr (eds), Participatory design and health information technology, IOS Press, Amsterdam, pp. 45–59.Google Scholar
  2. Agid, Shana (2016). “...It’s your project, but It’s not necessarily your work...”: Infrastructuring, Situatedness, and designing relational practice. In Bossen, C., R.C. Smith; A.M. Kanstrup; J. McDonnell; M. Teli; and K. Bødker (eds): Proceedings of the 14th participatory design conference: Full papers - Volume 1, New York: ACM, pp. 81–90.Google Scholar
  3. American Society of Anesthesiologists (2011). Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures. Anesthesiology, vol. 114, no. 3, pp. 495–511.Google Scholar
  4. Appadurai, Arjun (2014). Foreword. In S. Graham and C. McFarlane (eds): Infrastructural lives: Urban infrastructure in context. Oxford: Routledge, pp. xii-xiii.Google Scholar
  5. Bannon, Liam J.; and Pelle Ehn (2013). Design: Design matters in participatory design. In J. Simonsen and T. Robertson (eds), Routledge international handbook of participatory design (pp. 37–63). New York: Routledge.Google Scholar
  6. Berg, Marc (1999). Accumulating and coordinating: Occasions for information Technologies in Medical Work. Computer Supported Cooperative Work, vol. 8, no. 4, pp. 373–401.Google Scholar
  7. Bjögvinsson, Erling; Pelle Ehn; and Per-Anders Hillgren (2012). Design things and design thinking: Contemporary participatory design challenges. Design Issues, vol. 28, no. 3, pp. 101–116.Google Scholar
  8. Björgvinsson, Erling; Pelle Ehn; and Per-Anders Hillgren (2010) Participatory design and ‘democratizing innovation’, Proceedings of the 11th biennial Participatory Design Conference, PDC 2010, Sydney, Australia, November 29 – December 3, 2010, New York: ACM, pp. 41–50.Google Scholar
  9. Blomberg, Jeanette; and Helena Karasti (2013). Reflections on 25 years of ethnography in CSCW. Computer Supported Cooperative Work, vol. 22, no. 4–6, pp. 373–423.Google Scholar
  10. Bødker, Keld; Finn Kensing; and Jesper Simonsen, (2004). Participatory IT design. Designing for business and workplace realities. Cambridge: MIT Press.Google Scholar
  11. Bødker, Susanne; Christian Dindler and Ole Sejer Iversen (2017). Tying knots: Participatory Infrastructuring at work. Computer Supported Cooperative Work (CSCW), vol. 26, no. 1–2, pp. 245–273.Google Scholar
  12. Bossen, Claus; and Randi Markussen (2010). Infrastructuring and ordering devices in health care: Medication plans and practices on a hospital ward. Computer Supported Cooperative Work, vol. 19, no. 6, pp. 615–637.Google Scholar
  13. Botero, Andrea; Helena Karasti; Joanna Saad-Sulonen; Hanne Cecilie Geirbo; Karen S. Baker; Elena Parmiggiani; and Sanna Marttila (eds) (2019) Drawing together: Infrastructuring and politics for participatory design - a visual collection of cases, issues, questions, and relevant literature. University of Oulu, INTERACT Research Unit, INTERACT Series, no. 1.Google Scholar
  14. Bowker, Geoffrey C. (1994). Science on the run: Information management and industrial geophysics at Schlumberger, 1920–1940. Cambridge, MA: MIT Press.Google Scholar
  15. Bowker, Geoffrey C.; and Susan L. Star (1999). Sorting things out: Classification and its consequences. Cambridge, MA: MIT Press.Google Scholar
  16. Brandt, Eva; Thomas Binder; and Elizabeth Sanders. (2013). Tools and techniques: Ways to engage telling, making and enacting. In J. Simonsen; and T. Robertson (eds), Routledge international handbook of participatory design (pp. 145–181). New York, NY: Routledge.Google Scholar
  17. Clarke, Adele E.; and Susan L. Star (2008). The social world framework: A theory/methods package. In E. J. Hackett, O. Amsterdamska, M. Lynch; and J. Wajcman (eds): The handbook of science and technology studies. Cambridge, MA: MIT Press, pp. 113–137.Google Scholar
  18. Clement, Andrew; Brenda McPhail; Karen L. Smith; and Joseph Ferenbok (2012). Probing, mocking and prototyping: Participatory approaches to identity infrastructuring. In PDC2012: Proceedings of the 12th participatory design conference. New York: ACM Press, pp. 21–30.Google Scholar
  19. Dagiral, Éric; and Ashveen Peerbaye (2016). Making knowledge in boundary infrastructures: Inside and beyond a database for rare diseases. Science and Technology Studies, vol. 29, no. 2, pp. 44–61.Google Scholar
  20. Edwards, Paul (2010). A vast machine: Computer models, climate data, and the politics of global warming. Cambridge, MA: MIT Press.Google Scholar
  21. Edwards, Paul N.; Steven J. Jackson; Geoffrey C. Bowker; and Cory P. Knobel (2007). Understanding infrastructure: Dynamics, tensions, and design. Final report of the workshop History and Theory of Infrastructure: Lessons for New Scientific Cyberinfrastructures. NSF, Office of Cyberinfrastructure. Accessed 6 Jul 2019.
