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Extant literature has increased our understanding of the multifaceted nature of the digital divide, showing that it entails more than access to information and communication resources. Research indicates that digital inequality mirrors to a significant extent offline inequality related to socioeconomic resources. Bridging digital divides is critical for sustainable digitalized societies. Ιn this paper, we present a literature review of Information Systems research on the digital divide within settings with advanced technological infrastructures and economies over the last decade (2010–2020). The review results are organized in a concept matrix mapping contributing factors and measures for crossing the divides. Building on the results, we elaborate a research agenda that proposes [1] extending established models of digital inequalities with new variables and use of theory, [2] critically examining the effects of digital divide interventions, and [3] better linking digital divide research with research on sustainability. [ABSTRACT FROM AUTHOR]

Advancements in human/AI interactions led to smartification of public services via the use of chatbots. Here, we present findings from a clinical inquiry research project in a key public service organisation in Norway. In this project, researchers and practitioners worked together to generate insights on the action possibilities offered to human service agents by chatbots and the potential for creating hybrid human/AI service teams. The project sensitised service agents to discover affordances based on their actual practices, rather than on the predefined use of chatbots. The different affordances identified can be useful for practitioners who design and deploy chatbot-based services. The action possibilities afforded by chatbots provide new ways for service agents and chatbots to work as a team addressing citizens' needs. Drawing from the whole research process, we offer three lessons learned from the Norwegian Government on human/AI partnerships, theory-based interventions, and institutionalised collaborative research that can be useful for researchers that want to engage with practice and organisations that want to evolve their technology use, stimulate innovation, and engage with research. [ABSTRACT FROM AUTHOR]

Being responsible for Artificial Intelligence (AI) harnessing its power while minimising risks for individuals and society is one of the greatest challenges of our time. A vibrant discourse on Responsible AI is developing across academia, policy making and corporate communications. In this editorial, we demonstrate how the different literature strands intertwine but also diverge and propose a comprehensive definition of Responsible AI as the practice of developing, using and governing AI in a human-centred way to ensure that AI is worthy of being trusted and adheres to fundamental human values. This definition clarifies that Responsible AI is not a specific category of AI artifacts that have special properties or can undertake responsibilities, humans are ultimately responsible for AI, for its consequences and for controlling AI development and use. We explain how the four papers included in this special issue manifest different Responsible AI practices and synthesise their findings into an integrative framework that includes business models, services/products, design processes and data. We suggest that IS Research can contribute socially relevant knowledge about Responsible AI providing insights on how to balance instrumental and humanistic AI outcomes and propose themes for future IS research on Responsible AI. [ABSTRACT FROM AUTHOR]

Enterprise architecture (EA) is a systematic way of designing, planning, and implementing process and technology changes to address the complexity of information system (IS) landscapes. EA is operationalized when architecture visions move towards realization through concrete projects. We report a case study on the dynamics of operationalizing EA in the Norwegian hospital sector by exploring different EA project trajectories. Our empirical context is an institutionally pluralistic setting where multiple logics coexist. We show that the distinct logic of EA is added to the institutional context and we find that tensions among existing medical, technical, and managerial logics and EA principles and assumptions emerge. We contribute to the under‐researched topic of EA operationalization by suggesting a model that demonstrates how the meeting of multiple institutional logics can lead to varying degrees of differentiation or even disassociation from EA visions during decision‐taking in projects. Furthermore, we advance extant research on IS projects' implementation in institutionally pluralistic settings by providing an empirical account of actors' interactions and project leadership arrangements that contribute to the persistence of coexisting logics in a dynamic equilibrium. [ABSTRACT FROM AUTHOR]

