Paper short abstract:

I borrow the concept of 'plug-ins' from my empirical observations in the development of a regional health portal to propose an alternative mode of theorizing integration processes in e-Health that combines a sociotechnical approach with insights from the figurational sociology of Norbert Elias.

Paper long abstract:

Between 2009 and 2012 I studied and actively contributed to the development of Zorgportaal Rijnmond (ZPR), a health portal for the Rotterdam Rijnmond Region in the Netherlands. My aim was to understand the human work required to 'integrate' infrastructures, standards, and users in a health portal in the making. I used 'infrastructural inversion' to make visible some of the hidden practices in integration processes in e-Health; while this yielded useful insights for developers, project leaders, and managers involved in ZPR, the interactionist character of my approach prevented me from grasping the complex interdependencies surrounding the project. Inspired by Bruno Latour (Reassembling the Social, 2005) I borrow the concept of 'plug-ins' from my empirical observations and 'spell out' its metaphorical meaning to propose an alternative mode of theorizing 'integration' in e-Health. In my paper I describe how infrastructural work in the ZPR project entailed ongoing network extensions (i.e., 'plug-ins') in continuously expanding networks of interdependency. In doing so, I combine my sociotechnical approach to e-Health with insights from the figurational sociology of Norbert Elias, who emphasized the importance of studying dynamic relations of human interdependency. I argue that the latter approach can be complementary to "the interdependence of technical networks and standards […] and the real work of politics and knowledge production" described by Geoff Bowker and Susan Leigh Star (Sorting Things Out, 1999), and reflect on the implications of this theoretical conflation for the study of digital information infrastructures in use.