Challenges to the Development of Information Infrastructures: A Synthesis of the Findings

Challenges to the Development of Information Infrastructures: A Synthesis of the Findings

DOI: 10.4018/978-1-4666-1622-6.ch006


In Chapters 4 and 5, two case studies involving the development of new information infrastructures were described and analyzed using the commons perspective and associated theoretical framework. Although the two case studies exhibited great differences in scope (regional versus national), context (Greek versus English health system), and time frame, each involved a set of contextual characteristics, an action arena, and a set of outcomes. The purpose of this chapter is to synthesize the findings from the analysis of the two case studies, while also drawing links with findings from other settings. This synthesis leads to some theoretical implications while establishing stronger associations between the literature on information infrastructures and traditional commons arrangements.
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The presentation of the two case studies in the order they appear was deliberate in order to illustrate the challenges of developing an information infrastructure from a pilot across a region (Crete case study), to a fully-scaled national information infrastructure (English case study). Both case studies contribute to extant research by demonstrating how a commons perspective can enrich our understanding of negotiations and relevant outcomes in information infrastructure development across different scales.

Extant research has certainly offered useful conceptualizations of information infrastructure development by focusing, on the one hand, on the ways that organizations can achieve strategic business-IT integration (e.g. Weill & Broadbent, 1998; Weill & Ross, 2004), and on the other, the ways by which integration efforts often lead to (un)intended consequences and drift (e.g. Bowker & Star, 1999; Ciborra & associates, 2001; Hanseth et al., 2006; Sahay et al., 2009).

As Sahay et al., (2009) critically note, however, we have little empirical knowledge about why and how negotiations occur in order to better understand these (un)intended consequences. In their own analysis of a health information systems project (HISP) in India, Sahay et al., (2009) propose a focus on different sets of actors (large and powerful vs. small and relatively powerless), the systems these actors seek to introduce within the same context, and the political capacity and credibility each of these actors bring into the negotiations. They present a compelling narrative of how a small actor–a local NGO–struggles against a large powerful actor–state health authorities–to develop a local/regional health information infrastructure, and discuss how consequences unfold.

The commons framework adopted in this book builds upon and extends studies focusing on negotiations that take place between key actors in the development of information infrastructures. In particular, the commons framework offers greater insight into the role of different actors, as well as the power asymmetries between them, by focusing on different actors’ property rights and the consequences those rights generate in the ordering of relationships between key actors, as well as the successful or failed development of information infrastructures.

In the Crete case study, the HEALTHnet pilot was initiated by a small actor, CreteTech, who, by giving hardware and software for free, and engaging a small community of key healthcare professionals in the region of Crete, sought to establish political-technical credibility in the region. Like the early pilots in the HISP project in India (Sahay et al., 2009), and other developing countries (see Braa et al., 2004), the HEALTHnet pilot encountered user resistance partly due to the lack of support from the government agencies, something which brought the legitimacy of the project into question among users.

However, the fiercest form of resistance arose from contestations around the property rights of different communities on the implemented technologies. These varied from an IP rights dispute between CreteTech and a once collaborating general practitioner, to a questioning of the collective choice rights of individual hospitals to remove HEALTHnet applications and manage their own self-funded projects, and a constitutional right dispute between CreteTech and other IT providers in the region with the Regional Health Authorities of Crete over who had control over which technologies implemented in the region. The negotiations between these various actors and the property rights they claimed over the various technologies led to processes of so called “reflexive standardization”–i.e. alternative outcomes than the intended objective of ‘standardized’ or ‘integrated’ systems (Hanseth et al., 2006).

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