Users as Heterogeneous Engineers - The Challenge of Designing Sustainable Information Systems in Health Care

The Invisible Work of Maintenance in Community Health

“…Previous research in healthcare has used the notion of "heterogeneous engineer" [103], a type of system builders [68], to call for attention to the active role of users negotiating multiple perspectives while designing sustainable information systems in healthcare [103]. Conceptualizing frontline health workers as system builders can help provide a "new image" [38], establish legitimacy [56] and raise their profile recognizing their maintenance practices and caring efforts bringing these nuances to the front stage of design rather than being in the background.…”

“…Conceptualizing frontline health workers as system builders can help provide a "new image" [38], establish legitimacy [56] and raise their profile recognizing their maintenance practices and caring efforts bringing these nuances to the front stage of design rather than being in the background. As such, the role of frontline health workers should be seen as performative [103] and acted out and highly influenced by the sociocultural context and the network of infrastructural arrangements, rather than being considered only as infomediaries and intermediaries of health services [54]. Designing interventions in community health should recognize and value the crucial role of frontline health workers as system builders to promote their active participation throughout the design process [51].…”