We present effects-driven IT development as an instrument for pursuing and reinforcing Participatory Design (PD) when it is applied in commercial information technology (IT) projects. Effects-driven IT development supports the management of a sustained PD process throughout design and organizational implementation. The focus is on the effects to be achieved by users through their adoption and use of a system. The overall idea is to (a) specify the purpose of a system as effects that are both measurable and meaningful to the users, and (b) evaluate the absence or presence of these effects during real use of the system. Effects are formulated in a user-oriented terminology, and they can be evaluated and revised with users in an iterative and incremental systems-development process that involves pilot implementations. In this paper we investigate the design, pilot implementation, and effects assessment of an electronic patient record. Effects concerning, among other things, clinicians’ mental workload were specified and measured, but apart from the planned changes associated with these effects the pilot implementation also gave rise to emergent, opportunity-based, and curtailed changes. We discuss our experiences regarding conditions for making the specification of effects and their real-use evaluation central activities in IT projects.
Keywords: Effects-driven IT development, sustained participatory design, organizational implementation, effects specification, prototyping, pilot implementation, formative evaluation.