  22. Ehn, Pelle (2008) Participation in design things. Proceedings of the 10th biennial Anniversary Conference on Participatory Design, PDC 2008, Bloomington, Indiana, USA, October 1–5, 2008s, New York, NY: ACM, pp. 92–101.Google Scholar
  23. Gerson, Elihu M.; and Susan Leigh Star (1986): Analyzing due process in the workplace. ACM Transactions on Office Information Systems, vol. 4, no. 3, pp. 257–270.Google Scholar
  24. Harvey, Penelope; Casper Bruun Jensen; and Atsuro Morita (eds) (2017). Infrastructures and social complexity. A companion. New York: Routledge.Google Scholar
  25. Heidegger, Martin (1962/1927). Being and time (J. Macquarrie and E. Robinson, Trans.). New York: Harper.Google Scholar
  26. Henderson, Austin; and Morten Kyng (1991) There’s no place like home: Continuing Design in use. In Greenbaum, J. and M. Kyng (eds) Design at work: Cooperative Design of Computer Systems. Lawrence Erlbaum, Hills- dale, pp. 219–240.Google Scholar
  27. Hertzum, Morten; and Jesper Simonsen (2011). Effects-driven IT development: Specifying, realizing, and assessing usage effects. Scandinavian Journal of Information Systems, vol. 23, no. 1, pp. 3–28.Google Scholar
  28. Hertzum, Morten; and Jesper Simonsen (2015). Visual overview, oral detail: The use of an emergency-department whiteboard. International Journal of Human-Computer Studies, vol. 82, pp. 21–30.Google Scholar
  29. Hertzum, Morten; and Jesper Simonsen (2016). Effects of electronic emergency-department whiteboards on clinicians' time distribution and mental workload. Health Informatics Journal, vol. 22, no. 1, pp. 3–20.Google Scholar
  30. Hertzum, Morten; and Jesper Simonsen (2019). Configuring information systems and work practices for each other: What competences are needed locally. International Journal of Human-Computer Studies, vol. 122, pp. 242–255.Google Scholar
  31. Hillgren, Per-Anders; Anna Seravalli; and Anders Emilson (2010). Prototyping and infrastructuring in design for social innovation. CoDesign, vol. 7, no. 3–4, pp. 169–183.Google Scholar
  32. Hine, Christine (2009). How can qualitative internet researcher define the boundaries of their projects? In Annette N. Markham; and Nancy K. Baym (eds): Internet inquiry: Conversations about method. Thousand Oaks, CA: Sage Publications, pp. 1–20.Google Scholar
  33. Jensen, Casper Bruun (2014). Continuous variations: The conceptual and the empirical in STS. Science. Technology and Human Values, vol. 39, no. 2, pp. 192–213.Google Scholar
  34. Jensen, Casper Bruun; and Britt Ross Winthereik (2013). Monitoring movements in development aid: Recursive partnerships and infrastructures. Cambridge, MA: The MIT Press.Google Scholar
  35. Kaltenbrunner, Wolfgang (2015). Infrastructural inversion as a generative resource in digital scholarship. Science as Culture, vol. 24, no. 1, pp. 1–23.Google Scholar
  36. Karasti, Helena (2014). Infrastructuring in participatory design. In PDC'14: Proceedings of the 13th conference on participatory design. New York: ACM Press, pp. 141–150.Google Scholar
  37. Karasti, Helena; and Karen S. Baker (2004) Infrastructuring for the Long-Term: Ecological Information Management. Proceedings of the 37th Annual Hawaii International Conference on System Sciences (HICSS’37), Big Island, HI, USA, 5–8 Jan. 2004, IEEE, p. 10.Google Scholar
  38. Karasti, Helena; and Jeanette Blomberg (2018). Studying Infrastructuring ethnographically. Computer Supported Cooperative Work, vol. 27, no. 2, pp. 233–265.Google Scholar