Cloud enterprise resource planning (ERP) solutions allow organizations to support and coordinate key business processes by leveraging virtualization. Nevertheless, moving ERPs to the cloud is not straightforward, and organizational cloud ERP initiatives raise multiple concerns. We conducted an in-depth systematic review of relevant research literature and identified six key concerns related to cloud ERP implementation: a) the introduction of new ERP work arrangements, launch b) the migration of legacy data, c) the assurance of compliance with extant rules and regulations for security, d) the continuous alignment between ERP functionality and business processes, e) the ongoing integration between ERPs and the rest of the organization's application portfolio, and f) the establishment of adequate reliability levels. The identified concerns are associated with both transition management and operations supported by cloud ERPs. All the identified concerns are also related to the need to achieve infrastructural embeddedness. This need sets ERPs apart from other types of cloud-based applications, such as office automation solutions that do not have as many dependencies and exchanges with other systems and repositories within an organization's information infrastructure. We argue that the challenge of embeddedness has different implications for organizations of different sizes, and we call for further empirical research. [ABSTRACT FROM AUTHOR]

In this article, we examine work with communal data in the context of clinical genetic testing. Drawing from prior research on digital research infrastructures and from the analysis of our empirical data on genetic testing, we describe how data generated in laboratories distributed all over the world are shared and re-used. Our research findings point to six different human-driven activities related to expanding, disambiguating, sanitizing and assessing the relevance, validity and combinability of data. We contribute to research within Health Informatics with a framework that foregrounds human-driven activities for data interoperability. [ABSTRACT FROM AUTHOR]

Enterprise Architecture allows addressing technologies and processes in a holistic way and mirrors choices related to process standardization and data integration. It has the potential to address long-standing problems in health information systems related to fragmented IT portfolios, immature IT infrastructures, and silo-structured organizing. Nevertheless, uptake of Enterprise Architecture in hospitals has been slow. To understand the issues related to this slow uptake we have undertaken an interview study with architects and managers. The issues identified reveal a level of incongruence between healthcare as a domain and the practice of EA. Specifically, by analyzing the experiences of architects and managers we identified four different areas of such incongruence that create the need to reconcile a) Bottom-up vs. Top-down Planning b) Clinical vs. SystemsÂ' Knowledge, c) Local vs. Global Arrangements and d) Patient Safety vs. Patient Privacy. Building on prior related research we propose ways for resolving the incongruence issues identified. [ABSTRACT FROM AUTHOR]

In this paper we investigate how data openness can be made possible in communal settings. We adopt a utility perspective that foregrounds the use value of data, conceptualizing them as "goods." On the basis of this conceptualization we explore 2 key goods' attributes: subtractability and exclusion. Our theoretical basis is built upon concepts from the theory of the commons, power theorizing, and notions related to data and information. Empirically, we investigate openness in the genetics domain through a longitudinal study of the evolving communal infrastructure for data related to 2 genes influencing women's susceptibility to breast and ovarian cancer (BRCA1 and BRCA2). We follow the continuously shifting "topology" of the BRCA information infrastructure and trace the multiple repositories that are put in place and the different arrangements for data collection, curation/quality assurance, access, and control that are tried out. In our analysis, we illustrate the actors' strategies for curbing the subtractability and exclusion attributes of data. We then propose a theoretically informed and empirically grounded framework that can guide understanding and action taking to enable data openness. [ABSTRACT FROM AUTHOR]

In this article, we examine three cases of e-health solutions for patients in Norway. For the analysis of the three cases, we focused on friction forces that come into play when different established arrangements need to change to accommodate novelty. We argue that the design of new technologies was shaped by friction related to institutionalised practices, regulatory regimes and entrenched patient roles. These friction forces connect the past with the present, come into action when aiming for novelty and result to the perpetuation of constituents of the past during change processes. Specifically, the e-health solutions under study were strongly influenced by established healthcare provision logics. All three initiatives expanded the healthcare information infrastructure towards the patients with as little disruption to established arrangements as possible. [ABSTRACT FROM AUTHOR]

