In a joint research project concerning the use and design of IT in public services, we are using a simple figure of on-going, design-oriented interactions to highlight shifting foci on relationships of codevelopment of services, citzenship and technology. We bring together a number of concrete examples of this on-going everyday co-development, presented from the different perspectives that we, as researchers from different disciplines and traditions, represent in the project. The article explores and discusses wokring relations of technology production and use that we see as central to what is actually making e-government happen - or not happen. The main challenge in this area, as we see it, concerns making visible, and developing supportive infrastructures for, the continuing local adaptation, development and design in use of integrated IT and public services.
Co-operation between research and industry and society, and the notion of innovation systems, are high on the agenda of national as well as international research politics. However, how to make co-operation between researchers and practitioners work, and what kind of research results could come out of such co-operation, is hardly discussed. The article uses evidence from three projects in the areas e-government and telecommunication to reflect on such co-operation. Scientific understanding and practices of design, development and use of ICT challenge and inform each other in these co-operative projects, which we have started to refer to as ‘situated innovation’. The article discusses the role of the researcher in such contexts, the character of the research results, and means to co-ordinate different rhythms and rationales in order to make research and practices of ICT development and use mutually enhancing.
The when and where of participatory design has traditionally been set, primarily, by the software design project. However, modern IT networks with a variety of applications from different software providers, new web-design tools, and the integration of customization processes with on-going version management, are just a few of the developments that are moving participation around IT design issues beyond the traditional software project. Using examples from a research project focusing on existing work practices and IT in use in public service administration, we explore various understandings of design, which challenge some of the assumptions underlying the basic framework of participatory design. If design is seen as continually on-going, and intricately interwoven with use, this raises several important issues for participatory design. It highlights design for change. It points towards the need for reconsidering software design processes. It brings into focus issues of coordination between use, design in use and adaptation and development. Crucially, it raises issues about shop floor IT management, that is, organizational and technical support for local adapting, and continual design and development in use, of IT, and the need for models and methods for sustainable, distributed co-constructive design processes.
Innovation systems, triple helix, and similar expressions, are used to conceptualise the growing need for more integrated forms of co-operation between academia and other societal actors, such as governmental agencies and industry, in order to produce knowledge relevant for society. However, there is as yet little reported experience from such recent and on-going co-operative projects of how research changes when it becomes involved in practices it is meant to contribute to. In this paper, the authors report about three different research projects where researchers co-operated with governmental agencies and industry around the development of ICT. Evidence from three domains, namely e-government, telecommunications and welfare services, indicates the need for problematising current mainstream understandings of innovation. Innovation, as we see it, is occurring through configurations of designers, developers and domain experts that form constituencies and where scientific knowledge is confronted by requirements, constraints and possibilities of the specific situation. In this context innovation of, or involving, ICT requires a significant amount of imagination, represents a relatively sharp break with established ways of doing things, and requires artful integration of different professional practices, communities, and technologies. We define these creative processes of co-development of work practices, organisations and technology as situated innovation.
Innovation systems, ‘triple helix’, and similar expressions, are used to conceptualise the growing need for more integrated forms of co-operation between academia and other societal actors, such as governmental agencies and industry, in order to produce knowledge relevant for society. However, there is as yet little reported experience from such recent and on-going co-operative projects of how research changes when it becomes involved in practices it is meant to contribute to. In this paper, the authors report about three different research projects where researchers co-operated with governmental agencies and industry around the development of ICT. Evidence from three domains, namely e-government, telecommunications and welfare services, indicates the need for problematising current mainstream understandings of innovation. Innovation, as we see it, is occurring through configurations of designers, developers and domain experts that form constituencies and where scientific knowledge is confronted by requirements, constraints and possibilities of the specific situation. In this context innovation of, or involving, ICT requires a significant amount of imagination, represents a relatively sharp break with established ways of doing things, and requires artful integration of different professional practices, communities, and technologies. We define these creative processes of co-development of work practices, organisations and technology as ‘situated innovation’.
Specific, situated Participatory Design (PD) practices have always been at the heart of Participatory Design research. The role of the very situatedness and specificity of PD practice for theory-building within PD research is, however, seldom discussed explicitly. In this article, we explore why and in which ways the specificity and situatedness of PD practices are crucial for PD research. We do so by developing the notion of PD as situated innovation based on a pragmatic epistemology. PD research aims at developing and continuously unfolding what PD can, might and should be. We show implications of such a pragmatic epistemology of PD on understanding and arguing for PD research approaches. These concepts are illustrated referring to PD practices as experienced in PD research projects. Our epistemological argumentation supports the emphasis on exploring new PD practices and learning and theorizing about PD from the specificities, in line with recent debate contributions.