  39. Karasti, Helena and Anna-Liisa Syrjänen (2004) Artful infrastructuring in two cases of community PD. Proceedings of the 8th biennial Participatory Design Conference, PDC 2004, Toronto, Canada, July 27-31, 2004, vol. 1, New York, NY: ACM, pp. 20–30.Google Scholar
  40. Karasti, Helena; Karen S. Baker and Florence Millerand (2010): Infrastructure time. Long-term matters in collaborative development, Computer Supported Cooperative Work, vol. 19, no. 3–4, pp. 377–415.Google Scholar
  41. Karasti, Helena; Volkmar Pipek; and Geoffrey C. Bowker (2018) An afterword to 'Infrastructuring and collaborative Design'. Computer Supported Cooperative Work (CSCW): The Journal of Collaborative Computing and Work Practices, vol. 27, no. 2, pp. 267–289.Google Scholar
  42. Kensing, Finn; and Jeanette Blomberg (1998). Participatory design: Issues and concerns. Computer Supported Cooperative Work, 7(3–4), pp. 167–185.Google Scholar
  43. Kensing, Finn; and Andreas Munk-Madsen (1993). PD: Structure in the toolbox. Communications of the ACM, vol. 36, no. 6, pp. 78–85.Google Scholar
  44. Korn, Matthias; and Amy Voida (2015). Creating friction: Infrastructuring civic engagement in everyday life. In Proceedings of the 5th decennial Aarhus conference: Critical alternatives. Aarhus, Denmark: Aarhus University Press, pp. 145–156.Google Scholar
  45. Lambert, Eva; and Sharon Carey (2015). Practice guideline recommendations on perioperative fasting: A systematic review. Journal of Parenteral and Enteral Nutrition.Google Scholar
  46. Larkin, Brian (2013). The politics and poetics of infrastructure. Annual Review of Anthropology, vol. 42, pp. 327–343.Google Scholar
  47. Lassen, Jens V.; and Jesper Simonsen (2014). User-driven designs in medical informatics: Developing and implementing support for inter-departmental coordination of hospital work using electronic whiteboards. In J. Molka-Nielsen; and J. Pries-Heje (eds): Selected papers of the information systems research seminar in Scandinavia, IRIS 37: Association for Information Systems, AIS Electronic Library (AISeL).Google Scholar
  48. Le Dantec, Christopher A.; and Carl DiSalvo (2013.) Infrastructuring and the formation of publics in participatory design. Social Studies of Science, vol. 42, no. 2, pp. 241–264.Google Scholar
  49. Maltby, J. Roger (2006). Fasting from midnight - the history behind the dogma. Best Practice and Research: Clinical Anaesthesiology, vol. 20, no. 3, pp. 363–378.Google Scholar
  50. Marres, Noortje; Michael Guggenheim; and Alex Wilkie (2018) Inventing the social. Mattering Press, Manchester.Google Scholar
  51. Mayernik, Matthew S.; Jillian C. Wallis; and Christine L. Borgman (2013). Unearthing the infrastructure: Humans and sensors in field-based scientific research. Computer Supported Cooperative Work, vol. 22, no. 1, pp. 65–101.Google Scholar
  52. Michael, Mike (2012). What are we busy doing?: Engaging the idiot. Science, Technology and Human Values, vol. 37, no. 5, pp. 528–554.Google Scholar
  53. Monteiro, Eric; Neil Pollock; Ole Hanseth; and Robin Williams (2013). From artefacts to infrastructures. Computer Supported Cooperative Work (CSCW): The Journal of Collaborative Computing and Work Practices, vol. 22, No. 4–6, pp. 575–607.Google Scholar
  54. Nardi, Bonnie A.; and Yrjö Engeström (1999). A web on the wind: The structure of invisible work. Computer Supported Cooperative Work, vol. 8, no. 1–2, pp. 1–8.Google Scholar