This paper addresses the design of hybrid information spaces supporting patients and healthcare providers to have information in common and also, patients to manage privately personal health information. We studied efforts to develop such information spaces by following the design of two Personal Health Record applications and focusing particularly on design tensions that relate to their hybrid role. We identified and grouped tensions along three key themes: control allocation, content origination and user environment localization. For the resolution of tensions, functionality-related decisions were taken by professional design teams during the early design phases. These included the introduction of functionality that enables end-users to create regions with custom characteristics and dynamically adjust the regional boundaries. Delegating to end-users some of the regionalization work entailed in the design of such hybrid spaces points to a design strategy of providing generic enabling environments instead of configuring solutions “a priori” by designers that are external to use settings. Prior research on Personal Health Records mostly emphasizes the challenges of bridging patient and provider perspectives, in our research we shift attention to enabling hybridity and to the roles of designers and end-users for regionalization. [ABSTRACT FROM AUTHOR]

This paper draws from the literature on collective action and the governance of the commons to address the governance of genetic data on variants of specific genes. Specifically, the data arrangements under study relate to the BRCA genes (BRCA1 and BRCA2) which are linked to breast and ovarian cancer. These data are stored in global genetic data repositories and accessed by researchers and clinicians, from both public and private institutions. The current BRCA data arrangements are fragmented and politicized as there are multiple tensions around data ownership and sharing. Three key principles are proposed for forming and evaluating data governance arrangements in the field. These principles are: equity, efficiency and sustainability. [ABSTRACT FROM AUTHOR]

In this paper, we examine infrastructuring in the context of developing national, public eHealth services in Norway. Specifically, we analyze the work of a project team engaged in the design and development of new web-based capabilities for communication between citizens and primary healthcare practitioners. We frame the case as a study of re-infrastructuring to signify a particular occasion of infrastructuring that entails facilitating a new logic within established social and technological networks. To make sense of the particularities of re-infrastructuring, we draw from research in infrastructure studies which considers embeddedness as a resource in infrastructure evolution. We analyze how actors worked to re-infrastructure through adapting primary care information systems, information flows and representations of patient data. Our findings show how the work of re-infrastructuring revolves around addressing two key design concerns: a) bringing novelty without being trapped in the existing arrangements or harming what is in place, b) bringing changes that are within a specific direction although they happen through distributed decision taking. [ABSTRACT FROM AUTHOR]

This paper investigates the design of electronic services for patient-healthcare provider interactions. Empirically, the paper draws from two cases on electronic health appointment management within the Norwegian healthcare system. We investigated the realisation of these new electronic services through the lens of service design adopting a process approach and following their evolution over time. Our findings suggest that the design of services for patient-provider interactions requires a) reconsideration of the whole relationships going beyond the digital solution part, b) flexibility that allows user-defined tailoring of digital solutions after being introduced to use, c) support of continuity in user involvement, d) creative exploitation of the regulatory constraints. [ABSTRACT FROM AUTHOR]

Objectives To demonstrate the usefulness of combining the “multi-level perspective” with the concept of “institutional work” for studying the relations between new technology introduction, socioeconomic pressures, policy and work practices. To this purpose, we examine the introduction of e-prescription and e-reimbursement in Greece by applying a combination of the two theoretical constructs. Methods Theoretically informed interpretive study. Data have been collected using qualitative data collection techniques including documents’ review, observations, and interviews. Results We illustrate how changes at the macro level (a public debt crisis which resulted in commitments to external funding bodies) created pressure on the established regime of weak governance within Greek healthcare. This pressure facilitated the introduction of new information systems that support coordination and governance. The new systems aim to change the pre-existing institutional relations and to orient practitioners towards new modes of acting. Practitioners adjust their work practices by trying to accommodate the two newly introduced systems. In doing so, they manage the boundaries between ways of acting that they deem as amenable to alterations and norms that they think that have to be preserved. Conclusion Combining a focus to the micro level of work practices with a global framework that maps transition processes can produce valuable insights. Positioning e-prescription and e-reimbursement within the “bigger picture” helps us to appreciate the conditions that facilitated their fast-paced implementation. [ABSTRACT FROM AUTHOR]