In this short paper, we present glimpses from an interdisciplinary research and development project aimed at enhancing local democracy by developing ICT support for the consultation process around the comprehensive plan of a municipality. For the participating researchers, the project offered the opportunity of combining and comparing approaches and methods from two different design traditions that share democratic ideals and ambitions of nurturing citizen/user participation in design processes. This proved to be more challenging than we had originally anticipated. Differences in perspective gave different interpretations of the design context as well as of how participatory the processes actually were.
”Om vi ska modernisera offentliga sektorn måste vi vända på perspektivet, riva stuprännor, placera individen i centrum och arbeta utifrån en uttalad kundfokusering.” Känns refrängen igen? Under senare år har den blivit tongivande i debatten om hur offentliga sektorn ska öka sin effektivisering och leva upp till medborgarnas allt högre krav. Att tänka medborgarcentrerat går väl an, men hur är det egentligen möjligt att tänka omvänt, att i grunden förstå att både teknik, medborgarskap och yrkesidentitet är något töjbart och föränderligt? Hur lär vi oss att se dessa fysiska ting och till synes stabila begrepp som en ständigt pågående aktivitet som formuleras i nuet, som kontinuerligt förändras och omskapas utifrån ett plats- och situationsberoende samspel? I detta kapitel diskuteras hur medborgarskap, yrkesroller och delaktighet jämte stödjande teknik på en och samma gång kan tolkas som beständiga och anpassningsbara enheter.Det ges också exempel på hur samspelet mellan stabilitet och elasticitet ömsom öppnar och stänger för deltagande utifrån konkreta exempel hämtade från några utvecklingsprojekt som bedrivits inom offentlig sektor.
The goal of this paper is to present how citizen-driven design of e-government can be promoted through trans-local cooperation. Our case study consists of the Augment project, which focuses on the design of a mobile service for co-creation of local accessibility. Our approach is action research based in the Scandinavian tradition of Participatory design. Experiences from this project highlight issues concerning how to reconfigure the basis for design of public services. In order to cultivate spaces for citizen-driven design and local innovation, we made iterative use of global collaborations. In the initial phase, influences from R&D cooperation with India provided new spaces for participatory design practices. In the next phase, a proof-of-concept process allowed for broader local stake-holder involvement. In the third phase, the service concept was shared and expanded with partner regions in Europe through exchange of Best Practices. Currently, we are moving towards phase four, the commercialization process. Beyond the iterative design of the mobile service itself, and what trans-local collaboration contributed in this context, we also discuss reconceptualization of innovation as incremental change. We argue that transnational collaboration can be deliberately made use of for leveraging incremental change on a local level and strengthening regional innovation systems and practices.
This paper presents experiences from a proof-of-concept project concerning a tool for e-participation, Augment; a map-based mobile accessibility service which relies on user-generated content. Using a Participatory Design approach, the aim has been to include future users in the project from the start, so as to ensure that the resulting service will be a useful and sustainable tool for co-constructing accessibility in everyday life in collaboration among involved stakeholders. The project has been struggling with the complexities of combining academic competencies in Participatory Design and traditional project management and systems development approaches. One of the most difficult issues has been balancing widely differing experienced needs for controlling distributed end-user participation. Our experiences so far raise serious questions about how to combine models of open innovation and increased user-involvement with current mainstream user-centered software and service development models. While user-centered design seems to call for users-on-demand, user-driven innovation of e-participation tools could, we argue, benefit more from developers-on-demand.
This paper draws upon experiences and involvement in several joint research- and development (R&D) projects, organised as a kind of “micro innovation system”, involving multi-organisational and multi-disciplinary cooperators, mainly within the area of e-government or IT-support for homecare. Each project was organised around development or costumization of a computer application, supporting for instance on-line public services, citizen participation or IT-support for home care within the public sector. However, after realisation of the projects, only a few of the applications are maintained. These projects could be regarded as concrete examples of the ongoing reconfiguration of a cluster in a regional innovation system (Miettinen, 2002, p.17, OECD, 1999), and not just as single, stand-alone projects in an expanding region, but also as vital parts in ongoing enactment and refiguration of an extensive national innovation system. The issue then becomes : what implications does this joint innovative growth-stimulation have for the question of completion of research in a growth-intense region, which is concentrating not solely on quick fixes but also on stabilizing innovation? What are the practical and ethical consequences of “making an exit” in the middle of an ongoing mustering of strength – for instance for the citizens, the researchers and the society? These issues are discussed in relation to empirical material gathered during involvement in the start-up of an e-government arena, within the framework of TANGO (Thematic arenas Nourish Growth Opportunities), a program partly funded through Innovative Actions within the European Regional Development Funding (ERDF). Findings, reflections and insights show tensions and ongoing negotiations concerning different perspectives expressed as process- as well as product-orientation in the development. The large amount of ICT-projects, are seen from another perspective, also contributing to the increasing growth in the region. One of the municipalities was appointed “National Leader in Growth municipality” in the year of 2001. The TANGO project itself may actually also be seen as a result of increased regional growth. But the question still remains: is it ever possible to stabilize innovation?
