A Socio-Temporal Perspective on Pilot Implementation: Bootstrapping Preventive Care

  • Troels MønstedEmail author
  • Morten Hertzum
  • Jens Søndergaard


Systems for preventive care seek to provide healthcare services to citizens at risk of developing disease. In doing so they wrestle with identifying the citizens at risk of developing lifestyle-related disease and with reshaping the existing healthcare infrastructure into effective health offers for these citizens. In this study we analyze how a system for preventive care was enacted through a pilot implementation. The temporariness of the pilot implementation was, we argue, central to its contribution toward bootstrapping the system. By being temporary the pilot implementation became a means of acquiring clinical evidence for the cost-effectiveness of the system prior to committing to its long-term and large-scale use. The temporariness also legitimized temporary solutions to issues that otherwise made it difficult to bring actors, practices, and technologies into alignment. Once aligned, even if merely temporarily, the resurfacing of these issues after the pilot implementation will be shaped by the experiences from the pilot implementation. In this way pilot implementations have a generative role in infrastructure evolution; they are not merely tests but help bootstrap systems by making alignment manifest and benefits salient. We discuss this generative side of learning in pilot implementations and the extent to which they can enact a system by bootstrapping it.

Key Words

Alignment Bootstrapping Healthcare information systems Pilot implementation Preventive care Temporary organizations 



This paper is a revised and thoroughly extended version of a paper presented at the InfraHealth2017 workshop on infrastructures for healthcare. In the interest of full disclosure, we declare that the third author has been the head of RUGP during the TOF project and involved in managing the project. We are grateful to [names blinded for review] for support in identifying interviewees with a stake in the pilot implementation. Special thanks are due to the interviewees.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of People and TechnologyRoskilde UniversityRoskildeDenmark
  2. 2.Department of CommunicationUniversity of CopenhagenCopenhagenDenmark
  3. 3.Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark

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