The Generative Role of Objects in Infrastructure Design: A Case of Designing a System for Continuity of Care

Abstract

This study explores the generative role of objects in design work. While the CSCW literature includes a range of contributions on infrastructure design and ways of accounting for diverse existing systems, practices and perspectives in design, the focus has typically been on the point of use, rather than the earlier stages of design processes. However, as more worker groups become involved in design there is a need to understand the microdynamics of collaborative design in this phase and the interplay between problem framing and exploration. We examined how the design of an information system in the health sector evolved through the instantiation and exploration of intermediary objects that become generative in the design process. The data comprised observations over 2 years from design meetings with a team of health professionals and software developers mandated to develop a system for the registration and sharing of patient information across primary care units. The analysis showed how intermediary objects formed focal points from which infrastructure design problems were framed and collectively explored. These processes required considerable negotiation and exploration within and between the interdependencies that become relevant in the design process. We identified how intermediary objects take different representational forms and become generative in two ways: By producing new or transformed objects, and by revealing layers of complexity inherent in the design problem. We discussed implications of the analysis as regards aspects of the infrastructure design that can be handled in the design team versus aspects that should be delegated to local adaptation.