In the autumn of 2004, two higher educational programs in e-government will be starting up at Blekinge Institute of Technology in Southern Sweden. One of these is a Master’s level program, while the other is a more basic, two-year vocational education. Each will be the first of its kind in Scandinavia, and both will be offered as net-based distance education. The interdisciplinary group of researchers/teachers now developing the courses for these educational programs, in co-operation with several other research groups in Scandinavia, see this co-construction of distance education as the beginning of an active Scandinavian network of competence around higher education and ongoing research and development in the e-government area. We are currently exploring the possibilities of using distance education in this area as a way of networking around on-going e-government research and competence enhancement in Scandinavia. The Scandinavian tradition of Participatory Design, as well as ideas about e-government as constantly ongoing co-construction, have inspired us in our work with developing the new educational programs. A reference group consisting of representatives from a number of municipalities and various government agencies plays an important role in this work.
Wireless technologies, cloud computing and connectivity have enabled mobile services that extend the coverage of health services, resulting in a branch of eHealth now commonly referred to as mHealth. However, at least in Sweden, where the healthcare sector is heavily institutionalized and regulated, mHealth has so far mainly evolved in the form of applications for support of healthy life-style and self-management of chronic diseases, implemented outside of the firewalls of traditional healthcare delivery environments. In this paper we present an on-going Indo-Swedish research and development project in which we are putting mHealth design into context both from a patient's perspective and from the perspective of a healthcare team working within a professional healthcare organization. Our research approach is inspired by the Scandinavian tradition of Participatory Design of ICT and informed by studies of how to measure usability, user experience and impact of mHealth interventions. The involved research teams are multi-disciplinary, including researchers from engineering, computing and health sciences. The project includes, on the Swedish side, a partner from the public healthcare sector, three SME:s and an industrial partner who is currently providing Electronic Patient Record and other healthcare information system solutions and who is interested in developing mobile solutions for healthcare professionals. We are currently in the process of collaborative articulation and specification of problems, goals and requirements within the framework of the first Swedish case study of the project, focused on mobile support for patients with diabetes type 2 and their healthcare teams.
In the DitA project, we are studying and actively working with the development of integrated services and IT design within the public sector. This is a research and development project that is being run in cooperation between Blekinge Institute of Technology, five municipalities, two consultancy firms and a Call Center. During nearly three years (April 2000 - December 2002), the DitA project is being financed by Vinnova, the Swedish Agency for Innovation Systems. The DitA project focuses on the continual design and development of supportive technologies for public services. We are especially interested in how these processes can be integrated in practice with the redesign and development of the contents and organisation of integrated public services on-line. There has been a rapid and widespread development of local Internet/intranet solutions for public services during the past few years. At the same time as the public sector is "going on-line", and interdependently with this, public service administration is having to come to terms with an on-going internal metamorphosis. New ways of managing and sharing information, and of constructing and organising public services within and between different service providers in the public sector, are being tested and explored. In the DitA project, we are studying how IT can be used to support local participation in the continual design and development of public services. The challenge is, as we see it, to explore how IT can contribute to creating an informated (that is, competent, well-informed and informative) rather than an automated public sector. During the initial phase of the project, we have mainly studied the daily use of computer support for service delivery at a number of different workplaces within municipal public service administration. We have also been studying at close hand the largely cooperative processes of design during the local development and tailoring of a document management part of a municipal intranet system. Now, during the second phase of the DitA project, we are focusing more on citizens' active participation in the design process than we have done previously.
Accountability is an important issue for design, in more than one sense. In software engineering literature, accountability is mainly seen as a goal for quality assurance of design processes. In ethnomethodological studies, accountability is a central concept for understanding how people organize their everyday actions and interactions. Where the different research approaches meet, in Human Computer Interaction (HCI) and Computer Supported Cooperative Work (CSCW) literature, new and hybrid understandings of accountability arise. In this paper, I explore and compare uses of the concept of accountability in a selection of texts. Finally, using a specific case as an example, I discuss what focusing on ethnomethodological understandings of accountability might imply for design of information technologies.
