User Participation in Infrastructuring: Exploring the Space for Action (original) (raw)
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2012
This chapter seeks to contribute to the ongoing debates in the domain of Participatory Design by discussing the various trends and questions within the context of the Health Information Systems Programme (HISP) initiative ongoing over nearly two decades. The focus in this chapter is to discuss issues of Participatory Design during the course of the design, developme t, implementation and scaling of the DHIS software within an action research framework in the context of the public health sector in various developing countries. Further, we discuss ParticipatoryDesignwith respect to changes over time in technological and poli ical contexts and the challenges following from that; from stand-alone MSOffice to cloud computing and fully open source technology – enabling local Participatory Design! In this chapter, we try to describe this rather complex HISP movement over time following three broad phases; ‘traditional’ Participatory Design; pilots and networking Participatory Design, and P...
Journal of Biomedical Informatics, 2008
Participatory Design (PD) methods in the field of health informatics have mainly been applied to the development of small-scale systems with homogeneous user groups in local settings. Meanwhile, health service organizations are becoming increasingly large and complex in character, making it necessary to extend the scope of the systems that are used for managing data, information and knowledge. This study reports participatory action research on the development of a PD framework for large-scale system design. The research was conducted in a public health informatics project aimed at developing a system for 175,000 users. A renewed PD framework was developed in response to six major limitations experienced to be associated with the existing methods. The resulting framework preserves the theoretical grounding, but extends the toolbox to suit applications in networked health service organizations. Future research should involve evaluations of the framework in other health service settings where comprehensive HISs are developed.
Health Information Systems Programme: Participatory Design within the HISP network
Routledge eBooks, 2012
This chapter seeks to contribute to the ongoing debates in the domain of Participatory Design by discussing the various trends and questions within the context of the Health Information Systems Programme (HISP) initiative ongoing over nearly two decades. The focus in this chapter is to discuss issues of Participatory Design during the course of the design, development, implementation and scaling of the DHIS software within an action research framework in the context of the public health sector in various developing countries. Further, we discuss Participatory Design with respect to changes over time in technological and political contexts and the challenges following from that; from stand-alone MS Office to cloud computing and fully open source technologyenabling local Participatory Design! In this chapter, we try to describe this rather complex HISP movement over time following three broad phases; 'traditional' Participatory Design; pilots and networking Participatory Design, and Participatory Design and web technologies. After this historical reconstruction, we describe and discuss current trends and challenges, focusing on the new area of cloud computing and the need for integration with other systems. We elaborate on practical challenges and potentials of doing Participatory Design in the context of developing countries and in a longitudinal perspective. The reader will learn about Participatory Design in a global development perspective and about the importance of networking Participatory Design projects and to share software, lessons and resources across countries 'South-North-South' as a way to achieve sustainability and scalability. Rapid spread of communication technologies such as mobile Internet is currently changing the context for Participatory Design in developing countries. The chapter provides the reader with analysis and discussion on the potential for Participatory Design and empowerment of users in developing countries in the new area of cloud computing and in an environment where multiple systems need to be integrated. The emerging cloud-based infrastructure represents both an opportunity and a threat. While users even in rural Kenya may now feel empowered by having instant access to own and other data, global actors are aggressively promoting their own software-based services. To counteract the latter, the challenge is to enable development of local capacity to master the new technologies, for which Participatory Design may provide both the means and the end.
2006
This paper reports on a project establishment undertaking as proposed by the STEPS methodology (Software Technology for Evolutionary Participatory System Design). Project establishment in STEPS is aimed at getting an inner understanding of a project's environment. This understanding spans getting insights about the user environment, establishing a project team and ends with an initial proposal of the next steps as proposed by STEPS. We describe the methodology we applied: sustained individual and group interactions with the staff at the hospital informed by concepts of participation, collaboration and Joint Applications Design. By reflecting on selected instances of our engagement with the hospital staff, we report as findings the observations that before our project ideas can get ground, there are preliminary reviews and concerns (auxiliary to the central theme of participation) that need to be addressed. They touch on tools, processes and the prevailing organizational culture. The task at hand evolved to be that of cultivating a 'participatory culture' on the hospital staff. At the end of the paper we present an outlook from our project establishment experience. We argue that our experiences as described in the paper inform our next steps. We frame our experiences into literature on: a) Power distance dimension in describing national cultures, b) empowerment and democracy in the practice of participatory design and c) incremental system development that proceeds from first defining a core system.
Representative Participation in a Large-Scale Health IT Project
Computer Supported Cooperative Work, 2022
User involvement is widely recognized as best practice in the development of information technology (IT) systems. In large-scale IT projects, the involvement of users and other stakeholder groups is typically in the form of representatives, as opposed to the direct (in-person) participation characteristic for smaller projects. The potential new sharing of power that representative participation entails vis-à-vis direct stakeholder involvement, and the implications of such a shift, are an important discussion in the context of participatory design. This paper extends and adds to previous work on this subject. Drawing on stakeholder interviews conducted as part of a case study of an electronic health record implementation project in Norway, this paper seeks to describe and analyze problems that can arise with representative participation in a large-scale project. Our focus is on an observed decline of interaction between health professionals participating actively in the project and their advisory units consisting of colleagues without a formal project role. The paper describes how the project's structural arrangements might explain this decline. The paper also describes how the participating health professionals' involvement of the advisory units at regular intervals early in the project (broad involvement) was replaced by more ad hoc and competence-oriented approaches (narrow involvement). We further use the organizational structure of democracies as the basis for two analogies, (I) participants-as-political-representatives and (II) participants-as-technocrats. The observed decline in interaction between the participating health professionals and their advisory units can be seen as a transition in role from user representative to technocrat. Generalizing from the case, we suggest that (1) a project's structure strongly affects the possibilities of participating users to consult other users (e.g., non-participating colleagues) about issues concerning the design solution, (2) a project's structure conditions the role of participating users and who, or what, they represent, and (3) representative participation requires rethinking a project's structure.
User mobilization in bottom-up infrastructural transformation
Reports of the European Society for Socially Embedded Technologies, 2021
User mobilization plays a critical role in bottom-up processes of infrastructural transformation. In this study, we take a user perspective to how infrastructures transform, and investigate the work required to mobilize users. Our research is based on a case study of a project developing a novel solution for supporting data sharing in patient handovers in the context of primary care in the municipality of Oslo. We focus on the work of user representatives in the project activities, and specifically in their effort to engage their local organizations. In the analysis we identify three types of work for user mobilization: the work to identify benefits, anchor in the local leadership, and give a sense of ownership. We contribute to the literature on bottom-up user-driven change processes by showing the work required for user mobilization and conclude with implications for supporting users' learning.