This paper aims to contribute to the on-going discourse on how to design and introduce governance technology for highly reliable professional work within healthcare. With this aim, we study the Greek ePrescription initiative. The empirical data used in this paper were collected over a nine month period from three different pharmacies implementing the new ePrescription platform. The analysis of data led to the identification of tensions between the established way of performing work (which was based on professionalism and discretion) and the new way imposed by ePrescribing (which is based on activity control and monitoring). Pharmacists traditionally interpreted rules in the light of knowledge, practice/habitude and contextual specificities but with ePrescribing the rules are solidified. From "rules to interpret" they turned to "rules to follow". The tensions are currently resolved by pharmacists with the employment of workarounds. We view workarounds as indications of incongruence between technology and task that can be productively used for design improvement. Furthermore, we attempt to generalise the case-specific insights by linking redesign recommendations to the concepts of usability, tailorability, and generativity of information systems. [ABSTRACT FROM AUTHOR]

This paper investigates workarounds occurring while pharmacists use an electronic prescription (ePrescription) application. ePrescription enables physicians to send prescriptions electronically to pharmacies and was recently introduced in Greece as a solution for controlling the ever-increasing medication costs and improving patient safety. The research was carried out in two phases: (i) review of the relevant documentation, (ii) fieldwork (field observations and semi-structured interviews with the pharmacists) in three pharmacies. The workarounds identified fall into five categories and namely: (a) bypass of ePrescription application (i.e. ePrescription application is not used at all), (b) temporal nonconformity in the use of ePrescription application (i.e. usage of the application, but not at the formally specified time), (c) catachresis of ePrescription application (i.e. usage of the application, but not according to the intended way), (d) ePrescription application substitution by another electronic application, and (e) delegation of ePrescription application usage to non-authorized users. The outcome of the research can be used for the improvement of multiple work system elements such as the tools, the procedures, the organisational arrangements and the policies. [ABSTRACT FROM AUTHOR]

This paper investigates workarounds occurring while pharmacists use an electronic prescription (ePrescription) application. ePrescription enables physicians to send prescriptions electronically to pharmacies and was recently introduced in Greece as a solution for controlling the ever-increasing medication costs and improving patient safety. The research was carried out in two phases: (i) review of the relevant documentation, (ii) fieldwork (field observations and semi-structured interviews with the pharmacists) in three pharmacies. The workarounds identified fall into five categories and namely: (a) bypass of ePrescription application (i.e. ePrescription application is not used at all), (b) temporal nonconformity in the use of ePrescription application (i.e. usage of the application, but not at the formally specified time), (c) catachresis of ePrescription application (i.e. usage of the application, but not according to the intended way), (d) ePrescription application substitution by another electronic application, and (e) delegation of ePrescription application usage to non-authorized users. The outcome of the research can be used for the improvement of multiple work system elements such as the tools, the procedures, the organisational arrangements and the policies. [ABSTRACT FROM AUTHOR]

This paper takes a socio-technical perspective to analyze the ongoing practices of making an eHealth infrastructure, namely a web-based communication platform, which aims to improve healthcare delivery in Norway. The platform is planned to support interaction between patients and healthcare providers, patient access to personal health information, and dissemination of health knowledge to the public. The analysis is based on the 'scales of infrastructure' concept found in Information Systems research, which shows the complexity of the design, development and implementation process across three scales of activities for achieving durability: institutionalization, organizing work, and technology enactment. The case analysis brings the non-linearity of the ongoing practices to the foreground, enabling a more in-depth understanding of the relationship between technology design and infrastructural work. [ABSTRACT FROM AUTHOR]

This paper explores the normative and intentional issues of ensuring quality-in-use of large-scale information systems (IS) in the services sector. A descriptive model for observing the dynamics between key actors during system acquisition is proposed. The model supports the conceptualization of project dynamics in terms of different actors’ capability (power, capacity and knowledge) and perspectives (business, technical and human activity). A retrospective analysis of two case studies is performed using this model: different actors involved are identified and the interplay between them is analysed. Interpreting from the case studies, it is argued that ensuring a balance among perspectives is instrumental in arriving at usable systems. This paper contends that ensuring quality-in-use entails a normative part, which can be dealt with by methods and tools and an intentional part which cannot be prescribed, but can be influenced by facilitating the discourse between perspectives from the procurement stage and as the project unfolds. [ABSTRACT FROM AUTHOR]