At present, I am involved in a three-year research and development project called Design of IT in Use; technologies for supporting services to the citizens (Design av IT i användning, or DitA for short). This project, which is being funded by the Swedish Council for Work Life, is about the use, design and continual support and development of computer support for public administration and information services offered by one-stop shops and call centers. The main focus is on the ongoing integration of such systems with public electronic information systems, and on new developments and design to meet the increasing complexity and diversity of ICT (Information and Communication Technologies). One of the aims of our research is thus to participate in the developing of new forms for citizens' access to public information and public services via Internet. Our work in the DitA project is based on previous and ongoing longitudinal close-up studies of work practices and uses of technological support in actual physical locations such as one-stop shops and call centers. In our research work, we are actively involved in inter-organizational cooperation aiming to coordinate information and services on-line across and beyond old sectorial boundaries, both on the local, municipal level, and on a regional and national level. We are participating in the analysis and design of prototypes for on-line public information and public services, including the process of establishing focus groups and reference groups for the further development and testing of ideas, scenarios and prototypes. Through and beyond the challenges these developments are posing to traditional public service bureaucracies and their roles vis-à-vis the citizens?, we see more profound challenges to ways of understanding the use and design of modern technologies. We have found, in our research work, that we are having to search for new ways to grasp from where, whom, and what situation, these service centers are being contacted. The ?global access? offered by www is accompanied by a growing need to localize the user/citizen/person ? and for the user to be able to localize her- or himself - i. e. a need to design for and manage the specificities of the situation of use of IT. One concept we have been exploring recently, as a way of focusing this seeming paradox, is ?genius loci?, a concept used by architects and artists in reference to ?the spirit of the place?.
In this position paper for the MUM 2003 workshop in Norrköping, December 10th 2003, Designing for ubicomp in the wild: Methods for exploring the design of mobile and ubiquitous service, a brief description is given of methods used in connection with a series of ‘quick and dirty’ ethnographic studies of mobile ICT users. These studies were carried out as commissioned research during 2000. Because of predetermined constraints on the studies and resulting reports, alternative ways of describing and annotating interactions on the move were devised and tested. As a result, the initial single time line approach was abandoned and a number of messier, multi-branched chor(e)ographies of communication were developed. These were finally discarded at the time as failures. However, in connection with becoming more of a mobile ICT user myself, the issue of the social and situated construction of time, and the need for supporting several themes in parallel, along different time lines, has surfaced again, and now seems more relevant than ever.
The TANGO e-government arena is an on-going project in Southern Sweden, funded by the Innovative Actions of the European Regional Development Fund. The aim of the project is to establish cooperation between the public sector, private enterprise and university-based research in designing public e-services. Our starting point is e-government understood as co-construction of technology, society and citizenship in everyday life. This approach is based on the Scandinavian Tradition of Participatory Design, but also motivated by ongoing technological development. In cooperating around development of new, integrated services, catering to various categories of users as well as to a growing diversity of mobile technologies, we are aiming to establish feedback channels between practice and theory, between use and design, and between different academic disciplines where we see a need to synchronize the models and methods we work with. Our current research questions focus on exploring and managing multi-perspectivity as a resource for design. Some of us involved in the research and development projects within the TANGO arena are women. Some of us are feminists (some more so than others). We are trying to cross boundaries, synchronize different rhythms, pull in the same direction, although from different positions. Does this make TANGO a feminist project? And if so, what (ouch!) can be learned from it?
New information technology is developing faster than the models, metaphors and methods in use for conceptualizing the sharing and managing of information in organizations, in communities and in society in general. The way we utilize information technology today does not seem to succeed in supporting the everyday work practices through which organizations accomplish their work. In this PhD dissertation, the results of a research project about skill, cooperation and computer support in public service one-stop shops are presented and discussed. Based on these results, alternative metaphors are presented for understanding the constructive aspects of front office work practices, One hypothesis is, that there is added value in not only being aware of multiperspectivity as an issue, but of making use of it in design. A problem here is that many traditional research methods, as well as most methods for systems development, are designed to diminish rather than make use of ambiguity and diversity. The metaphor of inverted indexicality of language is introduced in order to conceptualize the construction of meaning in action. New ways of conceptualizing IT management on the shop floor - including design issues - are proposed. Metaphors like the art of IT management, gardening and caring for are indicative of the issues at stake.
The chapter begins with a sketchy overview of what I see as the major shift during the past century in mainstream social theorizing, and a comparison of this to recent and on-going developments of IT and software practice. These themes are then brought together in a brief personal narrative of experiences from four research and development projects I have been involved in during the past four years. 'Genius loci', interpreted here as 'the spirit of the place', is a metaphor borrowed from architectural discourse and Greek mythology. It is used in this context as an analytical tool for re-conceptualizing the relationship of the user to the development, design and use of public information systems accessible via the Internet. The use of this metaphor, and of the concept of 'strong subjectivity', is a way of exploring if it is possible to objectify and instrumentalize the actions, rather than the actors, in the on-going discourse around human-machine interaction.