  55. Neumann, Laura J.; and Susan L. Star (1996). Making infrastructure: The dream of a common language. In PDC1996: Proceedings of the fourth biennial participatory design conference. Palo Alto, CA: Computer Professionals for Social Responsibility, pp. 231–240.Google Scholar
  56. Nygren, Jonas (2006). The metabolic effects of fasting and surgery. Best Practice and Research: Clinical Anaesthesiology, vol. 20, no. 3, pp. 429–438.Google Scholar
  57. Parmiggiani, Elena (2015). Integration by infrastructuring: The case of subsea environmental monitoring in oil and gas offshore operations (doctoral dissertation). Trondheim, Norway: NTNU Press.Google Scholar
  58. Parmiggiani, Elena; and Eric Monteiro (2016). A measure of ‘environmental happiness’: Infrastructuring environmental risk in oil and gas off shore operations. Science and Technology Studies, vol. 29, no. 1, pp. 30–51.Google Scholar
  59. Parmiggiani, Elena; Eric Monteiro; and Vidar Hepsø (2015). The digital coral: Infrastructuring environmental monitoring. Computer Supported Cooperative Work, vol. 24, no. 5, pp. 423–460.Google Scholar
  60. Pihkala, Suvi (2018). Touchable Matters. Reconfiguring the practices of sustainable change through responseable engagements. Doctoral dissertation, University of Oulu Graduate School; University of Oulu, Faculty of Education, Finland.Google Scholar
  61. Pimenta, Gunther Peres; and José Eduardo de Aguilar-Nascimento (2014). Prolonged preoperative fasting in elective surgical patients: Why should we reduce it? Nutrition in Clinical Practice, vol. 29, no. 1, pp. 22–28.Google Scholar
  62. Pipek, Volkmar; and Volker Wulf (2009). Infrastructuring: Toward an integrated perspective on the design and use of information technology. Journal of the Association for Information Systems, vol. 10, no. 5, pp. 447–473.Google Scholar
  63. Pipek, Volkmar; Helena Karasti; and Geoffrey C. Bowker (2017). A Preface to ‘Infrastructuring and Collaborative Design.’ Computer Supported Cooperative Work (CSCW), vol. 26, no. 1–2, pp. 1–5.Google Scholar
  64. Rasmussen, Rasmus; Benedicte Fleron; Morten Hertzum; and Jesper Simonsen (2010). Balancing tradition and transcendence in the implementation of emergency-department electronic whiteboards. In J. Molka-Danielsen, H. W. Nicolaisen; and J. S. Persson (eds): Selected papers of the information systems research seminar in Scandinavia 2010. Trondheim, NO: Tapir Academic Press, pp. 73–87.Google Scholar
  65. Ribes, David; and Charlotte P. Lee (2010). Sociotechnical studies of cyberinfrastructure and e-research: Current themes and future trajectories. Computer Supported Cooperative Work, vol. 19, no. 3–4, pp. 231–244.Google Scholar
  66. Schmidt, Kjeld (2000). The critical role of workplace studies in CSCW. In P. Luff, J. Hindmarsh and C. Heath (eds): Workplace studies: Recovering work practice and informing design. Cambridge, UK: Cambridge University Press, pp. 141–149.Google Scholar
  67. Schmidt, Kjeld and Liam Bannon. (1992). Taking CSCW seriously: Supporting articulation work. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 1, no. 1–2, pp. 7–40.Google Scholar
  68. Schmidt, Kjeld; and Carla Simone (1996). Coordination mechanisms: Towards a Conceptual Foundation of CSCW systems design. Computer Supported Cooperative Work: The Journal of Collaborative Computing, vol. 5, no 2–3, pp. 155–200.Google Scholar
  69. Simon, Herbert A. (1981). The sciences of the artificial (Second ed.). The Murray Printing Company.Google Scholar
