Design for social media engagement: Insights from elderly care assistance
Introduction
Nearly forty years ago Richard Boland published a paper entitled “The Process and Product of System Design” in Management Science (Boland, 1978). This ground-breaking study reported the findings of an experiment conducted in the surgical division of a large teaching hospital. A number of teams, each comprising one nurse and one designer, were asked to engage in the design of health-care practices for personalized assistance while following two different interaction protocols. The first protocol was based on the traditional view of design, in which the designer acts as the problem solver who is engaged in interviewing nurses, analyzing data and collecting feedback and suggestions. The second protocol, labelled “alternative rationality”, consists of a discovery process in which the designer and the client engage in information sharing, mutual suggestions, and critiques. According to the traditional view, design is performed through an iterative learning process aimed at gaining consensus on data collected to find an appropriate solution for a given problem. In the alternative design, the designer acts as facilitator of a human-centred process; this alternative is characterized by shared leadership and aimed at building mutual consensus on the problem resolution. Drawing on the dichotomy between such different approaches to design, Boland presents a contingency theory of organization design by emphasizing the necessity to select an appropriate interaction protocol for a given design situation.
More recently, different communities of scholars and designers have advanced the two traditions of design with areas of overlap. For instance, to underline the mix of deliberate effects of design with emergent, unexpected or unintended ones, information systems (IS) scholars refer to concepts like design as “care” (Ciborra, 1996, Lanzara, 2009) and “cultivation” (Aanestad et al., 2012, Dahlbom and Mathiassen, 1993). By contrast, the traditional problem-solving view of design has gained momentum in the last decade in the mainstreams of both information system (IS) research and practice. The vast majority of approaches to design science research (DSR) views design as a problem-solving process aimed at achieving the internal consistency and coherence of the proposed solution (Hevner et al., 2004).
Although some efforts have been made developing methods addressing the emerging nature of the design artefact (Pries-Heje and Baskerville, 2008, Sein et al., 2011), recent changes in the contextual conditions of workers and institutions draw further attention to the alternative logic of design. The traditional view of design as a problem-solving activity performed in the controlled space of a workplace is challenged by today’s digital technologies, increasingly being present in all spheres of users’ personal and professional lives (Winter et al., 2014). Multimedia content, mobile connectivity, social networking and other emerging digital capabilities make it difficult to isolate a specific role played by an individual as user.
Focusing on a design problem related to the provision of personalized care to patients of a health-care institution, we recall Boland’s background. In our case, the design unfolds in a context in which elderly care assistance is mediated by digital tools, such as social-media technologies used within institutions, professions, and user communities. Considering digital tools apt instruments for personalized assistance when activated and monitored by healthcare organizations, social media is here defined as the emerging outcome of a set of interventions made on a digitally enabled patient-support network.
Digitally enabled patient-support networks provide an ideal setting for exploring the applicability of alternative views of IS design. Since in these settings the design is not straightforward, we focus on such an ill-defined problem to conduct our investigation on personalized assistance through social-media engagement. An inquiry on the design of personalized elderly assistance in the geriatric unit of an Italian hospital provides the basis for a better understanding of design as a socio-technical construction of digitally enabled elderly support networks. The proposed approach originates from the “Help and social interaction for elderly On a multimedia Platform with E-Social best practice” (HOPES1) project, which is aimed at providing social e-services to elderly Europeans and their social circles in an attempt to improve the quality of social relations between the elderly and their social environments. An ADR project (Sein et al., 2011) has been undertaken in the final part of the HOPES project with the objective of building and validating a model for personalized elderly care assistance through social media. Our findings demonstrate how this model provides an alternative approach to design personalized assistance. Involving elderly support networks through social media engagement helped to overcome recipients’ IT-illiteracy. Our study contributes to build prospective and normative knowledge, as defined by pragmatism, in addition to prescriptive and descriptive knowledge (Gregor and Hevner, 2013). Finally, while addressing the main challenges related to the provision of elderly care services, practical implications for a wider area of interests are discussed, envisaging settings in which lessons learned about elderly care assistance through social media engagement can be applied.
The paper is structured as follows: First, works related to design views in IS research and to the role of social media as an ensemble artefact are discussed to clarify current research knowledge; next, the research approach is introduced, followed by the empirical findings from the ADR project at the Geriatric Campus; then, theoretical contributions and lessons learned are covered; finally, implications for research and practice are explored.
Section snippets
Design views in IS research
In recent years, design science has attracted much attention as an engaged form of research in IS, organization and management studies (Gregor and Jones, 2007, Hevner et al., 2004, Romme, 2003, Van Aken, 2004). Such studies are characterized by a problem-solving orientation and a prescriptive form of inquiry. In the IS field, design science research (DSR) has been recognized as an important stream of research that is aimed at generating knowledge through the development of socio-technical
Research approach
The aim of this paper is to emphasize the view of IS design as a socio-technical construction. By applying the above-mentioned conceptions of design as “care” and of social media as an ensemble artefact to the domain of elderly care assistance, we show how IS design can shape digitally enabled elderly support networks by engaging people and institutions in the provision of personalized assistance. The interconnection of the technology artefact, the information artefact and the social artefact
ADR at Geriatric Campus
During a project meeting in July 2012, the HOPES partners agreed to execute an ADR project in Rome during the final part of the project, aiming to develop and test a model for the provision of personalized care assistance for the elderly through social media. According to the ADR methodology, the model was expected to emerge from mutual interactions among the sociotechnical components of the geriatric unit and its interaction context. That is, in addition to the elderly and their family
Discussion
Our inquiry on the design of personalized elderly assistance yields insights on the role of social-media technologies in healthcare. Social-media engagement, intended as the mutual shaping of technologies, information and social interactions, can transform the ways in which healthcare organizations operate. Social-media tools are enacted in different ways within elderly support networks. Information, in the form of digital content, is produced, retrieved and channelled across elderly support
Conclusion
This study emphasizes an alternative view of design as an emergent process of engagement and learning. By conducting an ADR project at Geriatric Campus, our work has contributed to social media practices through the development of user utility and a model for elderly assistance, as well as through the formulation and refinement of four design principles. Elderly people may benefit more than most other groups from the emergence of social media artefacts. A crucial part of the HOPES project is
Acknowledgments
We thank Richard Baskerville, Ole Hanseth, Ola Henfridsson, Matti Rossi, Maung K. Sein, the anonymous reviewers, and the editors for constructive and insightful comments on earlier versions of this manuscript. Further, special thanks go to the personnel at the Geriatric Unit of the “Geriatric Campus”, the “evangelists” who have implemented social media in the elderly support networks, and the nine seniors who willingly decided to be involved in this research activity. Without their
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