När tekniken förändras, måste också forskningsområden som fokuserar teknik och teknik i användning ompröva sina tankemodeller. Etnometodologin, läran om hur människor organiserar sin vardag, är en riktning inom sociologin som kommit att spela en allt viktigare roll i forskning om människa-dator-interaktion (HCI) och datorstött samarbete (CSCW). I den här presentationen ges några exempel på hur detaljerade studier av människors vardagliga handlande i arbetet kan leda till omprövning och ifrågasättande av hur funktionella våra nuvarande modeller och tankefigurer för organisationer och arbetets organiserande egentligen är. Vad händer till exempel om man fokuserar på aktiviteter och relationer istället för på hierarkiska beslutsstrukturer? Om man ser organisationer som ständigt pågående aktiviteter och underhåll av relationer? Hur skulle ett effektivt teknikstöd i arbetet kunna utformas, för den här förståelsen av vad en organisation är? Begreppet ?accountability?, som är centralt i etnometodologin, används här som ett led i argumenteringen för nya tankemodeller som underlag för utveckling av mobila tjänster.
In this panel, social scientists and computer scientists who have been involved in different ways in the work of challenging traditional understandings of abstraction in software design and development discuss the tensions between narratives and abstraction, metaphors and models, moods and modes – and more.
Slutrapport för utvecklingsprojektet Design av IT i användning - teknikstöd för medborgarservice (DitA), inlämnad till VINNOVA (finansiär) 2003-03-31. Kort sammanfattning och historik om projektet, publikationslista och lista över andra kunskapsspridande aktiviteter med koppling till projektet.
In this commentary of Carsten Sørensen's keynote address and commentary, I argue that it may be the concept of the smart manager—so fundamental to management science—rather than the concept of the smart machine, which is still haunting IS research today. © Scandinavian Journal of Information Systems, 2016.
During the twenty-some years since ethnographic field studies in the workplace first began to be taken seriously as having possible relevance for the design of information technology, accountability has been one of the recurring concepts in the literature exploring these areas. Like usability and actability, accountability sounds like an important issue but proves a difficult feature to define. Of what exactly is it an attribute? Who defines it? For whom? Under what conditions? In this paper, I explore and compare a few of the various uses of the concept of accountability that I have come across in ethnomethodological and CSCW literature. In the third section, I tentatively indicate what focusing on accountability, in one or several different interpretations of the concept, might imply for design of IT in some specific cases. These brief and sketchy examples, aiming to be thought-provoking rather than analytically thought-through and articulated, are selected from recent development projects and on-going research work with which I have been involved or come in contact.
In the inter-disciplinary research and development project Design of IT in Use; supportive technologies for citizens? services (DitA), we are studying the use, design and continual support and development of computer support for public administration and information services offered by one-stop shops. Our main focus is on the ongoing integration of such systems with public electronic information systems, and on new developments and design to meet the increasing complexity and diversity of ICT (Information and Communication Technologies). One of the aims of our research is to participate in developing new forms for citizens' access to public services via Internet. The DitA-project is funded by the Swedish Agency for Innovation Systems, VINNOVA, During our ethnographic field studies of work practices in public service one-stop shops, we have observed how closely interwoven people?s on-going choices of action and use of technology are with issues of accountability. This, in turn, has lead us to question whether the importance of considering and supporting accountability issues and needs is perhaps underestimated in the design and development of ICT. Even when designers deliberately focus on use- and action-oriented concepts such as usability and actability, it doesn?t necessarily follow that accountability surfaces as an explicit issue for design. When it does, it is often narrowed down to questions of human-computer interface design, and focused on system accountability versus the user (form and content of feedback information, etc). However, accountability issues, when explored in specific use contexts, are closely linked to social and organizational issues on a number of different levels. Accountability itself, when focused through the prism of people in action, becomes multifarious and ambiguous, begging further exploration of context and involved relationships. In the DitA project, we have deliberately attempted to focus on the concept of accountability in action and how it can be supported and mediated by the design of ICT infrastructures.
The TANGO e-government arena is an on-going project in Southern Sweden, funded by the Innovative Actions of the European Regional Development Fund. The aim of the project is to establish cooperation between the public sector, private enterprise and university-based research in designing public e-services. Our starting point is e-government understood as co-construction of technology, society and citizenship in everyday life. This approach is based on the Scandinavian Tradition of Participatory Design, but also motivated by on-going technological development. In cooperating around development of new, integrated services, catering to various categories of users as well as to a growing diversity of mobile technologies, we are aiming to establish feedback channels between practice and theory, between use and design, and between different academic disciplines where we see a need to synchronize the models and methods we work with. Our current research questions focus on exploring and managing multi-perspectivity as a resource for design.
Can buzzwords be methodically exploited to develop more self-reflective and participatory research methods and practices within the ICT area? Research policies as well as research funding agencies rely heavily on buzzwords, yet tend to grow uncomfortable when these are deliberately highlighted and concatenated in research applications. This paper presents a multi-disciplinary R&D project in which we are exploring emerging methods and practices of participatory design of public e-services in India and Sweden. Using buzzwords as boundary objects, comparing methods and practices, with specific e-government projects we are involved in as examples, we attempt to address blind angles inherent in different cultural and disciplinary perspectives.
