Facing the Lernaean Hydra: The Nature of Large-Scale Integration Projects in Healthcare

Larsen, Eli; Ellingsen, Gunnar

doi:10.1007/978-3-642-14874-3_7

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Massive amounts of pre-allocated resources [38] are wasted while the systems are either inoperable or end up being discarded [30,36,39,40,41]. Thus, when countries have been developing CGISs, the room for errors has been exceeded.…”

Section: Healthcare Information Systems As a Critical Servicementioning

confidence: 99%

Problem in Patient Information System Acquirement in Finland: Translation and Terminology

Rantanen

Heimo

2014

IFIP Advances in Information and Communication Technology

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Part 4: Health, Care, Well-Being and ICTInternational audienceHealthcare information systems and their development has risen to be an issue discussed widely amongst Finnish media and public. The discussion varies from the many faults in design, functionality, usability and the enormous costs these systems produce to the citizens as well as how to best fix these problems. Yet it seems that common terminology with eHealth systems in the discussion is lacking rendering the quality of the discussion far from where it could be. Hence this paper will focus on the issue of terminology-based problems in Finnish public eHealth development discussion

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Section: Healthcare Information Systems As a Critical Servicementioning

confidence: 99%

Problem in Patient Information System Acquirement in Finland: Translation and Terminology

Rantanen

Heimo

2014

IFIP Advances in Information and Communication Technology

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“…The challenge for those designing healthcare IS is to balance the restriction and promotion of generativity (Grimmelman and Ohm, 2010). In a public healthcare setting, healthcare authorities play a large role in the purchase and design of systems and do not always facilitate an evolutionary design processes or include users (Larsen and Ellingsen, 2010). This limits the close cooperation between users and designers.…”

Section: Implications and Limitationsmentioning

confidence: 99%

Users as Designers of Information Infrastructures and the Role of Generativity

Johannessen¹,

Gammon²,

Ellingsen³

2012

THCI

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The user role in the design of information systems is increasingly portrayed as active and complex, and the relationships between users and developers are portrayed as blurry. Information systems have become ubiquitous in most work processes, and users typically rely on several large scale information systems tightly integrated into other information systems, machines and work practices. In this paper we propose the notion of generativity as a framework to assess generative socio-technical characteristics of such systems, conceptualized as information infrastructures. Further, the paper will discuss the role these characteristics play in users' involvement by exploring the ways in which users can contribute as designers and thereby expand on the conceptual views of users and design processes of generative information infrastructures.Empirically, this paper presents the evolution of an information system for cooperation between general practice and hospital laboratories, where users in both settings participated in the design process. The system was designed using agile methods, and design and implementation were continuous and iterative co-existing processes. The case showed that a high degree of generativity in the system itself is a necessary condition for users to make changes. However, in an integrated and complex setting the flexibility of the existing and integrated systems will heavily influence the possibility to make changes. The paper also provides an in-depth illustration of how user and designer roles evolve together with circumstances and relationships. However, we argue that this type of evolvement requires dedicating a considerable amount of time and effort to achieve a climate in which such evolvement can take place. Finally, design is more than just the development of technology. It is also the development of work practices in which users' contributions are decisive. Designing work practices alongside the design of the technology has given rise to insights that feed directly into the design process. Acknowledging users' substantial contributions in design processes can aid in refining conceptualizations of users and developers along with bolstering efforts to facilitate appropriate user involvement.

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“…Thus, some of the same problems visible in eHealth and other critical eGovernment systems can be found in the biometric passport control system as well. In this case the common problems were detection of problems after adoption and the poor implementation of security (Mercuri, 2001;Fleischman, 2010;Heimo et al, 2010;Larsen and Elligsen, 2010). Other problems were the possibility for biometric data to be stolen, unequal treatment of EU -and local citizens and the erosion of privacy.…”

Section: Jices 102mentioning

confidence: 99%

How to abuse biometric passport systems

Heimo

Hakkala

Kimppa

2012

Journal of Information, Communication and Ethics in Society

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Purpose -The purpose of this paper is to show that most, if not all RFID/biometric passports have clear technical and social problems in their intended use and that there are clear problems with the databases into which biometric data are being collected, due to use of this data for other (publicly), non-intended uses. Design/methodology/approach -The approach of this paper is both a meta-study of the flaws in the technological specifications as well as the social implementation of RFID/biometric passports. Finland is used as a case, but the results extend beyond Finland in most, if not all the topics presented -not necessarily all results to all implementations, but all to some others. Findings -The current implementations of RFID/biometric passports are lacking in both technical and social implementations and pose clear risks to their use, both due to lax implementation of the technology itself but specifically due to the social changes brought about. These problems cause both erosion of privacy and trust. Research limitations/implications -Further research into other potential social implications on a national level is required. The authors fear that the cases presented do not necessarily reflect all the potential problems, but just the most evident ones. Practical implications -The problems with the technological implications can be averted by using the best technological solutions, and thus the best technological solutions should be used instead of the ones proven to be lacking. Social implications -The social implications should at least be brought forth for public discourse and acknowledged, which currently does not seem to happen. Originality/value -The paper contributes to the understanding of problems with current RFID/biometric passport implementations as well as inherent social problems that are hard, if not impossible to avoid. The problems belong under the category of critical eGovernment applications, and similar issues are visible in other eGovernment applications.

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Facing the Lernaean Hydra: The Nature of Large-Scale Integration Projects in Healthcare

Cited by 6 publications

References 8 publications

Problem in Patient Information System Acquirement in Finland: Translation and Terminology

Problem in Patient Information System Acquirement in Finland: Translation and Terminology

Users as Designers of Information Infrastructures and the Role of Generativity

How to abuse biometric passport systems

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