title: Infrastructures in healthcare: the interplay between generativity and standardization.
abstract: OBJECTIVE
  To investigate how the design, development and implementation process of a new patient-centered portal unfolds by focusing on its evolutionary infrastructural development.
  
  
  METHODS
  We conducted a case study on a patient-centred portal in Norway. We used qualitative data collection techniques including observations, interviews and attendance of design workshops with users. We performed an interpretive analysis of the data through the lens of technology enactment.
  
  
  RESULTS
  The case analysis reveals that the patient-centred portal has a strong generative character. However, for the enactment of the technology continuous sociotechnical negotiations take place. Grounded in the empirical data and their analysis we complement and expand the existing understanding of generativity.
  
  
  CONCLUSIONS
  We characterize generativity as sociotechnical and resulting from negotiations for technology enactment. We discuss in detail such negotiations and show how they shape the evolution of infrastructures that are generative while standardized.
authors.affiliation: University of Oslo, Department of Informatics, Postbox 1080, Blindern, 0316 Oslo, Norway. miriag@ifi.uio.no
authors.forename: Miria
authors.initials: M
authors.lastname: Grisot
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Vassilakopoulou
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D016901:Intergenerational Relations; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards*; D012933:Social Identification