Problem-based learning is emphasized in teaching as well as in research at the Blekinge Institute of Technology, where we come from. Students work in projects, often in collaboration with businesses and other organizations in the region. Cross-disciplinary course modules and co-operative projects are offered, involving students and staff from different subject areas. As far as possible, student projects are linked to on-going research projects, and research, too, is carried out in close cooperation with the surrounding society, the public sector and enterprises/industries in the region. Consequently, when we decided to offer a net-based summer course in 2002, an important aspect was how we could continue to link our on-going interdisciplinary research cooperation to the course in a constructive way, such that the students could be involved in problem-based learning of relevance to both their own situations and our research work. In this paper, we describe and reflect on some of the experiences from our first net-based summer course, in which we used three main themes and a combination of individual and group tasks to support reflection and dialogue around the literature and the students? own contributions to the course. The course was net-based, but also included F-2-F; three consecutive days of ?live? lectures and seminars at the university campus in Ronneby.
The TANGO e-government arena is a project in Southern Sweden, funded by the Innovative Actions of the European Regional Development Fund. The project is now nearing its end, and we are thus at the stage of reflectively reviewing what has actually been accomplished and how this relates to the original goals of the project. In July 2002, when the project began, the aim was to establish cooperation between the public sector, private enterprise and university-based research in designing public e-services. In cooperating around development of new, integrated services, catering to various categories of users as well as to a growing diversity of mobile technologies, we have aimed towards es-tablishing feedback channels between practice and theory, between use and design, and between different academic disciplines where we see a need to synchronize the models and methods we work with. Our research questions have focused on exploring and managing multi-perspectivity as a resource for design. In this paper we look at how we organized our cooperation around these goals, and attempt to address those basic summing-up-the-project questions; How well have we succeeded? What have we learned in the process?
In this paper, we present an on-going research project in which we are focusing on examining how users of map-based services on-line experience the quality of these services when the traffic load is high, and how the users' experiences of acceptable or not acceptable quality can be related to measurable parameters which can be used to manage network traffic and improve technical solutions. The project is a multi- and interdisciplinary project in cooperation between researchers within human work science and informatics, and researchers within telecommunication systems. Additionally, there are two external partners in the project: a provider of Internet-based map services, and a municipality which uses this provider's map services regularly. One of the main methodological issues addressed in the project is how laboratory based, quantitative research methods from research on Quality of Service in the telecommunication systems area can be related to qualitative research methods focusing on workplace- or other live-world based use situations and Quality of Expereince as defined by users of the services. How can experiments and studies be designed, and results shared, such that both network traffic measuring and evaluation of user experiences retain their own paradigmatic validity and relevance, while fruitfully informing service design?
In this position paper we present an on-going case study where the aim is to design and implement mobile technologies for self-care for patients with type 2 diabetes. The main issue we are addressing in this paper is how to bridge clinical and non-clinical settings when designing self-care technologies. Usability, User Experience and Participatory Design are central aspects of our research approach. For designing with and for patients in home settings and everyday life situations, this approach has so far not been problematic. However, when it comes to designing with and for user groups located within a large healthcare organization, in a highly institutionalized clinical setting, the situation is different. We have recently introduced the Health Usability Maturity Model (UMM) to our project partners as a potential tool for bringing usability and participa-tory design issues to the fore as strategic assets for transforming healthcare delivery with ICT.
The project within which this paper was co-authored focuses on the domain of e-government and is a deliberate attempt by the involved partners to cultivate and expand local and regional spaces for situated innovation, design and development of public services and ICT use in the public sector. Our starting point is e-government understood as co-construction. The project is currently being funded by the Innovative Actions within ERDF, the European Regional Development unding. The partners of the e-overnment arena are public service providers, ICT providers and researchers from a number of different disciplines. In this paper, we focus on communication networks and accountability. Are communication networks enablers or disablers for e-government services, and how can they be held accountable to their users? To what extent might we need to help each other unpack ‘black boxes’ and exchange them for ‘glass boxes’ in communicating with users and across disciplinary boundaries? Using metaphors and models from telecommunications, software engineering, informatics, business administration and human work science, and inspired by the Scandinavian tradition of Participatory Design, we attempt to establish a common basis to explore the evolving technologies and practices in e-government.
Knowledge sharing has become an important issue that challenges the efficient healthcare delivery in eHealth system. It also rises as one of the mostdemanding applications with reference to dynamic interactivities among various healthcare actors (e.g. doctors, nurses, patients, relatives of patients). Inthis paper, we suggest an activity theory based ontology model to represent various healthcare actors. The goal of the suggested model is to enhance inte-ractivities among these healthcare actors for conducting more efficient knowledge sharing, which helps to design eHealth system. To validate the feasibilityof suggested ontology model, three typical use cases are further studied. A questionnaire based survey is carried out and the corresponding survey resultsare reported, together with the detailed discussions.
