The policy-practice divide: How assumptions undermine authentic participation in digital public healthcare

IF 7.8 1区管理学 Q1 INFORMATION SCIENCE & LIBRARY SCIENCE

Government Information Quarterly Pub Date : 2025-04-03 DOI:10.1016/j.giq.2025.102027

Mäjt Wik, Daniel Curto-Millet, Tomas Lindroth

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引用次数: 0

Abstract

Assumptions influence decision-making and guide behavior within organizations, and unexamined or unaligned assumptions can lead to flawed strategies. This is especially true in complex and rapidly changing environments, such as those encountered in digital transformation initiatives. Despite this, assumptions are not a common object of empirical study. In this article, we explore the role of assumptions in reshaping organizational practices regarding participation in a public digital transformation initiative in Swedish healthcare. We find a critical disconnect between assumptions in policy and practice, showing how prevailing assumptions uphold legacy approaches to participation and, consequently, impede the potential to utilize digital technology for new, more innovative ways to personalize care. We contribute a framework that illustrates the consequences of assumptions on participation. Drawing on Aronstein's ladder of citizen participation and the Scandinavian tradition of participatory design, we advocate for authentic participation that takes into account the contextual nature of patients' lives and work practices leveraging digital technology.

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政策与实践的鸿沟：假设如何破坏对数字化公共医疗的真正参与

假设影响组织内的决策和指导行为，未经检验或不一致的假设可能导致有缺陷的战略。在复杂和快速变化的环境中尤其如此，例如在数字转换计划中遇到的环境。尽管如此，假设并不是实证研究的常见对象。在本文中，我们探讨了假设在重塑瑞典医疗保健中参与公共数字化转型倡议的组织实践中的作用。我们发现政策和实践中的假设之间存在严重脱节，表明主流假设如何支持传统的参与方式，从而阻碍了利用数字技术实现新的、更具创新性的个性化护理方式的潜力。我们提供了一个框架，说明假设参与的后果。借鉴Aronstein的公民参与阶梯和斯堪的纳维亚传统的参与式设计，我们提倡真正的参与，考虑到患者生活和工作实践的背景性质，利用数字技术。

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来源期刊

Government Information Quarterly INFORMATION SCIENCE & LIBRARY SCIENCE-

CiteScore

15.70

自引率

16.70%

发文量

106

期刊介绍： Government Information Quarterly (GIQ) delves into the convergence of policy, information technology, government, and the public. It explores the impact of policies on government information flows, the role of technology in innovative government services, and the dynamic between citizens and governing bodies in the digital age. GIQ serves as a premier journal, disseminating high-quality research and insights that bridge the realms of policy, information technology, government, and public engagement.