Medical Information Systems often need to be custom designed to
fit the organization where they will be implemented. Participatory
Design (PD) is a well known method for eliciting the user input
that is necessary during this process. Recently it has been
suggested that PD as it is often practiced falls short of providing
the necessary level of user input that is needed to meet the
evolving needs of users over time. It is suggested that we refocus
and look at design itself as a socio-technical process within
healthcare organizations. By building “socio-technical systems
that design themselves” we will better meet these evolving needs.
In this paper we present a case study of design as it is practiced at
a gastro-surgical department at a University hospital in Sweden.
The experiences of the department are used as a framework for
discussing this issue and its implications for the CSCW/HCI
community.