Background/Objective: This paper sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. Methods: Interviews were conducted with nursing staff working at a primary healthcare centre in South East Sweden. Each interview took place was conducted on a one-to-one basis in dialogue form, using open questions and supported by an interview guide. It was then analysed using a phenomenological hermeneutic method. Participants were eligible for the study if they had given their informed consent and if they worked with discharge planning and home-based healthcare provision. In total, 10 of the 30 persons working at the primary healthcare centre participated in the study. Results: It was found that nursing staff in primary healthcare regarded the planning session as stressful, time-consuming and characterised by a lack of respect between nursing staff at the hospital and nursing staff in primary healthcare. They also described uncertainty and hesitation about using video conferences where patients might probably be the losers and nursing staff the winners. Conclusions: It is suggested that there is a need for improvement in communication and understanding between nursing staff at the hospital and nursing staff in primary healthcare in order to develop discharge planning. There is also a need for the nursing staff in primary healthcare to obtain more information about how Information Technology (IT) solutions could support their work and help them to find ways to collaborate.
The problems and challenges that arise in the task of improving discharge planning have been an area of concern for many years, including problems related to the lack of time for professionals to participate. In a county council area in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation. As part of a larger research study of the implementation process, interviews were conducted with two of the implementers. The interviews were analysed qualitatively, using directed content analysis with a deductive approach to considering a framework developed by Nilsen et al. The results of this study are consistent with the actual framework but with the addition of time, i.e. time to prepare, time to understand, time to run through and time to reflect. Further research is proposed to focus more on leadership during the implementation process and its influence on the meaning of time.
Challenges of improving discharge planning have been an area of concern for many years, including problems related to lack of time for professionals to participate. In a county in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation of the professionals. To examine the implementation process, interviews were conducted with the implementers, who were project leaders, discharge planning coordinators in the hospital, and in home-care. The interviews were analysed qualitatively, using directed content analysis with a deductive approach to a theoretical framework that was composed from theories about implementation processes to be suitable for the healthcare sector, consisting of the factors: implementation objects; implementation actions; actors; users; inner context and outer context. The results of this study are consistent with the framework but with the addition of a new dimension – time, i.e. time to prepare; time to understand; time to run through and time to reflect. It is suggested that implementation frameworks are useful when IT is introduced in healthcare. Framing the implementation process supports the exposure of factors and highlights relationships and states of dependence between those factors which may affect implementation.
This article describes healthcare managers’ experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested thatmanagers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Recently, the care of chronic disease has become a worldwide challenge. Although the healthcare domain has begun to adopt new ICT technologies such as the Internet of Things and cloud computing, it is still in its initial phase. In this chapter, the authors conduct a small-scale two-step case study of diabetes care in Blekinge, Sweden. The first step is intended to acquire insight into the actual care situation to improve the original conceptual model. In the second step, we validate the feasibility of the improved model working in real healthcare. The results show that the Internet of Things and cloud computing is acceptable by both healthcare providers and recipients for home-based chronic diseases healthcare with little concerns of security and privacy in the future. In our hybrid cloud model, hospitals and primary healthcare centers could continue using their own exciting databases as private clouds. The best approach for home-based healthcare data is to collect it by connecting the different devices directly and storing and processing them in public clouds. To realize this model in the future, we suggest that a professional IT healthcare education team should be created to support both healthcare providers and recipients. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
The internet based social network has been applied to serve many social functions, such as democratic decision making, knowledge sharing, educa‐ tion, and healthcare. In this paper, we provide a prototype of virtual community designed for home-based chronic diseases healthcare. We studied the concept “community” from the activity theory model in order to design the prototype with a solid theoretical base. Then we conducted a questionnaire from healthcare recipients and interviewed healthcare providers to gather the requirements for the design of the community. With some user stories we described the requirements as use cases for our design and a conceptual prototype is built based on the requirements. This virtual community servers as a shared platform for all the stakeholders who are engaged in the healthcare activity. With this shared community platform, the interoperability problems of current healthcare systems can be moderated
The care of chronic disease has become the main challenge for healthcare institutions around the world. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Recently, cloud computing has been applied to healthcare domain; however, adapting to and using this technology effectively for home-based care is still in its initial phase. We have proposed a conceptual hybrid cloud model for home-based chronic disease care, and have evaluated its future feasibility by a case study of diabetes care in Blekinge, Sweden. In this paper, we discuss some possible future opportunities and challenges to apply this cloud model with the huge population for home-based chronic diseases care. To apply this model in practice, a professional IT healthcare education team is needed for both healthcare providers and healthcare recipients. For home-based healthcare, a monitoring system with an automatic alarm to healthcare providers is also necessary in some cases. Also, how to record and integrate excises data through wearable devices in a cloud should be considered. Given the high demand, sharing medical images through the cloud should be another research focus.
Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. ‘health promoting communication’.
E-förvaltning, dvs offentliga e-tjänster, e-administration och e-demokrati, har kommit att bli ett vanligt inslag i kommuners, landstings, medborgares och myndigheters vardag. Trots att det idag finns stor erfarenhet av och praktisk kompetens inom e-förvaltning, erbjuds emellertid inte så ofta möjlighet till reflektion och och erfarenhetsutbyte eller till att utveckla en teoretisk referensram kring den pågeående förändringsprocessen. Boken vill bidra till en begreppsutveckling och har också till syfte att stimulera dialogen mellan praxis och forskning utifrån olika perspektiv och förståelser.
The introduction of eGovernment services and applications leads to major changes in the structure and operation of public administrations. We describe the work in progress in an Italian project called "SPO.T." aimed at the analysis, development, deployment and evaluation of tools and environments to support the people who plan, deliver, use and evaluate user-centred provision of One-Stop-Shop services to citizens. The "SPO.T." project has focused on two requirements: 1. the support tools and environments must facilitate the active involvement of all stakeholders in the definition and evolution of eGovernment applications and services, and it is argued that through participatory design changes of structure, process and culture can be delivered effectively; 2. they must embody a set of architecturally coherent resources which reflect the new roles and relationships of public administration and which are sufficiently generic to be relevant to a wide range of local contexts across the community.
The introduction of eGovernment services and applications leads to major changes in the structure and operation of public administrations. In this paper we describe the work in progress in an Italian project called SPO.T. aimed at the analysis, development, deployment and evaluation of tools and environments to support the people who plan, deliver, use and evaluate user-centred provision of One-Stop-Shop services to citizens. The SPO.T. project has focused on two requirements: 1. the support tools and environments must facilitate the active involvement of all stakeholders in the definition and evolution of eGovernment applications and services, and it is argued that through participatory design changes of structure, process and culture can be delivered effectively; 2. they must embody a set of architecturally coherent resources which reflect the new roles and relationships of public administration and which are sufficiently generic to be relevant to a wide range of local contexts across the community.
A National Strategy for E-health has been introduced in Swedish county councils. The strategy indicates that health care needs to become more accessible. To generate usable and sustainable e- Health solutions in Swedish health care, Participatory Design (PD) was introduced as a working method in an e-Health project in the south of Sweden. The project has met with opposition; e-health solutions are not exactly what Swedish health care wanted at the same time as different arenas within the health care organization have difficulties understanding each other. The aim of this study is to find work methods that result in applicable, usable, and sustainable ICT- solutions in every day work within Swedish health care. The study suggests that a modification of third generation of PD may be one way to the challenges PD has come across in the health care context.
Aim To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation. Background Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation. Methods An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis. Results Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities. Conclusion and implication for nurse management Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation.
Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses’ solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.
A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.
BACKGROUND: Chronic somatic health conditions are a global public health challenge. Being engaged in one's own health management for such conditions is important, and mobile health (mHealth) solutions are often suggested as key to promoting engagement. OBJECTIVE: The aim of this study was to review, critically appraise, and synthesize the available research regarding engagement through mHealth for persons with chronic somatic health conditions. METHODS: An integrative literature review was conducted. The PubMed, CINAHL, and Inspec databases were used for literature searches. Quality assessment was done with the guidance of Critical Appraisal Skills Programme (CASP) checklists. We used a self-designed study protocol comprising 4 engagement aspects-cognitive, behavioral and emotional, interactional, and the usage of mHealth-as part of the synthesis and analysis. RESULTS: A total of 44 articles met the inclusion criteria and were included in the analysis. mHealth usage was the most commonly occurring engagement aspect, behavioral and emotional aspects the second, cognitive aspects the third, and interactional aspects of engagement the least common aspect in the included articles. The results showed that there is a mix of enablers and barriers to engagement in relation to the 4 engagement aspects. The perceived meaningfulness and need for the solution and its content were important to create and maintain engagement. When perceived as meaningful, suitable, and usable, mHealth can support knowledge gain and learning, facilitate emotional and behavioral aspects such as a sense of confidence, and improve interactions and communications with health care professionals. CONCLUSIONS: mHealth solutions have the potential to support health care engagement for persons with chronic somatic conditions. More research is needed to further understand how, by which means, when, and among whom mHealth could further improve engagement for this population. ©Hanna Tuvesson, Sara Eriksén, Cecilia Fagerström. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 24.07.2020.