Representative Participation in a Large-Scale Health IT Project

Area of Science:

• Health Informatics
• Information Systems Engineering
• Participatory Design

Background:

• User involvement is crucial for successful information technology (IT) system development.
• Large-scale IT projects often rely on representative user participation rather than direct involvement.
• The shift in power dynamics and implications of representative participation require further investigation.

Purpose of the Study:

• To describe and analyze problems associated with representative participation in large-scale IT projects.
• To examine the decline in interaction between active project participants and their advisory units.
• To understand how project structures influence user roles and representation.

Main Methods:

• Case study of an electronic health record implementation project in Norway.
• Analysis of stakeholder interviews.
• Application of analogies based on democratic organizational structures (participants-as-political-representatives and participants-as-technocrats).

Main Results:

• Observed decline in interaction between health professionals in the project and their advisory units.
• Project structural arrangements contributed to this decline.
• Shift from broad user involvement to ad hoc, competence-oriented approaches, indicating a transition from user representative to technocrat roles.

Conclusions:

• Project structure significantly impacts users' ability to consult colleagues.
• Project structure influences the role and representation of participating users.
• Effective representative participation necessitates a re-evaluation of project structures.