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How Do Users Perceive a Design-in-Use Approach to Implementation? A Healthcare Case

  • Morten HertzumEmail author
  • Arnvør Torkilsheyggi
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11748)

Abstract

The implementation of information systems in organizational settings is a protracted process that includes the mutual adaptation of system and organization to each other after the system has gone live. We investigate a design-in-use approach to this implementation process. Rather than a centrally run implementation process with preset goals, the management in the studied hospital tasked the individual departments with exploring and embracing the possibilities afforded by a network of interconnected electronic whiteboards. The responsibility for driving this process was assigned to local super users in the departments. On the basis of interviews with 17 clinicians we find that (a) they perceive the design-in-use approach in conflicting ways, (b) the super users are more positive about the approach than the end-users, (c) standardization across departments conflicts with design in use within departments, (d) intradepartmental change is perceived more positively, (e) the design-in-use process is inextricably sociotechnical, and (f) the clinicians’ perception of design in use is more about implementing change than about preparing it or about training and support. The conflicting perceptions of the design-in-use approach, for example, include whether it gained momentum, met local needs, and made for an engaging process. We discuss the implications of our findings for a design-in-use approach to implementation.

Keywords

Design in use Organizational implementation Healthcare 

Notes

Acknowledgements

This paper is dedicated to the memory of the second author, Arnvør Torkilsheyggi, who tragically died before the paper saw publication. The paper reports work conducted in the Clinical Communication project, which was a research and development collaboration between Region Zealand, Imatis, Roskilde University, and University of Copenhagen. The second author’s participation in the project was co-funded by Region Zealand. We are grateful to Claus R. Mortensen for his support in identifying the interviewees. Special thanks are due to the interviewees.

