Re-Infrastructuring for eHealth: Dealing with Turns in Infrastructure Development

Abstract

In this paper, we examine infrastructuring in the context of developing national, public eHealth services in Norway. Specifically, we analyze the work of a project team engaged in the design and development of new web-based capabilities for communication between citizens and primary healthcare practitioners. We frame the case as a study of re-infrastructuring to signify a particular occasion of infrastructuring that entails facilitating a new logic within established social and technological networks. To make sense of the particularities of re-infrastructuring, we draw from research in infrastructure studies which considers embeddedness as a resource in infrastructure evolution. We analyze how actors worked to re-infrastructure through adapting primary care information systems, information flows and representations of patient data. Our findings show how the work of re-infrastructuring revolves around addressing two key design concerns: a) bringing novelty without being trapped in the existing arrangements or harming what is in place, b) bringing changes that are within a specific direction although they happen through distributed decision taking.