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)


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.


Design in use Organizational implementation Healthcare 



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.


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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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