From Solution Traps to Solution Patchwork: Easing Tensions in Designing Digital Health in the Global Context

Two recently published viewpoint articles by JMIR Publications highlighted the 2 faces of medical informatics research. On the one hand, they spotlight the significant advances digital technologies bring to health management and delivery. Over the last decade, technological advances have transformed health care worldwide. Consumers have much broader access to digital health tools, gathering an unprecedented amount of data that can be used to gain personalized insights. Digital technologies support medical professionals in clinical and administrative work like never before. On the other hand, these articles emphasize the persisting divide between the potential of these technologies and their integration into everyday practice. Substantial barriers remain that often hinder the broader adoption of digital health tools. In this viewpoint article, we offer a pragmatic perspective on a problem often overlooked in medical informatics: the incompatibility of coexisting solutions in complex sociotechnical contexts. It problematizes underlying assumptions in medical informatics-oriented and design-oriented research approaches, such as design science research, more precisely by conceptualizing the "solution trap." The solution trap refers to situations in which designers introduce a new solution without recognizing existing ones, creating tensions among coexisting sociotechnical practices. We emphasize the need for a nuanced understanding of context unevenness and propose solution patchwork as a coordination approach to evade the solution trap. Solution patchwork describes an approach in which designers integrate new artifacts into established practices and institutional logics to ensure compatibility across the broader sociotechnical system. The solution patchwork sensitizes medical informatics researchers and designers to navigate the problem and solution spaces in health systems globally.