Possibilities and Challenges of Transition to Ambulant Health Service Delivery with ICT Support in Psychiatry

Transformations of established institutional orders are to be expected alongside the appearance of novel ICT-enabled models of service delivery. Such transformations are neither simple nor short-term, but involve complex and fundamental changes in normative, regulative, and technical aspects. In this paper we describe the initial stages of a project redesigning psychiatric services for children and adolescents. New collaboration models, supported by new ICT applications, were introduced into the ordinary structures of health care services in Finnmark, the northernmost county of Norway. Our aim is to contribute to the understanding of how the preexisting technical and organizational systems and models, the installed base, impact radical change. We address the potential for user-driven innovations, and focus our analysis on the quality of generativity in the existing information infrastructure. The salient challenges in our case were related to the existing technical information infrastructure in the health sector. The new solution was pushed outside the established information infrastructure. While this may be only a temporary situation, we argue that, as a result of this process, the new solution emerged with a greater potential for future generativity than it would have had it been more linked to the existing information infrastructure.