Making Sense of Discursive Formations and Program Shifts in Large-Scale Digital Infrastructures

The current literature on discourse theory in IS offers powerful lenses for describing and explaining how organizations manage their encounters with new digital technologies. These contributions have mostly conveyed an actor-centric view of discourse as dominated by communication. Less attention has been paid to the systemic role of discourse, the understanding of program shifts, and the emergence of new programs in large-scale digital infrastructures. To investigate this issue, we ask: How does discourse influence the emergence of new programs in large-scale digital infrastructures? And how can policymakers and managers make sense of the public and professional discourse around large e-health infrastructures? Our in-depth case study investigated 18 years of the development of a regional e-health infrastructure in Norway. Drawing on Foucault (2002), we identified three important program shifts, each reflecting the interaction between digitalization trends promoted through macrodiscourses, and infrastructure conditions through microdiscourses. We found that program shifts happen when macro- and microdiscourses converge, leading to the emergence of discursive formations. We identified three processes through which this happens: connection, matching, and merging. In describing our second contribution, we discuss how policymakers and managers can use this framework to make sensible decisions.