Doing infrastructural work: The role of boundary objects in health information infrastructure projects

By their nature information infrastructures require the co-operation of a broad range of diverse stakeholders and interests in order emerge and evolve over-time. Boundary objects provide a means through which those from different social worlds can collaborate without having to reach a consensus in order to do so. In this article we explore the role of such objects, whose infrastructural properties have often been overlooked. We respond to calls to examine the different types of objects used to elicit feedback from potential users and other stakeholders in complex information system projects. Our focus is specifically on health information systems and in particular those involving the implementation of electronic record systems at a national or regional scale. Such projects are notoriously complex and are frequently marked by a diversity of intentions and lack of agreement. When attempted at a national scale at least, they typically fail to meet intended objectives and projects are often abandoned altogether. We suggest that understanding how different types of boundary object—repositories or ideal types—inhibit infrastructural development can assist in understanding these difficulties and point to ways of better supporting the generativity required for the infrastructuralisaton of complex information systems.