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Representative Participation in a Large-Scale Health IT Project

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 characte...

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Autores principales: Zahlsen, Øivind Klungseth, Svanæs, Dag, Dahl, Yngve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795112/
https://www.ncbi.nlm.nih.gov/pubmed/36589309
http://dx.doi.org/10.1007/s10606-022-09457-0
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author Zahlsen, Øivind Klungseth
Svanæs, Dag
Dahl, Yngve
author_facet Zahlsen, Øivind Klungseth
Svanæs, Dag
Dahl, Yngve
author_sort Zahlsen, Øivind Klungseth
collection PubMed
description 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.
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spelling pubmed-97951122022-12-28 Representative Participation in a Large-Scale Health IT Project Zahlsen, Øivind Klungseth Svanæs, Dag Dahl, Yngve Comput Support Coop Work Research Article 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. Springer Netherlands 2022-12-28 /pmc/articles/PMC9795112/ /pubmed/36589309 http://dx.doi.org/10.1007/s10606-022-09457-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Zahlsen, Øivind Klungseth
Svanæs, Dag
Dahl, Yngve
Representative Participation in a Large-Scale Health IT Project
title Representative Participation in a Large-Scale Health IT Project
title_full Representative Participation in a Large-Scale Health IT Project
title_fullStr Representative Participation in a Large-Scale Health IT Project
title_full_unstemmed Representative Participation in a Large-Scale Health IT Project
title_short Representative Participation in a Large-Scale Health IT Project
title_sort representative participation in a large-scale health it project
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795112/
https://www.ncbi.nlm.nih.gov/pubmed/36589309
http://dx.doi.org/10.1007/s10606-022-09457-0
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