Infrastructuring as an Occasion for Resistance: Organized Resistance to Policy-Driven Information Infrastructure Development in the U.S. Healthcare Industry

Abstract

Various industries are developing information infrastructures to improve the efficiency and quality of work. Little research attention has been paid to how workers might resist the development of a new infrastructure beyond the point of technology use. In industries in which government agencies have taken a top-down, policy-driven approach to developing infrastructures, though, coordinated, distributed resistance—or organized resistance—is likely to play a role in implementation outcomes because policies limit the flexibility of organizations and workers in adopting and using infrastructure technologies. This paper presents the results of a qualitative study of the United States government’s multi-billion dollar electronic medical record (EMR) infrastructure program aimed to support data collection and sharing within and between healthcare organizations. It describes how healthcare professionals manifested their resistance through professional organizations at the political level via organized resistance.