  70. Simonsen, Jesper; and Morten Hertzum (2012). Sustained participatory design: Extending the iterative approach. Design Issues, 28(3), pp. 10–21.Google Scholar
  71. Simonsen, Jesper; Jørgen Ole Bærenholdt; John Damm Scheuer; and Monika Büscher (2010). Synergies. In J. Simonsen; J.O. Bærenholdt; M. Büscher; and J.D. Scheuer (eds), Design Research: Synergies from Interdisciplinary Perspectives (pp. 201–212). Routledge.Google Scholar
  72. Simonsen, Jesper; Morten Hertzum; and Helena Karasti (2015): Supporting clinicians in Infrastructuring. In Enrico Maria Piras; and Gunnar Ellingsen (eds): Proceedings of the Fifth International Workshop on Infrastructures for Healthcare (IHC): Patient-centred Care and Patient generated Data, 18–19 June, 2015, University of Trento, Trento, Italy.Google Scholar
  73. Simonsen, Jesper; Morten Hertzum; and John Damm Scheuer (2018). Quality development in health care: Participation vs. Accreditation. Nordic Journal of Working Life Studies, vol. 8, no. S3, pp. 49–69.Google Scholar
  74. Star, Susan L. (1999). The ethnography of infrastructure. American Behavioral Scientist, vol. 43, no. 3, pp. 377–391.Google Scholar
  75. Star, Susan L; and Geoffrey C Bowker (2002). How to infrastructure? In L. A. Lievrouw; and S. Livingstone (eds): The handbook of new media: Social shaping and consequences of ICTs. London: Sage, pp. 151–162.Google Scholar
  76. Star, Susan L; and Karen Ruhleder (1994). Steps towards an ecology of infrastructure: Complex problems in design and access for large-scale collaborative systems. In Proceedings of the CSCW1994 conference on computer supported cooperative work. New York: ACM Press, pp. 253–264.Google Scholar
  77. Star, Susan L; and Karen Ruhleder (1996). Steps toward an ecology of infrastructure: Design and access for large information spaces. Information Systems Research, vol. 7, no. 1, pp. 111–134.Google Scholar
  78. Star, Susan Leigh; and Anselm Strauss (1999). Layers of Silence, Arenas of Voice: The Ecology of Visible and Invisible Work. Computer Supported Cooperative Work (CSCW), vol. 8, nos. 1–2, pp. 9–30.Google Scholar
  79. Stengers, Isabelle (2018). Another science is possible: A manifesto for slow science. Wiley.Google Scholar
  80. Strathern, Marilyn (1995). The relation: Issues in complexity and scale. Cambridge: Prickly Pear Press.Google Scholar
  81. Strauss, Anselm (1985): Work and the division of labor. The Sociological Quarterly, vol. 26, no. 1, pp. 1–19.MathSciNetGoogle Scholar
  82. Strauss, Anselm (1988): The articulation of project work: An organizational process. The Sociological Quarterly, vol. 29, no. 2, pp. 163–178.MathSciNetGoogle Scholar
  83. Suchman, Lucy (1995). Making work visible. Communications of the ACM, vol. 38, no. 9, pp. 56–64.Google Scholar
  84. Ulriksen, Gro Hilde; Rune Pedersen; and Gunnar Ellingsen (2017). Infrastructuring in healthcare through the OpenEHR architecture. Computer Supported Cooperative Work, vol. 26, no. 1–2, pp. 33–69.Google Scholar
  85. Yndigegn, Signe (2016). Managing resistance and negotiating co-design: Reflections on troublesome and elusive moments. Doctoral dissertation, IT University of Copenhagen, Denmark.Google Scholar
  86. Zerubavel, Eviatar (1979). Patterns of time in hospital life: A sociological perspective. Chicago, Il: University of Chicago Press.Google Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of People and TechnologyRoskilde UniversityRoskildeDenmark
  2. 2.University of SiegenSiegenGermany
  3. 3.University of CopenhagenCopenhagenDenmark

Personalised recommendations