References

  1. 1.
    Aanestad, M., Driveklepp, A.M., Sørli, H., Hertzum, M.: Participatory continuing design: “living with” videoconferencing in rehabilitation. In: Kanstrup, A.M., Bygholm, A., Bertelsen, P., Nøhr, C. (eds.) Participatory Design and Health Information Technology, pp. 45–59. IOS Press, Amsterdam (2017)Google Scholar
  2. 2.
    Aarts, J., Berg, M.: Same system, different outcomes: comparing the implementation of computerized physician order entry in two Dutch hospitals. Methods Inf. Med. 45(1), 53–61 (2006)Google Scholar
  3. 3.
    Balka, E., Wagner, I.: Making things work: dimensions of configurability as appropriation work. In: Proceedings of the CSCW 2006 Conference on Computer Supported Cooperative Work, pp. 229–238. ACM Press, New York (2006)Google Scholar
  4. 4.
    Bikson, T.K., Eveland, J.D.: Sociotechnical reinvention: implementation dynamics and collaboration tools. Inf. Commun. Soc. 1(3), 270–290 (1998)Google Scholar
  5. 5.
    Bjögvinsson, E., Ehn, P., Hillgren, P.-A.: Design things and design thinking: contemporary participatory design challenges. Des. Issues 28(3), 101–116 (2012)Google Scholar
  6. 6.
    Blackwell, A.F.: End-user developers – what are they like? In: Paternò, F., Wulf, V. (eds.) New Perspectives in End-User Development, pp. 121–135. Springer, Cham (2017).  https://doi.org/10.1007/978-3-319-60291-2_6Google Scholar
  7. 7.
    Bowers, J.: The work to make a network work: studying CSCW in action. In: Proceedings of the CSCW 1994 Conference on Computer Supported Cooperative Work, pp. 287–298. ACM Press, New York (1994)Google Scholar
  8. 8.
    Dittrich, Y., Bolmsten, J., Eriksson, J.: End user development and infrastructuring – sustaining organizational innovation capabilities. In: Paternò, F., Wulf, V. (eds.) New Perspectives in End-User Development, pp. 165–206. Springer, Cham (2017).  https://doi.org/10.1007/978-3-319-60291-2_8Google Scholar
  9. 9.
    Dittrich, Y., Eriksén, S., Hansson, C.: PD in the wild: evolving practices of design in use. In: Binder, T., Gregory, J., Wagner, I. (eds.) Proceedings of the Seventh Conference on Participatory Design, PDC2002, pp. 124–134. CPSR, Palo Alto (2002)Google Scholar
  10. 10.
    Fischer, G.: End-user development and meta-design: foundations for cultures of participation. J. Organ. End User Comput. 22(1), 52–82 (2010)Google Scholar
  11. 11.
    Hartswood, M., et al.: Co-realisation: towards a principled synthesis of ethnomethodology and participatory design. Scand. J. Inf. Syst. 14(2), 9–30 (2002)Google Scholar
  12. 12.
    Henderson, A., Kyng, M.: There’s no place like home: continuing design in use. In: Greenbaum, J., Kyng, M. (eds.) Design at Work: Cooperative Design of Computer Systems, pp. 219–240. Erlbaum, Hillsdale (1991)Google Scholar
  13. 13.
    Hertzum, M.: Electronic emergency-department whiteboards: a study of clinicians’ expectations and experiences. Int. J. Med. Inform. 80(9), 618–630 (2011)Google Scholar
  14. 14.
    Hertzum, M., Simonsen, J.: Effects-driven IT development: specifying, realizing, and assessing usage effects. Scand. J. Inf. Syst. 23(1), 3–28 (2011)Google Scholar
  15. 15.
    Hertzum, M., Simonsen, J.: Configuring information systems and work practices for each other: what competences are needed locally? Int. J. Hum.-Comput. Stud. 122, 242–255 (2019)Google Scholar
  16. 16.
    Karasti, H., Baker, K., Millerand, F.: Infrastructure time: long-term matters in collaborative development. Comput. Support. Coop. Work 19(3&4), 377–415 (2010)Google Scholar
  17. 17.
    Ko, A.J., et al.: The state of the art in end-user software engineering. ACM Comput. Surv. 43(3), article 21 (2011)Google Scholar
  18. 18.
    Ludwig, T., Dax, J., Pipek, V., Wulf, V.: A practice-oriented paradigm for end-user development. In: Paternò, F., Wulf, V. (eds.) New Perspectives in End-User Development, pp. 23–41. Springer, Cham (2017).  https://doi.org/10.1007/978-3-319-60291-2_2Google Scholar
  19. 19.
    Maceli, M., Atwood, M.E.: “Human crafters” once again: supporting users as designers in continuous co-design. In: Dittrich, Y., Burnett, M., Mørch, A., Redmiles, D. (eds.) IS-EUD 2013. LNCS, vol. 7897, pp. 9–24. Springer, Heidelberg (2013).  https://doi.org/10.1007/978-3-642-38706-7_3Google Scholar
  20. 20.
    Mackay, W.E.: Patterns of sharing customizable software. In: Proceedings of the CSCW 1990 Conference on Computer Supported Cooperative Work, pp. 209–221. ACM Press, New York (1990)Google Scholar
  21. 21.
    Markus, M.L.: Technochange management: using IT to drive organizational change. J. Inf. Technol. 19(1), 4–20 (2004)Google Scholar
  22. 22.
    Mehandjiev, N., Sutcliffe, A., Lee, D.: Organizational view of end-user development. In: Lieberman, H., Paternó, F., Wulf, V. (eds.) End User Development. HCIS, vol. 9, pp. 371–399. Springer, Dordrecht (2006).  https://doi.org/10.1007/1-4020-5386-X_17Google Scholar
  23. 23.
    Møller, N.L.H., Vikkelsø, S.: The clinical work of secretaries: Exploring the intersection of administrative and clinical work in the diagnosing process. In: Dugdale, J., Masclet, C., Grasso, M., Boujut, J.F., Hassanaly, P. (eds.) From Research to Practice in the Design of Cooperative Systems: Results and Open Challenges, pp. 33–47. Springer, London (2012).  https://doi.org/10.1007/978-1-4471-4093-1_3Google Scholar
  24. 24.
    Mørch, A.I., Andersen, R.: Mutual development: the software engineering context of end-user development. J. Organ. End User Comput. 22(2), 36–57 (2010)Google Scholar
  25. 25.
    Nah, F.F.-H., Zuckweiler, K.M., Lau, J.L.-S.: ERP implementation: chief information officers’ perceptions of critical success factors. Int. J. Hum.-Comput. Interact. 16(1), 5–22 (2003)Google Scholar
  26. 26.
    Nicolaou, A.I.: Firm performance effects in relation to the implementation and use of enterprise resource planning systems. J. Inf. Syst. 18(2), 79–105 (2004)MathSciNetGoogle Scholar
  27. 27.
    Okamura, K., Fujimoto, M., Orlikowski, W.J., Yates, J.: Helping CSCW applications succeed: The role of mediators in the context of use. Inf. Soc. 11(3), 157–172 (1995)Google Scholar
  28. 28.
    Orlikowski, W.J.: Improvising organizational transformation over time: a situated change perspective. Inf. Syst. Res. 7(1), 63–92 (1996)Google Scholar
  29. 29.
    Orlikowski, W.J., Hofman, J.D.: An improvisational model for change management: the case of groupware technologies. Sloan Manag. Rev. 38(2), 11–22 (1997)Google Scholar
  30. 30.
    Park, S.Y., Chen, Y., Rudkin, S.: Technological and organizational adaptation of EMR implementation in an emergency department. ACM Trans. Comput.-Hum. Interact. 22(1), 1:01–1:24 (2015)Google Scholar
  31. 31.
    Pipek, V., Kahler, H.: Supporting collaborative tailoring. In: Lieberman, H., Paternó, F., Wulf, V. (eds.) End User Development. HCIS, vol. 9, pp. 315–345. Springer, Dordrecht (2006).  https://doi.org/10.1007/1-4020-5386-X_15Google Scholar
  32. 32.
    Pipek, V., Wulf, V.: A groupware’s life. In: Bødker, S., Kyng, M., Schmidt, K. (eds.) Proceedings of the Sixth European Conference on Computer-Supported Cooperative Work, ECSCW 1999, pp. 199–218. Kluwer, Amsterdam (1999)Google Scholar
  33. 33.
    Powell, S.G., Baker, K.R., Lawson, B.: A critical review of the literature on spreadsheet errors. Decis. Support Syst. 46(1), 128–138 (2008)Google Scholar
  34. 34.
    Pries-Heje, L., Dittrich, Y.: ERP implementation as design: looking at participatory design for means to facilitate knowledge integration. Scand. J. Inf. Syst. 21(2), 27–58 (2009)Google Scholar
  35. 35.
    Priestman, W., Sridharan, S., Vigne, H., Collins, R., Seamer, L., Sebire, N.J.: What to expect from electronic patient record system implementation: lessons learned from published evidence. J. Innov. Health Inform. 25(2), 92–104 (2018)Google Scholar
  36. 36.
    Rasmussen, R., Fleron, B., Hertzum, M., Simonsen, J.: Balancing tradition and transcendence in the implementation of emergency-department electronic whiteboards. In: Molka-Danielsen, J., Nicolaisen, H.W., Persson, J.S. (eds.) Selected Papers of the Information Systems Research Seminar in Scandinavia 2010, pp. 73–87. Tapir Academic Press, Trondheim (2010)Google Scholar
  37. 37.
    Sanchez, R., Mahoney, J.T.: Modularity, flexibility, and knowledge management in product and organization design. Strateg. Manag. J. 17(Winter Special Issue), 63–76 (1996)Google Scholar
  38. 38.
    Simonsen, J., Hertzum, M.: Sustained participatory design: extending the iterative approach. Des. Issues 28(3), 10–21 (2012)Google Scholar
  39. 39.
    Spencer, M.: Brittleness and bureaucracy: software as a material for science. Perspect. Sci. 23(4), 466–484 (2015)Google Scholar
  40. 40.
    Star, S.L., Ruhleder, K.: Steps toward an ecology of infrastructure: design and access for large information spaces. Inf. Syst. Res. 7(1), 111–134 (1996)Google Scholar
  41. 41.
    Torkilsheyggi, A., Hertzum, M.: Incomplete by design: a study of a design-in-use approach to systems implementation. Scand. J. Inf. Syst. 29(2), article 2 (2017)Google Scholar
  42. 42.
    Trigg, R.H., Bødker, S.: From implementation to design: tailoring and the emergence of systematization in CSCW. In: Proceedings of the CSCW 1994 Conference on Computer Supported Cooperative Work, pp. 45–54. ACM Press, New York (1994)Google Scholar
  43. 43.
    Truex, D.P., Baskerville, R., Klein, H.: Growing systems in emergent organizations. Commun. ACM 42(8), 117–123 (1999)Google Scholar
  44. 44.
    Tyre, M.J., Orlikowski, W.J.: Windows of opportunity: temporal patterns of technological adaptation in organizations. Organ. Sci. 5(1), 98–118 (1994)Google Scholar
  45. 45.
    Yetim, F., Draxler, S., Stevens, G., Wulf, V.: Fostering continuous user participation by embedding a communication support tool in user interfaces. AIS Trans. Hum.-Comput. Interact. 4(2), 153–168 (2012)Google Scholar
  46. 46.
    Åsand, H.-R.H., Mørch, A.I.: Super users and local developers: the organization of end user development in an accounting company. J. Organ. End User Comput. 18(4), 1–21 (2008)Google Scholar

Copyright information

© IFIP International Federation for Information Processing 2019

Authors and Affiliations

  1. 1.University of CopenhagenCopenhagenDenmark
  2. 2.Roskilde UniversityRoskildeDenmark

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